Connors Catherine, McNeill Stephanie, Hrdlicka Henry Charles
Department of Inpatient Physical Therapy, Gaylord Specialty Healthcare, Wallingford, CT, United States.
Department of Inpatient Occupational Therapy, Gaylord Specialty Healthcare, Wallingford, CT, United States.
JMIR Rehabil Assist Technol. 2022 Feb 10;9(1):e30794. doi: 10.2196/30794.
Although several reports have described the diagnosis and treatment of patients with COVID-19-associated Guillain-Barré syndrome (GBS), there is a paucity of literature describing the occupational and physical therapy (OT and PT) strategies used in the long-term acute care hospital (LTACH) setting to rehabilitate these patients.
To expand this body of literature, we present a case report highlighting the treatment strategies used to rehabilitate and discharge an individual from an independent LTACH facility, following diagnosis and treatment of COVID-19-related GBS at a regional ACH.
A 61-year-old male was admitted to an LTACH for the rehabilitation of GBS following COVID-19 infection and intravenous immunoglobulin treatment. Rehabilitation in the LTACH setting uses a variety of skilled treatment interventions to meet patient-driven goals and maximize their function to the highest level possible in preparation of their discharge to a subacute or homecare setting. In this case, this was accomplished through individual OT and PT sessions, OT/PT cotreatment sessions, and targeted group therapy sessions focused on leg, arm, and fine motor coordination exercises.
With the OT and PT standard of care, the patient's improvement was demonstrated by several outcome measures, including manual muscle testing, range of motion, grip strength, and the activity measure for postacute care. The patient was successfully rehabilitated and returned to the community after presenting with COVID-19-associated GBS.
This report highlights the complex rehabilitation needs patients require to regain independence after diagnosis of COVID-19-associated GBS.
尽管已有多篇报道描述了新型冠状病毒肺炎（COVID-19）相关吉兰-巴雷综合征（GBS）患者的诊断和治疗，但关于长期急性病医院（LTACH）环境中用于康复这些患者的职业和物理治疗（OT和PT）策略的文献却很少。
为了扩充这方面的文献，我们呈现一份病例报告，重点介绍在一家地区性急性病医院（ACH）对COVID-19相关GBS进行诊断和治疗后，将一名患者从独立的LTACH设施康复并出院所采用的治疗策略。
一名61岁男性在感染COVID-19并接受静脉注射免疫球蛋白治疗后，因GBS康复入住LTACH。LTACH环境中的康复采用多种专业治疗干预措施，以实现患者驱动的目标，并在准备将其转至亚急性或家庭护理环境时，尽可能将其功能最大化。在本病例中，这是通过单独的OT和PT治疗、OT/PT联合治疗以及专注于腿部、手臂和精细运动协调练习的针对性团体治疗来实现的。
采用OT和PT标准护理，通过多项结果指标证明了患者的改善，包括徒手肌力测试、关节活动范围、握力以及急性后期护理活动指标。该患者在出现COVID-19相关GBS后成功康复并重返社区。
本报告强调了COVID-19相关GBS患者在诊断后恢复独立所需满足的复杂康复需求。
