Enhancing the Functional Recovery of Upper Extremities in Guillain Barre Syndrome for 10-year-Old by Combining Immersive Virtual Reality with Conventional Rehabilitation - A Unique Case Study

Abstract

Background: Guillain-Barré Syndrome (GBS) is a rare autoimmune disorder affecting the peripheral nervous system, characterized by muscle weakness and pain. While conventional physiotherapy (PT) is a standard treatment, emerging technologies like immersive virtual reality (IVR) may enhance the rehabilitation outcome. Objective: This case study aimed to investigate the efficacy of combining IVR with conventional PT in the rehabilitation of a 10-year-old male diagnosed with GBS, focusing primarily on upper extremity (UE) function. Methods: The patient presented with bilateral weakness in the upper and lower extremities, along with difficulty in transitioning between positions, and reported pain in B/L UE. Conventional PT, supplemented with IVR specifically targeting UE function, was administered. Outcome measures included pain assessment using the Numerical Pain Rating Scale (NPRS), muscle power evaluation via the Medical Research Council scale (MRC), and functional independence assessed with the Functional Independence Measure (FIM). Results: Following the intervention, the patient exhibited significant improvements in pain reduction from 8/10 to 1/10, muscle power in the shoulder and elbow from 2/5 to 4/5, and wrist and finger muscles from 3/5 to 4/5. Additionally, enhancements in self-care and transfer components of FIM demonstrated increased independence in activities of daily living. Conclusion: Combining IVR with conventional PT provides a unique rehabilitation approach that enhances recovery. This approach fosters active participation, immersion, and motivation within a stimulating and enjoyable environment, which is particularly appealing for a 10-year-old patient. This case study represents the pioneering use of virtual reality in pediatric Guillain-Barré Syndrome rehabilitation, particularly in the Indian context. Key words: Guillain Baree Syndrome, Immersive Virtual Reality, Pediatric rehabilitation, Gamified exercise program.