Physical therapy in a pregnant young woman with sequels of Guillain-Barré syndrome: case report

• Autor(a) principal: de Quadros, Letícia Ruebenich
• Data de Publicação: 2017
• Outros Autores: Grave, Magali Teresinha Quevedo
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Scientia Medica (Porto Alegre. Online)
• Texto Completo: https://revistaseletronicas.pucrs.br/scientiamedica/article/view/25318
• topic: musculoskeletal abnormalities; polyneuropathies; Guillain-Barré syndrome; physical therapy; neurology; pregnancy.; anormalidades musculoesqueléticas; polineuropatias; síndrome de Guillain-Barré; fisioterapia; neurologia; gravidez.

DOI: 10.15448/1980-6108.2017.1.25318Aims: 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.