Effect of Neurodevelopmental Treatment and Myofascial Release in Spastic Quadriplegic Cerebral Palsy: A Case Report

Indy Viorohma Asinta Zahra; Agus Widodo; Ika Hayati

doi:10.24843/mifi.000001800

Authors

Indy Viorohma Asinta Zahra Physiotherapist Professional Education Program, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia Author
Agus Widodo Physiotherapist Professional Education Program, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia Author
Ika Hayati KRMT Wongsonegoro Regional General Hospital, Semarang, Indonesia Author

DOI:

https://doi.org/10.24843/mifi.000001800

Keywords:

cerebral palsy, spastic quadriplegia, neurodevelopmental treatment, myofascial release, muscle spasticity, neurological examination

Abstract

Background: Spastic quadriplegic cerebral palsy (CP) is a severe subtype characterized by generalized spasticity and significant motor developmental delay. Physiotherapy interventions such as Neurodevelopmental Treatment (NDT) and Myofascial Release (MFR) are commonly used; however, evidence regarding their combined effects remains limited.

Objective: To evaluate the effects of combined NDT and MFR on spasticity, neurological function, and gross motor ability in a child with spastic quadriplegic CP.

Methods: This study employed a single-case report design. A 1-year-old male with a history of prematurity (32 weeks gestation), low birth weight (1.5 kg), and prior Pediatric Intensive Care Unit admission presented with severe motor delay and generalized spasticity. The intervention consisted of NDT and MFR administered twice weekly for four weeks. Outcomes were assessed using the Modified Ashworth Scale (MAS), Gross Motor Function Classification System (GMFCS), and Hammersmith Infant Neurological Examination (HINE). Data were analyzed descriptively using longitudinal comparison.

Results: Spasticity at the knee decreased from MAS 1+ to 1, indicating reduced resistance to passive movement. Neurological function improved, with HINE increasing from 34 to 39. However, no change was observed in gross motor function, as GMFCS remained at level V. These findings indicate clinically meaningful improvements in muscle tone and neurological status, despite unchanged functional mobility.

Conclusion: Combined NDT and MFR may improve spasticity and neurological function in severe CP, although gross motor improvements require longer-term intervention.