Patient Information: Male, Age 45
Diagnosis: Guillain-Barre Syndrome / Muscle Weakness
History: This gentleman was admitted to a skilled nursing facility after prolonged hospitalization
with the diagnosis of Guillain-Barre Syndrome, an autoimmune disorder that causes rapid and
unexpected muscle weakness. He was referred for rehabilitation services due to significant
weakness, impacting all areas of functional mobility and activities of daily living (ADLs). Prior to the
hospital admission, he was living at home and working full time. He enjoyed walking his dog and
building model trains.
• Muscle Strength: Fair (3/5) throughout the right arm and leg; trace (1/5) throughout the left arm and leg.
• Bed Mobility: Maximal (>75%) assistance.
• Self-care: Moderate (50-75%) assistance for feeding and upper body hygiene; dependent (100%) assistance for dressing, bathing, and toileting.
• Transfers: Dependent (100%) assistance.
• Ambulation: Unable to walk.
• Modality: Omnistim® FX2 Pro Patterned Electrical Neuromuscular Stimulation (PENS), OmniStand™.
5x per week.
• Protocol Specifics: Upper extremity triphasic PENS ADL protocol alternated with trunk flexion/extension protocol to facilitate strength and improve postural control. Lower extremity triphasic PENS ADL protocol alternated with quadricep/hamstring protocol to facilitate neuromuscular reeducation and strength to improve sit to stand and gait abilities. OmniStand™ Dynamic Balance System progressed from static to dynamic balance activities to improve activity tolerance and minimize fall risk.
• Other Therapy Services Provided: Progressive resistance exercise, dynamic balance training, functional mobility training, therapeutic activities, and patient/caregiver education.
Strength: Good (4/5) throughout both arms and legs.
• Ambulation: 300 feet independently with a two-wheeled walker; close supervision to walk without an assistive device. Able to ascend and descend 4 steps with handrails and close supervision.