What is Juvenile Guillain-Barré syndrome?
Guillain-Barré syndrome, or GBS, is a condition affecting the peripheral nervous system. ‘Juvenile’ means it affects children. GBS usually occurs after a virus, and involves the immune system attacking the protective layer of the nerves that control the muscles. GBS starts in the outer, or distal parts of the body, such as the hands and feet. It can spread to other areas rapidly. GBS can also spread to the heart and lung muscles, affecting breathing. The more severe the GBS, the longer rehabilitation will take. Most children with GBS make a full recovery, if they receive medication in time. Recovery involves strengthening the weak muscles which have been affected by the nerve damage. GBS is a medical emergency and requires an inpatient hospital stay to begin with, BBP assess and rehabilitate GBS superheroes after their hospital stay.
What are the symptoms?
Children with GBS suffer from weakness in different parts of their body. Depending on the severity of the GBS, it could affect hands or feet, or both. It could have spread further to involve the arms or legs, and the trunk or spine muscles.
Our GBS superheroes don’t tend to need us for long! Three-year-old Teddy was super brave during her inpatient stay at an excellent London children’s hospital. When she came out, she was willing and ready to work out with team BBP. After six weeks, Teddy increased her leg strength and could walk and run independently again, making a full recovery. Teddy keeps us updated on her fun activities every now and then, and recently she had lots of fun at a waterpark! Go Teddy!
How can physiotherapy Help?
Physiotherapy aims to rehabilitate the weak or paralysed muscles. We are specialists in reassuring and motivating children to work hard, without even noticing it! Sometimes children become frustrated when they can’t do what they used to do, but we help adapt and facilitate to build strength and tactile feedback.
We make our superheroes strong again the BBP way! We work on this in three ways, activation, movement, and strength work. We work our magic to place the muscles in the optimum position for activation, eliminating gravity and facilitating activity. Once the muscles have ‘woken up’ we integrate play and fun into moving joints again, using our specialised techniques to aid motivation. After this stage, we move on to strengthening. One of our GBS superheroes worked so hard, he was even stronger after his sessions than he was before he contracted GBS!
We will demonstrate lots of positions to aid participation and function. These positions enable strengthening, as well as promoting flexibility and function. Depending on your superhero’s needs, we may write a positioning programme with multiple positions to use daily. These will be integrated into daily activities, such as playing, school work and brushing teeth!
Range of movement
Sometimes children with GBS can develop hypertonia, or high muscle tone. This is because the wrong messages are going to the muscles, due to the nerve damage, and it causes stiff, or rigid muscles. It is important to recognise and monitor this, to avoid permanent stiffness (contractures). At BBP, we measure range of movement at the initial assessment and frequently after, and will pick up any signs of hypertonia. We will develop a stretching programme including active and facilitated stretches, as well as positions for sustained stretches throughout the day.
Advice and education
When your child has GBS it is a stressful time for the whole family. We understand that you may feel helpless and vulnerable during this time, while wanting to give your child the best outcome possible. A huge part of our BBP intervention is educating and empowering parents to give their superhero the best outcome possible. We will spend all the time needed chatting, reassuring and supporting our superhero’s whole family. After a BBP consultation, you will feel confident in the knowledge that your child’s needs and goals will be attended to, with a full report and programme as a reminder.
When your GBS superhero is up and walking again, there may be some differences in their gait (walking pattern) due to some subtle weaknesses or muscle imbalances. Although these may not initially limit your child’s function, or ability to have FUN, it may cause problems later on. We are experts in comprehensive gait analysis, and will update your superhero’s exercise regime, goals and programme accordingly, to iron out those asymmetries and get your superhero back to their pre-GBS ability!
Function and playing
Your superhero will be provided with short-, medium- and long-term SMART goals. All of their exercises, positions and intervention will prepare them for the favourite physical activities! We like to try these out during sessions, making sure your superhero stays motivated, enjoys physio and is back to their beloved adventures as soon as possible! One of our GBS heroes wanted nothing but to climb up her garden treehouse! Of course team BBP were excited to check it out too! She worked super hard on balance, upper and lower body strength, and motor planning, and five months after she was discharged from hospital, she was able to go back into her treehouse! She celebrated with a teddy bears’ picnic in the sky, with her sister!
Teamwork is vital to ensure the best outcome for all children. Here at BBP, we work with all professionals involved for a seamless approach to our GBS warriors’ care. After your child’s hospital stay, we will work with their inpatient team to establish their current programme, any new equipment, and any anxieties or worries your child might be facing. We will continue to work with neurologists, paediatricians, GPs, and OTs, and anyone else relevant to make sure only the best outcomes are achieved!
Contact us to find out how we can help your GBS superhero!