Peripheral nerve injuries
Injuries to the peripheral nerves due to trauma, chronic traction, compression, or shear
Myasthenia gravis
Symptoms:
- Muscle weakness, especially in the eyes, face, throat, and limbs
- Double vision
- Drooping eyelids
- Difficulty swallowing or speaking
- Weakness that worsens with activity and improves with rest
Interventions for myasthenia gravis
- Energy conservation techniques are the goal of the sessions
- No strength training as the patient becomes more fatigued with increased repetition of activity
- Attempt to conduct therapy sessions in the morning to decrease fatigue
- Avoid thermal modalities such as heat packs, whirlpool, etc.
Bell’s palsy
Symptoms
- Facial droop on one side of the face
- Drooling from one side
- Loss of taste to the anterior 2/3 of the tongue
- Changes in saliva and tear production
- Headache
- Loss of sensation to the anterior two-thirds of the tongue
- Sensory to face remains intact
Interventions for Bell’s palsy
- Spontaneous recovery can occur
- Corticosteroid use for inflammation
- Electrical stimulation for nerve stimulation
- Exercises for facial muscles
- Taping of the eyelid to prevent dry eye due to the inability to close the eyelid
Guillain–Barré syndrome (GBS)
Symptoms
- Causes motor and mild sensory loss distal to proximal in a symmetrical pattern
- Usually begins in the legs and will ascend towards the trunk/UE
- Worse prognosis if reaching the lungs and a need for mechanical ventilation
- Motor/sensory loss progressively worsens over 4 4-week period and then stabilizes
**Interventions for Guillain–Barré syndrome (GBS)
- Sessions focus on compensatory strategies to assist with gait and mobility
- Avoidance of overstretching and overuse during acute phases of diagnosis
- Strength training is performed once stabilization of the disease process occurs, with progression from isometric to concentric to eccentric activities
