Case Report

Effectiveness of gait training with lower limb orthosis for a patient with severe Guillain-Barre syndrome at a Kaifukuki rehabilitation ward

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

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