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Healthy Aging Tips from Sit and Be Fit's Mary Ann Wilson RN
By Mary Ann Wilson, RN

Guillain-Barre Syndrome (GBS) affects the peripheral nerves and impairs motor-unit recruitment. This results in a fewer number of successfully recruited muscle fibers, putting those recruited at a risk for overworking. It is important to avoid fatiguing the recovering muscles so a submaximal exercise program is best. A guide to intensity is that you should experience full recovery from exercise within 24 hours. A method to gauge your aerobic exertion level is to follow the Borg Rating of Perceived Exertion Scale of 0-10 where 0 represents no exercise and 10 represents maximal exertion. An individual with GBS should exercise at a level around 3-4 and take frequent rests at first, gradually reaching a continuous exercise state.

The strengthening component should begin with a submaximal resistance and a low number of repetitions a few times a week. Avoid intense eccentric (against gravity) exercises. Emphasize multi-joint exercises in movement patterns similar to normal function. For example, just doing a biceps curl is a single dimensional task while raising a weight from your right hip over to your left shoulder is a multiple dimensional functional task. When some tasks are practiced in part they don’t always transfer into the whole so it is best to practice the whole activity.

Exercise recommendations for managing GBS:

1) Strengthening using light weights, few repetitions, 3 times/week & progress
2) Avoid intense eccentric (lowering exercise)
3) Should experience full recovery from soreness and/or fatigue in 24 hours
4) Include multi-joint patterns of exercise

The exact cause of GBS is unknown, but is often preceded by an infectious illness such as a respiratory infection or the stomach flu. It causes muscle weakness, loss of reflexes, and numbness and tingling in the arms, legs, face and other areas. The syndrome affects only 1 or 2 people per 100,000. There is no cure but treatments can ease symptoms and reduce the duration. Some people may experience lingering effects such as weakness, numbness or fatigue. In most cases this will not get in the way of the activities of daily life. Occasionally there are long-term weakness or balance problems.

Recovery usually takes 6 to 12 months but can take up to 3 years. An important consideration regarding recovery is to avoid overworking the muscles. You have overworked if you have not recovered from soreness and/or fatigue within 24 hours. Your neurologist or rehab specialist can determine if all the muscles are ready for an exercise program.

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  1. What are the best exercises to do? I have a piece of equipment that has the pedals on it. I try to do it 10 minutes forward and 10 minutes back every day. I do have some 2 and 3 pound hand held weights as well. I am currently unable to walk. I have not been able to walk since January of 2018. They s tuck me in a nursing home to do therapy but they do not give me therapy anymore because they say my insurance will not pay for any. I have not had any therapy since February. I did not get that much last year either. I am a 60 year old woman unable to walk stuck in a nursing home full time. Thank you

    1. Dear Fern,
      We are so sorry to hear that your therapy has been discontinued. You are in a very challenging situation. The most important thing is, don’t give up hope. No matter what your current physical limitations are, you can improve your functional fitness and mobility. Do you have a DVD player? If so, we would love to send you a complimentary DVD. We can also send you a booklet of basic exercises that would be important for you to be practicing daily, along with some handouts like, Mary Ann’s 10-Minute Energizer Workout. Please send us an e-mail at [email protected] and she can send you some free resources. In the meantime, please know you are not alone. We would love to help you get back on your feet again!

      1. Good morning. For some reason I am just able to pull this up. Spotty internet for sure. I have sent you an email with the address. I truly appreciate your quick response to the above from July:-).
        Have a blessed holiday season.

  2. Good day,
    I am a 65 year old male and was diagnosed with Guillian-Barre Syndrome in 2016 after being treated for a sore throat that just wouldn’t go away , I was in the hospitalized for 2 weeks, unable to stand due to weakness and numbness in my legs, in addition I lost feeling and dexterity in my hands unable to perform day to day things like buttoning shirts finding my zipper, and all but lost my voice. I refused to be placed in a nursing home as my Insurance had limited coverage and I did not want to burden my sons with more financial responsibility. I was at home for 3 months unable to get around on my own, I paid for a couple of weeks of in home physical therapy, and continued the therapy on my own. I have not fully recovered to date my legs, feet and hand are always numb but i have some dexterity and feeling in my hands I am mobile and I drive to work. Fatigue is a big factor as I do not have much energy, but I push myself and I refuse to give up. I have a sit down job and I am looking for suggestions or Ideas for sit down exercises although I am mobile but cannot squat, my balance is not good.
    When I walk my legs feel like they may collapse without notice, I’ve had numerous falls, my last fall caused bruising to my left knee leaving me unable to move without assistance for about a week, fortunately I have not broken any bones.
    any suggestions for additional recovery would be greatly appreciated.
    Thank you,

    1. Dear Jorge,
      Mary Ann recommends, when you are at work or home, that you stand up and sit down every half hour while concentrating on using good technique. Start with the heels partially under the chair. Get your body into good alignment (lift the sternum, slide the head back so your ears are over the shoulders, roll the shoulders back and down several times). To begin with, at first, you can have your fingertips lightly resting on the desk in front of you, if needed. Shift your weight forward and press down through your heels. Push up to the standing position. If you can’t get all the way up, go as far as you can and slowly return to the seated position. Repeat at least 2 times every half hour. This will help strengthen your legs. Mary Ann also recommends working your ankle joints throughout the day and prior to practicing your sit-to-stand exercise. For example, circle your ankles in both directions; point the toes and flex the ankles; press the toes of one foot into the floor with the heel lifted and then press the heel into the floor with the toes lifted. Another recommendation Mary Ann has for you is to practice the seated calf stretch by extending the leg forward and pulling the toes back toward you. This will create a mild stretch. As with any exercise, if it hurts back off and modify the movement so you can practice it without pain. For your fingers, she recommends exercises throughout the day that work on tactile stimulation such as gentle rubbing and pressing without discomfort. Range of motion exercises for the fingers would also he helpful. Here are a few links from our blog library with finger exercises.
      If you would like a printed copy of our 8-page Neuropathy Exercise Guide sent to you, please reach out to [email protected] with your request. Even though you’re not managing this condition, the exercises presented in the Guide would be appropriate for you as well. We hope these ideas help. If you have any other questions, contact [email protected] Please keep us posted on your progress so we can share what works for you with others. Wishing you the best!

  3. I am able to walk mostly just around the house holding onto something as my balance and endurance leave something to be acquired. I am doing an upper body exercise routine, however we where thinking about adding an exercise equipment to help my lower half. We are having trouble deciding on a treadmill or a elongated stationary bike as I worked on in physical therapy exceedingly well. Any information to help make this choice would be so much appreciated. Thank you. Ashley

    1. Dear Ashley,
      Unfortunately, exercise equipment isn’t our area of specialty. That being said, Mary Ann thinks the treadmill might be the best choice. A treadmill can help you work on your walking technique and posture while strengthening your legs and improving balance. Keep in mind, the pace can be slowed down to give you an opportunity to improve your sensory awareness and foot placement. Here is a post from our blog library that shares tips for improving your gait.
      Another post from our library that you may find helpful is:
      Please let us know if we can help in any other way. Wishing you the best!

  4. Hi. I wax recently diagnosed with GBS. I spent 5 days in the hospital and received 5 IVIG treatments. I’m happy to say that I feel like I’m slowly recovering. However I have no strength in my fingers. Is there anything I can do to help my situation?

    1. Dear Ronald,
      We are happy to hear your GBS symptoms are slowly improving. Regarding your finger strength, Mary Ann recommends practicing gentle finger exercises throughout the day such as gentle rubbing and pressing, as long as there is no pain. . Range of motion exercises for the fingers would also he helpful. If you have a small ball, here is a great link for foot and hand exercises.
      Here are a few links other links from our blog library with finger exercises.
      Sit and Be Fit has put together an 8-page Neuropathy Exercise Guide which includes some good finger exercises. If you would like a copy sent to you through the mail, please reach out to [email protected] with your request. Even though you’re not managing neuropathy, the exercises presented in the Guide would be appropriate for you. We hope these ideas help. If you have any other questions, contact [email protected]. Please keep us posted on your progress so we can share what works for you with others. Wishing you the best!

  5. Hi ! After a flu shot and a pneumonia shot at the same time I developed symptoms of GBS about 2-3 weeks later. .Very week legs worsening to where I started falling after 4 weeks and need crutches to shuffle around, which is where I’m at after 60 days from onset. I am experiencing very slow improvement, but because of the severity of my last fall I am afraid to move around much. I have started using flex bands to exercise my legs and have been offered an exercise bicycle. While not your area of expertise, do you think it would be beneficial ? Any suggestions regarding overcoming my fear of falling would be appreciated.
    tx much

  6. Hi there, Just came across this article and found this really really helpful. My mum, aged 65 and in India, has been diagnosed with GBS a month back. She’s had her IVIg treatments and is out of hospital but we are unable to do PT because of India’s COVID situation. My worry is that situation will stay for another couple of months and in the meantime my mum will try something on her own which might harm her more. She is able to feel her legs and toes but struggles walking. At the moment she is unable to sit so her posture is mostly lying on her back. Her hands are also tingly so she is unable to hold the phone or spoon for a long time. Are you able to suggest some home exercises that she could do. I think our step 1 is for her to be able to sit, then stand and then walk. Some guidance will really really be helpful. Warm Regards

  7. Hi
    I was diagnosed with chronic GBS in June 2021 and was in hospital from June till September where my condition worsened as time passed to the point where I was completely paralysed. My treatment was a combination of IVIG (4 doses each after few weeks interval) steroids & Chemo medication after which finally my condition improved and since September I’ve been improving from being in a wheelchair to progressing to a walker and now I am able to walk with no support. But the sensation in my feet & hands is not back to normal. Is there anything I can do for my feet to get back the sensation ? Also I’ve been told that hydro therapy is highly recommended for GBS patients. Could you recommend what pool exercises can be done to help. Thank you

    1. Dear Tina,
      Can you forward your postal mailing address to [email protected] and request a free copy of our 8-page Exercise Guide for Neuropathy. It includes many wonderful exercises for the feet that will benefit you. Please also request the free GBS handout. It includes exercises for those recovering from and managing GBS symptoms. Pool exercises aren’t our specialty so we don’t have any printed information about hydrotherapy exercises but you could certainly incorporate the exercises from the handouts we will be sending you. Be encouraged by your progress thus far. It’s wonderful you are able to walk with no support! Keep up the great work of exercise and of moving forward with the vision of a complete recovery. Slow and steady wins the race. We are cheering you on. Warmest regards, Gretchen

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