PT Management of Posterior Tibial Tendon Dysfunction in a Patient with History of Guillain-Barré Syndrome and Anxiety

Document Type

Poster

Start Date

28-4-2026 12:00 PM

End Date

28-4-2026 2:00 PM

Description

Introduction: Treating patients with lengthy medical history and multimorbidity increases their complexity when assessing and managing their plan of care. Posterior tibial tendon dysfunction (PTTD) is a progressive condition characterized by dysfunction of the posterior tibial tendon resulting in pain, swelling, and loss of medial arch height that can progress to adult-acquired flatfoot deformity. Guillain-Barré Syndrome (GBS) can result in long-term neuromuscular impairment which further complicates rehabilitation efforts. Psychosocial barriers such as anxiety and depression can significantly impact patient adherence to therapy and clinical outcomes.

Purpose :The purpose of this case report is to emphasize the need for personalized patient care and the use of a multifaceted approach, such as the ICF model, for patient centered care.

Methods: The patient is a 74-year-old female with a primary diagnosis of right-sided pes planus and posterior tibial tendon dysfunction, later diagnosed with left-sided PTTD. Skilled physical therapy included progressive strengthening, manual therapy, proprioceptive training, orthotic education, and patient education with progression from isometric exercises to eccentric loading of the tendon.

Results: Improvements in ROM and manually resisted MMTs were noted with reduced irritability and decreased pain. Functional improvements were demonstrated by the LEFS score improving from 34 to 52.

Discussion: This case highlights the importance of addressing biomechanical, neuromuscular, and psychological factors when treating patients with complex comorbidities.

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Apr 28th, 12:00 PM Apr 28th, 2:00 PM

PT Management of Posterior Tibial Tendon Dysfunction in a Patient with History of Guillain-Barré Syndrome and Anxiety

Introduction: Treating patients with lengthy medical history and multimorbidity increases their complexity when assessing and managing their plan of care. Posterior tibial tendon dysfunction (PTTD) is a progressive condition characterized by dysfunction of the posterior tibial tendon resulting in pain, swelling, and loss of medial arch height that can progress to adult-acquired flatfoot deformity. Guillain-Barré Syndrome (GBS) can result in long-term neuromuscular impairment which further complicates rehabilitation efforts. Psychosocial barriers such as anxiety and depression can significantly impact patient adherence to therapy and clinical outcomes.

Purpose :The purpose of this case report is to emphasize the need for personalized patient care and the use of a multifaceted approach, such as the ICF model, for patient centered care.

Methods: The patient is a 74-year-old female with a primary diagnosis of right-sided pes planus and posterior tibial tendon dysfunction, later diagnosed with left-sided PTTD. Skilled physical therapy included progressive strengthening, manual therapy, proprioceptive training, orthotic education, and patient education with progression from isometric exercises to eccentric loading of the tendon.

Results: Improvements in ROM and manually resisted MMTs were noted with reduced irritability and decreased pain. Functional improvements were demonstrated by the LEFS score improving from 34 to 52.

Discussion: This case highlights the importance of addressing biomechanical, neuromuscular, and psychological factors when treating patients with complex comorbidities.