Physical therapy in a pregnant young woman with sequels of Guillain-Barré syndrome: case report
DOI:
https://doi.org/10.15448/1980-6108.2017.1.25318Keywords:
musculoskeletal abnormalities, polyneuropathies, Guillain-Barré syndrome, physical therapy, neurology, pregnancy.Abstract
DOI: 10.15448/1980-6108.2017.1.25318
Aims: To describe the assessment, the prescription of physical therapy procedures, and the outcome of a young pregnant woman with Guillain-Barré syndrome.
Case Description: A 20-year-old, 12-week pregnant, primiparous woman diagnosed with Guillain-Barré syndrome 6 years ago presented with gait disorders and lumbopelvic pain and sought medical care at the teaching outpatient clinic of physical therapy affiliated with UNIVATES, located in Lajeado, state of Rio Grande do Sul, Brazil. The examination revealed lower limb hypotrophy, peroneal and tibial denervation, abdominal and paravertebral muscle weakness, thoracic hyperkyphosis, lumbar hyperlordosis, anterior pelvic tilt, and loss of static and dynamic balance. After pregnancy was confirmed, the treatment focused on postural adjustments. The increase in both abdominal strength and proprioception allowed crutch walking. Lumbar hyperlordosis, measured by computed biophotogrammetry, decreased by approximately 20 degrees, comparing the beginning and the end of the same physical therapy session. After 16 weeks of physical therapy, there was increase in the muscle strength of knee extensors and hip flexors bilaterally, from an average of 3.5 and 3 to 5 and 4 degrees, respectively. The patient had an uneventful natural delivery at 37.5 weeks’ gestation, and the neonate was healthy.
Conclusions: Physical therapy received by a young pregnant woman with sequelae of Guillain-Barré syndrome was effective in the modulation of muscle tone, respiratory retraining, enhancement of trunk control, improvement of static balance, reduction of postural changes, and relief of lumbopelvic pain, eventually contributing to natural delivery.
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References
- Yuki N, Hartung HP. Guillain-Barré syndrome. N Engl J Med. 2012;366(24):2294-304. https://doi.org/10.1056/NEJMra1114525
- Fonseca T, Cardoso T, Perdigão S, Sarmento A, Morgado Rui, Costa MM. Síndrome de Guillain-Barré. Acta Médica Portuguesa. 2004;17:119-22.
- Beneti GM, Silva DLD. Síndrome de Guillain-Barré. Semina Ciênc Biol Saúde. 2006;27(1):57-69. https://doi.org/10.5433/1679-0367.2006v27n1p57
– Avila-Funes JA, Mariona-Montero VA, Melano-Carranza E. Síndrome de Guillain-Barré: etiologia y patogénesis. Rev Invest Clín. 2002;54(4):357-63.
- Cao-Lormeau VM, Blake A, Mons S, Lastère S, Roche C, Vanhomwegen J, Dub T, Baudouin L, Teissier A, Larre P, Vial AL, Decam C, Choumet V, Halstead SK, Willison HJ, Musset L, Manuguerra JC, Despres P, Fournier E, Mallet HP, Musso D, Fontanet A, Neil J, Ghawché, F. Guillain-Barré Syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study. Lancet. 2016;387(10027):1531-9. https://doi.org/10.1016/S0140-6736(16)00562-6
- World Health Organization. Situation Repot: Zika virus, microcephaly, Guillain-Barré syndrome [Internet]. Geneva: WHO; 2016 [cited 2016 Oct 27]. Available from: http://reliefweb.int/sites/reliefweb.int/files/resources/zikasitrep7Jul16-eng.pdf
- Brito C. Zika Virus: a new chapter in the history of Medicine. Acta Med Port. 2015;28(6):679-80. https://doi.org/10.20344/amp.7341
- Kindhauser MK, Allen T, Frank V, Santhana RS, Dye C. Zika: the origin and spread of a mosquito-borne virus. Bull World Health Organ. 2016;94(9):675-86C. https://doi.org/10.2471/BLT.16.171082
- Araujo LM, Ferreira ML, Nascimento OJ. Guillain-Barré syndrome associated with the Zika virus outbreak in Brazil. Arq Neuropsiquiatr. 2016;74(3):253-5. https://doi.org/10.1590/0004-282X20160035
- Chaves Filho JIG, Reis ILA, França AS, Cortela DCB. Revisão de literatura: a relação entre Zika Vírus e Síndrome de Guillain-Barré. Rev Ciênc Estudos Acad Med. 2016;(5):22-9.
- van Doorn PA, Ruts L, Jacobs BC. Clinical features, pathogenesis, and treatment of Guillain-Barré syndrome. Lancet Neurol. 2008;7(10):939-50. https://doi.org/10.1016/S1474-4422(08)70215-1
- Kraychete DC, Sakata RK. Neuropatias periféricas dolorosas. Rev Bras Anestesiol. 2011;61(5):641-58. https://doi.org/10.1016/S0034-7094(11)70075-7
- Fernández JAC, García JDC. Neuropatías periféricas. MEDISAN. 2003;7(4):35-41.
- Lima FAS, Lourenço AS, Azevedo VNG, Souza FS, Amaral RG. Síndrome de Landry-Guillain-Barré-Strohl na gravidez: relato de caso. Rev Para Med. 2005;19(4):67-70.
- Queiroz TN, Bisinotto FMB, Silva TMM, Martins LB. Anestesia para cesariana em gestante com Síndrome de Guillain Barré: relato de caso. Rev Bras Anestesiol. 2014;64(5):369-72. https://doi.org/10.1016/j.bjan.2013.02.004
- Lima FR, Oliveira N. Gravidez e exercício. Rev Bras Reumatol. 2005;45(3):188-90. https://doi.org/10.1590/S0482-50042005000300018
- Santos MM, Gallo AP. Lombalgia gestacional: prevalência e características de um programa pré-natal. Arq Bras Ciên Saúde. 2010;35(3):174-9. https://doi.org/10.7322/abcs.v35i3.78
- Bim CR, Perego AL, Pires-Jr H. Fisioterapia aplicada à ginecologia e obstetrícia. Iniciação Científica Cesumar. 2002;4(1):57-61.
- Milet ACD, Serrão C, Normando V. Análise da manovacuometria em indivíduos sadios nas posições sentada e em pé. Rev Para Med. 2005;19(3):43-46.
- Matos AP, Fagundes FRC, Oliveira RF, Pires-Oliveira DAA, Lamb M, Castelo LA. Reabilitação física em portadores de Legg-Calvé-Perthes após osteotomia de Salter: protocolo de orientação domiciliar. Conscientiae Saúde. 2013;12(1):82-9. https://doi.org/10.5585/conssaude.v12n1.3906
- Sarraf TA, Dezan VH, Rodacki ALF. Diferenças entre medidas quali e quantitativas durante testes de comprimento músculo-tendíneos dos flexores do quadril uni e biarticulares. Rev Bras Fisioter. 2005;9(2):195-202.
– Affonso Filho AA, Navarro RD. Avaliação do ângulo poplíteo em joelhos de adolescentes assintomáticos. Rev Bras Ortop. 2002;37(10):461-6.
- Junqueira RT, Ribeiro AMB, Scianni AA. Efeitos do fortalecimento muscular e sua relação com a atividade funcional e a espasticidade em indivíduos hemiparéticos. Rev Bras Fisioter. 2004;8(3):247-52.
- Sacco ICN, Alibert S, Queiroz BWC, Pripas D, Kieling I, Kimura AA, Sellmer AE, Malvestio RAE, Sera MT. Confiabilidade da fotogrametria em relação a goniometria para avaliação postural de membros inferiores. Rev Bras Fisiot. 2007;11(5):411-17. https://doi.org/10.1590/S1413-35552007000500013
- Souza JA, Pasinato F, Basso D, Corrêa ECR, Silva AMT. Biofotogrametria: confiabilidade das medidas do protocolo software para avaliação (SAPO). Rev Bras Cineantropom Desempenho Hum. 2011;13(4):299-305.
- Palisano RJ, Cameron D, Rosenbaum PL, Walter SD, Russell D. Stability of the gross motor function classification system. Dev Med Child Neurol. 2006;48(6):424-8. https://doi.org/10.1017/S0012162206000934
- Minosso JSM, Amendola F, Alvarenga MRM, Oliveira MAC. Validação, no Brasil, do Índice de Barthel em idosos atendidos em ambulatórios. Acta Paul Enferm. 2010;23(2):218-33. https://doi.org/10.1590/S0103-21002010000200011
- Muir SW, Berg K, Chesworth B, Speechley M. Use of the berg balance scale for predicting multiple falls in community-dwelling elderly people: a prospective study. Phys Ther. 2008;88(4):449-59. https://doi.org/10.2522/ptj.20070251
- Miyamoto ST, Lombardi Junior I, Berg KO, Ramos LR, Natour J. Brazilian version of the Berg balance scale. Braz J Med Biol Res. 2004;37(9):1411-21. https://doi.org/10.1590/S0100-879X2004000900017
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