Physiotherapy Management of Quadriplegic Cerebral Palsy Following Tuberculous Meningitis: A Case Report

Ifa Aulia Musyarifah Putri; Wahyuni; Ika Hayati

doi:10.24843/mifi.000001824

Authors

Ifa Aulia Musyarifah Putri Physiotherapist Professional Education Program, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Surakarta, Central Java, Indonesia Author
Wahyuni Physiotherapist Professional Education Program, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Surakarta, Central Java, Indonesia Author
Ika Hayati RSWN Semarang, Semarang, Central Java, Indonesia Author

DOI:

https://doi.org/10.24843/mifi.000001824

Keywords:

Cerebral Palsy, Tuberculous Meningitis, Physical Therapy Modalities, Muscle Spasticity, Neurodevelopmental Treatment

Abstract

Background: Cerebral palsy (CP) is a non-progressive motor disorder resulting from early brain injury. Tuberculous meningitis (TBM) is a severe central nervous system infection that can lead to permanent neurological impairment, including spastic quadriplegic CP. Early physiotherapy is essential to optimize functional outcomes in affected infants.

Objective: To describe the clinical outcomes of a structured physiotherapy program in an infant with quadriplegic cerebral palsy following tuberculous meningitis.

Methods: A case report was conducted on a 7-month-old male infant diagnosed with quadriplegic CP secondary to TBM. Baseline assessment included Modified Ashworth Scale (MAS), Hammersmith Infant Neurological Examination (HINE), Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), and Eating and Drinking Ability Classification System (EDACS). The patient received physiotherapy based on Neurodevelopmental Treatment (NDT), including positioning, sensory stimulation, head and trunk control exercises, hand function training, and spasticity inhibition. The intervention was delivered three times per week for four weeks.

Results: Spasticity decreased across multiple joints, particularly in finger flexors (MAS 3 to 2) and knee extensors (MAS 3 to 2). The HINE score improved from 33 to 42, indicating enhanced neurological function. Functional classifications remained unchanged (GMFCS IV, MACS IV, CFCS IV, EDACS I), reflecting persistent severe functional limitations.

Conclusion: A structured physiotherapy program based on NDT may improve neuromotor outcomes in infants with quadriplegic CP following TBM. However, findings should be interpreted cautiously due to the single-case design.