What is GBS?
In addition to occupational and physical therapists, other persons may participate in rehabilitation. These may include nurses, as well as social workers and psychologists.
The latter can play an important role to assist the patient and family in dealing with the new and sometimes overwhelming problems of paralysis, dependency, loss of income, and the associated multitude of emotional problems. Emotional reactions to severe illness can include frustration, depression, self-pity, denial, anger and so forth. Since prognosis for the Guillain-Barré patient is relatively optimistic, in spite of the potential gravity of the illness, a practical approach is to take one day at a time during the rehabilitation process.
There are a few differences between the Guillain-Barré and other patients in the rehabilitation hospital that warrant comment. Most of the patients in this kind of hospital have had a stroke, amputation or brain or spinal injury and will regain some but limited return of function. In contrast, the overall chance for return to a near normal life style is rather good for the Guillain-Barré patient. Furthermore, although most rehabilitation patients are strongly encouraged to exercise to maximum tolerance, this is usually not advised for the Guillain-Barré patient. Excessive exercise may lead to aches, cramps, pain and exhaustion of muscles that have inadequate nerve supply. Therefore, some moderation or pacing of exercises is often advised.
As with most aspects of medical care, rehabilitation for Guillain-Barré syndrome is individualised for the patient's particular problem.
The overall outlook for the Guillain-Barré patient is relatively optimistic. Although the exact percentages vary from study to study, the following values give an estimate for long-term prognosis. Up to 90% of patients reach nearly complete recovery. Some of these patients may have persisting, but mild, abnormalities that will not interfere with long term function. These may include abnormal sensations, such as tingling, achy muscles or weakness of some muscles that make walking or other activities awkward or difficult. Perhaps 5 to 15% of Guillain-Barré patients will have severe, long-term disability that will prevent return to their prior life style or occupation.
Rarely, a patient will be wheelchair bound for a prolonged time. It is important to emphasise that, as in many aspects of medicine, the prognosis or expectation for degree of recovery for any patient cannot be predicted. Strength returns at various rates. Although improvements may be noted from day to day, quite often they can be appreciated on a week to week basis. As strength and endurance increase, improvements may occur at a slower rate and only be noted on a month to month basis. Recovery may continue for anywhere from six months to two or more years.