Early Clinical Response to Physiotherapy in Suspected Guillain–Barré Syndrome: A Case Report

Abstract

Background: Guillain–Barré syndrome (GBS) may cause acute weakness, areflexia, pain, respiratory symptoms, and severe functional limitations requiring supportive rehabilitation.
Objective: To describe the early clinical response during inpatient physiotherapy in a patient with tetraparesis clinically suspected to be associated with GBS.
Methods: A 24-year-old woman with symmetrical ascending tetraparesis, bilateral areflexia, and normal sensory findings received two consecutive physiotherapy sessions during hospitalization. Interventions included transcutaneous electrical nerve stimulation, active-assisted and passive range of motion, static cervical contraction, strengthening, bridging, breathing exercises, stretching, and soft tissue release. Outcomes included Manual Muscle Testing, Numeric Rating Scale pain scores, deep tendon reflexes, thoracic expansion, Modified Borg Dyspnea Scale, Berg Balance Scale, and Barthel Index. Data were analyzed descriptively.
Results: Resting pain decreased from 2 to 1/10, upper trapezius tenderness from 5 to 3/10, thoracic tenderness from 4 to 3/10, and movement-related pain from 8 to 6/10. Muscle strength remained 2/5. Biceps, triceps, and patellar reflexes remained absent bilaterally, whereas thoracic expansion and Borg scores were unchanged. The Berg Balance Scale remained 0, and the Barthel Index score was 30, indicating severe dependence. No adverse event was reported.
Conclusion: Pain decreased during two physiotherapy sessions, whereas neuromuscular, balance, and respiratory-related outcomes remained unchanged. These observations describe a short-term clinical course and cannot establish the efficacy or general safety of the multimodal physiotherapy program or its individual components.