7. Guillain-Barré Syndrome (GBS)
Rare disorder that causes your immune system to
attack your peripheral nervous system.
Sometimes preceded by an infection, for example,
gastroenteritis.
Distal to proximal progression with potential respiratory
complications.
Symptoms usually worsen over a period of weeks, then
stabilize. Recovery can take a few weeks to a few
years.
Treatment options during the symptom period include
medicines or a procedure called plasma exchange.
• International Classification of Diseases (2015)
• Pulivarthi & Gurram (2014)
8.
9.
10. Eileen’s Initial
Interview
Living alone, two-
storey house, Cork
Bathroom
downstairs
(shower),
bedroom upstairs
Dependant
mobilizing, hoist to
commode
Ind. feeding,
dependant for
majority of PADL’s
Patient concerned
re: future use of
stairs
Support from son
and daughter
Independent prior
to admission, no
services
11. Goal Setting and Occupational Therapy Plan
Goal: Improve functional independence in
PADL’s, transfers and mobility. Plan: Conduct
assessments, provide advice on adaptive and
safe techniques. Discuss adaptive equipment to
improve independence.
Goal: Improve ROM, strength and dexterity in
upper limbs (patient left hand dominant). Plan:
Upper limb assessments and biometric training.
Goal: Return to home, use stairs independently.
Plan: Liaise with Physio re: stairs assessment.
Recommend patient for St. Finbarr’s rehabilitation.
14. Evidence-Based Practice
Nine Hole Peg Test – Suitable to detect changes in
dexterity over the course of interventions post-
stroke (Lin et al, 2010).
Montreal Cognitive Assessment – Provides
reasonable estimate of general intellectual
abilities in older adults (Sugarman & Axelrod,
2014). – Suitable screening tool for haemodialysis
patients, 76-78% correlation with test battery (Tiffin-
Richards et al, 2014).
Dynamometer – Jamar Dynamometer allows a
valid and constant grip force measurement.
Manugraphy provides more information on load
distribution. But overall, there is a high correlation
between scores (Mühldorfer-Fodor et al, 2014).
16. Discharge Planning & Review
Transfer to St. Finbarr’s Hospital for
rehabilitation. Complete transfer letter.
Continue to review ADL’s and upper limb
function prior to discharge.
Perceptual Assessment?
Home visit if rehab place does not become
available.
17. References
Christiansen, C., Baum, C. M., & Bass-Haugen, J. (Eds.). (2005). Occupational
therapy: Performance, participation, and well-being. Slack Incorporated.
Curtin, M., Molineux, M. and Supyk-Mellson, J. (Eds.) (2009) Occupational therapy
and physical dysfunction: enabling occupation, 6th ed., Edinburgh: Churchill
Livingstone Elsevier.
International Classification of Diseases. (2015). Guillain-Barré Syndrome. Available:
http://www.icd10data.com/ICD10CM/Codes/G00-G99/G60-G65/G61-/G61.0.
Last accessed 3rd March 2015.
Lin, K., Chuang, L., Wu, C., Hsieh, Y., & Chang, W. (2010). Responsiveness and
validity of three dexterous function measures in stroke rehabilitation. Journal Of
Rehabilitation Research & Development, 47(6), 563-571.
Mühldorfer-Fodor, M., Ziegler, S., Harms, C., Neumann, J., Cristalli, A., Kalpen, A., &
... Prommersberger, K. (2014). Grip force monitoring on the hand: Manugraphy
system versus Jamar dynamometer. Archives Of Orthopaedic & Trauma
Surgery, 134(8), 1179-1188.
Pulivarthi, S., & Gurram, M. K. (2014). A young patient with multisystem
complications after cytomegalovirus infection. Journal of neurosciences in rural
practice, 5(1), 59.
Sugarman, M. A., & Axelrod, B. N. (2014). Utility of the Montreal Cognitive
Assessment and Mini-Mental State Examination in predicting general intellectual
abilities. Cognitive And Behavioral Neurology, 27(3), 148-154.
Tiffin-Richards, F. E., Costa, A. S., Holschbach, B., Frank, R. D., Vassiliadou, A.,
Krüger, T., & ... Reetz, K. (2014). The Montreal Cognitive Assessment (MoCA) - A
Sensitive Screening Instrument for Detecting Cognitive Impairment in Chronic
Hemodialysis Patients. Plos ONE, 9(10), 1-9.
