Is a multidimensional robotic rehabilitation approach feasible in Guillain-Barrè syndrome? Report from a clinical case

Abstract

We describe the case of a 54-year-old patient, who was admitted to our Rehabilitation Unit with diagnosis of Guillain-Barré Syndrome (GBS). Neurophysiological investigation revealed an axonal polyneuropathy, with impairment of the motor component and preserved sensory function. Despite rapid diagnosis, therapeutic treatment and customized progressive rehabilitation program, nine months after the onset of the disease he presented severe motor sequelae and functional impairment. Patient's hospitalization lasted about two months, while he performed a conventional rehabilitation training. Besides, he underwent a 4-week comprehensive rehabilitation treatment, including both conventional and robotic multidimensional trainings, for 5 1-h sessions per week. Despite the residual global impairment, this treatment, specifically tailored on patient's skills and progress, promoted improvements in functional abilities such as motricity, trunk control, and activities of daily living. Therefore, this case report evidenced the feasibility and efficacy of a multidimensional robotic therapeutic approach along with conventional treatment in the post-acute phase of GBS.

Figure 1.

Multidimensional robotic treatment. The array includes two robotic devices, AMADEO and DIEGO, and a sensor-based system, PABLO (Fondazione Carlo Gnocchi): a) a robotic device for the treatment of the hand (AMADEO, Tyromotion), b) a robotic arm-shoulder therapy system (DIEGO, Tyromotion); c) a sensor-based therapy system for the entire upper limb and truk (PABLO, Ty romoyion).

Figure 2.

Functional and disability scales before (T0) and after (TT) training protocol. MI, Motricity Index; MRC scale, Medical Research Council Scale; BI, Barthel Index, Ul, Upper Limb.