Midori Tanaka, MD, Yoshitaka Wada, MD, PhD, Nobuyuki Kawate, MD, PhD
Jpn J Compr Rehabil Sci 12: 48-52, 2021
Introduction: We report the case of a patient with
severe Guillain-Barre syndrome (GBS), whose
ambulation recovered despite requiring total assistance
on admission to a Kaifukuki rehabilitation ward. Gait
training using knee-ankle-foot and ankle-foot orthoses
was highly effective, based on the improvement in
lower extremity muscle strength.
Case: A female in her 20s was previously diagnosed
with GBS and was transferred to a Kaifukuki
rehabilitation ward on hospitalization day 57. On
admission, the lower extremities had a manual muscle
test grade of 1, and the functional independence
measure motor score (mFIM) was 13. She began
training to stand upright using a tilt table and a kneeankle-
foot orthosis. Gait training with an adjustable
posterior strut ankle-foot orthosis was initiated from 9
weeks after admission, with the fixed, brake, resistance,
and freedom settings of the orthosis for the ankle joint
adjusted according to the improvement in lower
extremity muscle strength. At discharge, she was
ambulatory without assistive devices and foot orthoses,
and her mFIM had improved to 91. She returned to
work 2 months later.
Discussion: This report describes the effectiveness of
standing and gait training with a foot orthosis in
improving ambulation in a severe GBS patient admitted
to a Kaifukuki rehabilitation ward. Medical management
and high-intensity rehabilitation are essential for patients
with severe GBS during Kaifukuki rehabilitation.
Key words: Guillain-Barre syndrome, Kaifukuki rehabilitation, lower limb orthoses, gait training