Biofeedback treatment of upper extremity dysfunction in Guillain-Barré syndrome

Two cases are presented of the application of electromyographic biofeedback for increasing activity of wrist and finger musculature in patients with Guillain-Barré syndrome. Patient 1, a 59-year-old woman, quadriplegic, and on a portable respirator for more than five years prior to biofeedback was given visual and auditory feedback for increased output of wrist flexor, finger flexor, and thumb opposition muscles, bilaterally. All muscles improved in activity, 9/12 significantly, although no marked improvements in activities of daily living functions were noted. Patient 2, a 51-year-old man who had experienced good motoric return following onset of the disease, was given feedback for increased activity of finger extensor, finger adductor, thumb and fifth finger opposition, wrist extensor, and finger flexor muscles, bilaterally. Of 18 muscles or muscle groups treated, 17 showed significant increases in output. This patient became ADL functional. It is believed that biofeedback can be an important modality of treatment in this disease even following termination of more traditional therapies, as was true in the present cases, and that greater attention should be paid to patients with Guillain-Barré syndrome than has been to date. It is suggested that biofeedback be initiated, along with other therapies, once the acute stage of the disease is past.