What is Guillain-Barre Syndrome (GBS)

Written By Jessie Agrimis

GBS is a rare condition where the body’s own immune system mistakenly attacks the protective covering (called myelin) around the nerves. This damage, known as demyelination, disrupts how signals travel between the brain, spinal cord, and the rest of the body.

Individuals will present with rapidly progressing motor and/or sensory impairments symmetrically affecting the lower and upper limbs. Symptoms often appear suddenly over a few days to weeks. Symptoms generally peak by 2 weeks and plateau by 4 weeks; then recovery begins.

Early Stage (Hours-Days):

  • Tingling or “pins and needles” in toes, feet, or fingers

  • Weakness starting in legs and progressing upward

  • Difficulty walking or climbing stairs

  • Back pain or muscle aches

  • Facial weakness or difficulty with speaking/swallowing (in some cases)

Late Stage (Days-Weeks):

  • Severe muscle weakness or paralysis in legs, arms, and respiratory muscles (in severe cases)

  • Loss of ability to walk independently

  • Breathing difficulties (possible need for ventilation in severe cases)

  • Abnormal heart rate or blood pressure

  • Loss of bladder or bowel control (in severe cases)

Physical and Occupational Therapy

It’s important to begin moving as early as possible. A Physical Therapist or Occupational Therapist can help you start safe, appropriate activity while ensuring you don’t push to the point of fatigue. The “no pain, no gain” approach does not apply in this situation—overexertion can actually slow recovery rather than support it. With guided care, a therapist can help you work on the activities listed below and much more.

  • Energy conservation techniques

  • Home modification & adaptive equipment suggestions

  • Fine/gross motor skills

  • Strength training

  • Aerobic exercise and endurance

  • Effective breathing techniques

  • Preventing stiffness and loss of movement

  • Relearning daily activities (walking, self-care, work tasks)

Exercise Types and Recommendations for GBS

  • Strength training: 2-3x/week, 2-3 sets of 10-15 reps at low-moderate intensity; increase reps before resistance to avoid injury or excessive fatigue

  • Endurance Training: 2-3x/week, working up to 30 mins and increasing as able

  • Functional Training (walking, standing, daily tasks): Everyday! Minimum of 3-5x/week

  • Stretching/Range of Motion Exercises: 2-3x/week, 10-20 reps per joint for range or motion exercises, 30-60 sec holds for static stretching

  • Respiratory Exercises: Daily, 2-3x per day

    • Examples: pursed-lip breathing, segmental breathing, incentive spirometer

Jessie Agrimis
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