NSMRI-Based Physiotherapy for Combined-Type ADHD in a 6-Year-Old Child: A Case Report

Hasna Ghoida; Tiara Fatmarizka; Novy Hikmah

doi:10.24843/

Authors

Hasna Ghoida Professional Physiotherapy Education Program, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia Author
Tiara Fatmarizka GFBN Physiotherapy Clinic, Yogyakarta, Indonesia Author
Novy Hikmah GFBN Physiotherapy Clinic, Yogyakarta, Indonesia Author

DOI:

https://doi.org/10.24843/

Keywords:

Attention Deficit Disorder with Hyperactivity, Child, Motor Skills Disorders, Physical Therapy Modalities, Sensory Integration

Abstract

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by persistent inattention, hyperactivity, and impulsivity that may be accompanied by sensory processing dysfunction and motor coordination impairments. Evidence regarding the application of Neurosensorimotor Reflex Integration (NSMRI) in pediatric physiotherapy remains limited.
Objective: To describe the clinical outcomes of an NSMRI-based physiotherapy program in a 6-year-old child with combined-type ADHD.
Methods: A CARE-guideline-based case report was conducted involving a 6-year-old boy with combined-type ADHD, sensory processing dysfunction, and suspected developmental coordination disorder. The participant received a three-week physiotherapy program consisting of NSMRI-based activities, sensorimotor stimulation, manual therapy, Brain Gym exercises, facial stimulation, oral stimulation, caregiver education, and a home program. Outcomes were evaluated using DSM-5 ADHD criteria, the Developmental Coordination Disorder Questionnaire (DCDQ), and the Short Sensory Profile (SSP) at baseline (T1), mid-intervention (T2), and post-intervention (T3).
Results: The DCDQ score increased from 41 at T1 to 45 at T2 and 46 at T3. The SSP total score increased from 106 at T1 to 111 at T2 and 118 at T3. Clinical observations indicated improved participation in structured activities, better task engagement, reduced distractibility, and improved sensory responsiveness. The participant continued to meet the diagnostic criteria for combined-type ADHD at the final evaluation.
Conclusion: In this case, an NSMRI-based physiotherapy program delivered within a multimodal rehabilitation approach was associated with positive changes in sensory processing, motor coordination, and attention-related behaviors. Further studies with larger samples and controlled designs are required.