Guillain-Barré Syndrome (GBS) is an acute, immune-mediated polyneuropathy that causes rapidly progressive limb weakness, areflexia, and in severe cases respiratory failure. In the UK, GBS affects approximately 1–2 people per 100,000 per year. The majority of people make a good functional recovery, but the journey is often long and demanding.

The Phases of Recovery

GBS is typically described in three phases: the progressive phase, in which weakness advances over days to four weeks; the plateau phase, in which symptoms stabilise; and the recovery phase, in which function gradually returns as the peripheral nerves remyelinate. Physiotherapy has a role in all three phases, though its focus changes considerably as the condition evolves.

Physiotherapy in the Acute Phase

In the acute phase, the priority is preventing secondary complications — positioning to avoid pressure injury and contracture, passive movement to maintain joint range, and respiratory physiotherapy where respiratory muscles are affected. Early mobilisation, as soon as it is medically safe, is associated with better functional outcomes.

Physiotherapy in the Recovery Phase

As strength returns, physiotherapy focuses on progressive strengthening, balance retraining, gait rehabilitation, and fatigue management. Recovery can take months to years, and ongoing community-based physiotherapy is often essential to achieving maximum functional potential.

References

Willison, H.J. et al. (2016). Guillain-Barré syndrome. Lancet, 388(10045), 717–727. https://doi.org/10.1016/S0140-6736(16)00339-1

Khan, F. & Amatya, B. (2012). Rehabilitation interventions in patients with acute demyelinating inflammatory polyneuropathy: a systematic review. European Journal of Physical and Rehabilitation Medicine, 48(3), 507–522. https://pubmed.ncbi.nlm.nih.gov/22641035/