Individualized intermittent intensive physiotherapy program to improve the standing balance in a child with spastic diplegia: a case report

ABSTRACT

Conventional physiotherapy is effective in improving the strength, coordination, balance and independence in functional abilities in a child with cerebral palsy. Recent evidences proved that intermittent intensive physiotherapy [HPT] is effective for children with cerebral palsy [CP], but it described inconsistently throughout the research. So the purpose of this case report was to find out the effectiveness of an individualized intermittent intensive physiotherapy program for a child with CP. The patient was a 4.5 year old boy with spastic diplegia. Gross Motor Function Classification System [GMFCS] level III. The intermittent intense physiotherapy was tried over an 8 week period. Therapy session included a 3 week, 3 times per week intensive therapy phase, followed by a 1 week resting phase. Intervention included stretching, strengthening exercise; balance training and family instruction. Outcomes were assessed by using the quadriceps strength, knee range of motion, double leg balance time, one minute walking test and Gross Motor Functional Measure [GMFM] - 66. The patient demonstrated a gradual increase in quadriceps strength [R-60 / 20 to 95/ 20, L- 73/20 to 95/ 20], knee range of motion [R - 110 [degree sign] to 120 [degree sign], L-118 [degree sign] to 128 [degree sign], double leg balance time [38 seconds to 102 seconds., one minute walking test [650 cm to 825 cm] and GMFM-66 [61 to 68] scores throughout the 8 week period covered by this case report, with the greatest mean change score obtained when the intermittent intensive therapy schedule was used. Patient were maintained the improved motor performance during rest periods. The intermittent intensive physiotherapy program was effective in this child with CP