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41 Cards in this Set
- Front
- Back
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what is GB usually known as and why?
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elevator disorder…. Starts at your feet then goes proximal, then when recovery occurs--> it goes from proximal to distal
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what are the causes of GB?
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infection, post sugical, stress, vaccinations
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what is specifically happening in the body?
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immune system attacking the schwann cells
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what is the primary demyelination characterized by?
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decreased conduction velocity
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how is secondary axonal damage characterized?
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wallerian degeneration
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his GBS diagnosed?
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lumbar puncture for CSF test, electropyography
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what is looked for in CSF test?
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increase in protein, can increase by 90% in second week
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Symptoms of GBS?
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rapidly progressive symmetrical weakness in arms and legs, with/w-o sensory distribution, hyporeflexia/areflexia, absecence of CSF cellular reaction
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what are the initial signs of GBS?
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pain, numb toes, rapidly progressive symmetrical weakness in limbs
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how long does the disease progress?
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3-21 days,
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when in maximal weakness?
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4 weeks
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is the recovery phase fast or slow?
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slow
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what is the recovery limited by?
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the time it takes to remylineate
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is there a plateau period in GB?
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yes
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men or women get GB more?
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men get it 1.5 times more
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is age a factor of GB?
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yes, increases linearly with age
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what is a factor of mortality with GB?
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whther or not the pt needed a mechanical vent
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LOOK AT DIFF DX SLIDE ON PG 8 of the PPT
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LOOK AT DIFF SLIDE ON PG 8
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is there a cure for GB?
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no
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how long can it take for full recovery?
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2 years
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what is the percentage that get full recovery?
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80%
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what are factors for poor prognosis?
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vent support, axonal damage, older age, rapid progression to quadriplegia within 1 week of onset
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what are 2 weeks of medical management of GB?
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plasmapharesis and intravenous immunoglobulin administration (IVIG)
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what are the goals of PT with GB?
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minimize pain, prevent contractures, prevent secondary compllications, promote respiratory function, maximize indepedant functional mobility, educate
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what are the phases of GB?
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early/acute, ascending/worsening, stabilizing/plateau, descending/recovery
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what is the early/acute phase?
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onset of sx
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ascending/worsening phase of GB, dscribe…
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rapid disease progression till no further sx's occur
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describe the plateau/stabilizing phase
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sx's remain but do not worsen (usually within 4 weeks)
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describe descending/recovery phase.
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pt's condition improves and often to full recovery
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what are common impairments?
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pain, fatigue, hyporeflexia, weakness, limited AROM, parasthesia, decreased inspiratory and expir function, autonomic dysfunction
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what is the acute phase program for GB?
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maintain AROM/PROM, positioning, monito strength, breathing exercises, assistance with cough, education of patient and family and GBS, psychosocial support, monitor vitals due to ANS dusfunction
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what is the acending phase progrom for GB?
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supportive care, monitor vitals, prevention/maintenance of PROm, respiratory care (diaphagmatic breathing/cough), education of family regarding PROm and stretching, skin integrity
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what is the plateau phase prgram for GB?
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initiate upright tolerance, monitor vitals, activty tolerance and endurance, AAROM --> AROM, functional mobility (bed and transfer training)
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what is the recovery phase program for GB?
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monitor vitals, AROM to minimal resistance, assessment for assistive devices, functional mobility ( WB exercises, sitting balance, transfers, static/dynamic balance, WC mobility progressing towards gait training, increase independence with ADLs)
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what level of strength training for GB?
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submaximal
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what level of aerobic activity and what must be done?
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min-moderate level and monitor physiologic responses
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should you focus on slow twitch or fast twitch muscles?
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fast twitch
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what plane and how many joint(s) are good?
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multiplane and multijoint
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Look at bottom right slide of PG 11 in ppt
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look at bottom right slide of pg 11 in ppt
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what are the precautions of GB tx?
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maintain o2 sats, avoid fatigue, avoid veruse/painful ROM, progress strengthening from gravity eliminated to against gravity gradually, no high intensity exercise
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is recovery a slow or fast process and why?
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slow, nerve regenration is 3-4 mm/day
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