Occupational and Physical Therapy Strategies for COVID-Related Guillain-Barré Syndrome: A Case Report (Preprint)

2021 ◽  
Author(s):  
Catherine Connors ◽  
Stephanie McNeill ◽  
Henry Charles Hrdlicka

UNSTRUCTURED Background and Purpose: While several reports have described the diagnosis and treatment of patients with COVID-19 associated Guillian-Barré Syndrome (GBS), there is a paucity of literature describing the occupational and physical therapy strategies used in the long-term acute care hospital (LTACH) setting to rehabilitate these patients. Case Description: A 61 year-old male was admitted to an LTACH for the rehabilitation of GBS following COVID-19 infection and intravenous immunoglobulin treatment. Intervention: Rehabilitation in the LTACH setting uses a variety of skilled treatment interventions to meet patient driven goals and maximize their function to the highest level possible in preparation of their discharge to a subacute or homecare setting. In this case, this was accomplished through individual occupational and physical therapy sessions, occupational and physical therapy co-treatment sessions, and targeted group therapy sessions focused on leg, arm, and fine motor coordination exercises. Outcomes: With the occupational and physical therapy standard of care, the patient’s improvement was demonstrated by several outcome measures including manual muscle testing, range-of-motion, grip-strength, and the Activity Measure for Post-Acute Care. The patient was successfully rehabilitated and returned to the community after presenting with COVID-19 associated GBS. Discussion: This report highlights the complex rehabilitation needs patients require to regain independence after diagnosis of COVID-19 associated GBS.

2020 ◽  
Author(s):  
Sabrina Eggmann ◽  
Angela Kindler ◽  
Andrea Perren ◽  
Natalie Ott ◽  
Frauke Johannes ◽  
...  

Abstract Objective The aim of this case series was to describe the experience of Swiss physical therapists in the treatment of patients with COVID-19 during their acute care hospital stay and to discuss challenges and potential strategies in the clinical management of these patients. Methods We report 11 cases of patients with COVID-19 from five Swiss hospitals that illustrate the various indications for physical therapy, clinical challenges, potential treatment methods and short-term response to treatment. Results Physical therapists actively treated patients with COVID-19 on wards and in the ICU. Interventions ranged from patient education, to prone positioning, to early mobilization and respiratory therapy. Patients were often unstable with quick exacerbation of symptoms and a slow and fluctuant recovery. Additionally, many patients who are critically ill developed severe weakness, post-extubation dysphagia, weaning failure or presented with anxiety or delirium. In this setting, physical therapy was challenging and required specialized and individualized therapeutic strategies. Most patients adopted the proposed treatment strategies and lung function and physical strength improved over time. Conclusion Physical therapists clearly have a role in the COVID-19 pandemic. Based on our experience in Switzerland, we recommend that physical therapists routinely screen and assess patients for respiratory symptoms and exercise tolerance on acute wards. Treatment of patients who are critically ill should start as soon as possible to limit further sequelae. More research is needed for awake prone positioning, early breathing exercises as well as post-COVID rehabilitation. Impact To date there are few data on the physical therapist management of patients with COVID-19. This article is among the first to describe the role of physical therapists in the complex pandemic environment and to describe the potential treatment strategies for countering the various challenges in the treatment of these patients.


2006 ◽  
Vol 58 (3) ◽  
pp. 221-232
Author(s):  
Lisa Taylor ◽  
Kristen Goodman ◽  
Daniela Soares ◽  
Heather Carr ◽  
Gina Peixoto ◽  
...  

2011 ◽  
Vol 91 (10) ◽  
pp. 1490-1502 ◽  
Author(s):  
Susie Thomas ◽  
Shylie Mackintosh ◽  
Julie Halbert

Background Physical therapy has an important role in hip fracture rehabilitation to address issues of mobility and function, yet current best practice guidelines fail to make recommendations for specific physical therapy interventions beyond the first 24 hours postsurgery. Objectives The aims of this study were: (1) to gain an understanding of current physical therapist practice in an Australian acute care setting and (2) to determine what physical therapists consider to be best practice physical therapist management and their rationale for their assessment and treatment techniques. Design and Methods Three focus group interviews were conducted with physical therapists and physical therapist students, as well as a retrospective case note audit of 51 patients who had undergone surgery for hip fracture. Results Beyond early mobilization and a thorough day 1 postoperative assessment, great variability in what was considered to be best practice management was displayed. Senior physical therapists considered previous clinical experience to be more important than available research evidence, and junior physical therapists modeled their behavior on that of senior physical therapists. The amount of therapy provided to patients during their acute inpatient stay varied considerably, and none of the patients audited were seen on every day of their admission. Conclusions Current physical therapist management in the acute setting for patients following hip fracture varies and is driven by system pressures as opposed to evidence-based practice.


2011 ◽  
Vol 2 (3) ◽  
pp. 120
Author(s):  
A. Thrush ◽  
M. Rozek ◽  
J. Dekerlegand ◽  
K. OʼDonnell ◽  
S. Klunk

2019 ◽  
Vol 61 (4) ◽  
pp. 283-288
Author(s):  
Alina Olkhovik ◽  
Oleksandr Yurchenko ◽  
Olha Yezhova ◽  
Vladyslav Smiianov ◽  
Inna Mordvinova ◽  
...  

Introduction: Scleroderma remains one of the most severe rheumatic diseases and is characterized by a progressive course, disability, and a high level of mortality. According to world statistics, the average disease incidence rate ranges from 0.6 to 19 per 1 million, spreading out – from 4 to 242 per 1 million. An early start of physical therapy with the inclusion of new techniques in conjunction with medical treatment remains topical. Aim: To develop and experimentally test the effectiveness of a complex physical therapy program for people with a limited form of scleroderma. Clinical case: The study involved a woman with a limited form of scleroderma. At the beginning and the end of the study, laboratory studies were conducted: the level of hemoglobin, ESR, ionized calcium, Scl-70 (ANA-Screen); clinical signs were investigated: swelling of the hands, Raynaud’s phenomenon, fibrous myopathy, skin tightening assessment (according to G. Rodnan), goniometric studies and manual muscle testing. Physical therapy consisted of: daily kinesiotherapy in the form of active-passive exercises with an emphasis on fine motor skills of fingers and active exercises for the temporomandibular joint, coniferous salt bath for wrists, therapeutic massage and Kinesio taping of wrists. As a result of the study, the mobility of the joints of the upper limbs increased by an average of 5-35 °; the muscle strength increased from 3 to 5 points and the quality of life of the patient improved. Conclusions: Physical therapy made it possible to improve the mobility of the wrist and metacarpophalangeal joints, increase muscle strength, and reduce the main manifestations of the disease. The continuation of physical therapy complex will improve the quality of life of these patients and the further prognosis of treatment.


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