Multimodal Physiotherapy for Spasticity and Motor Function in Diplegic Cerebral Palsy: A Case Report

Abstract

Background: Spastic diplegic cerebral palsy is a neurodevelopmental disorder characterized by lower limb spasticity and impaired gross motor function. Although physiotherapy is widely applied, evidence regarding the clinical effectiveness of multimodal interventions remains limited, particularly in individual case contexts. This case highlights the short-term effects of a structured multimodal physiotherapy approach in a real-world clinical setting with limited resources.

Objective: To evaluate the clinical outcomes of a multimodal physiotherapy program on spasticity and gross motor function in a child with spastic diplegic cerebral palsy.

Methods: This study employed a single-case report design. A 3-year-8-month-old male with spastic diplegic cerebral palsy received a 4-week multimodal physiotherapy intervention consisting of passive range of motion, neurosensory stimulation, stability and proprioception training, and gait training. Spasticity was assessed using the Modified Ashworth Scale (MAS), and functional ability was measured using the Gross Motor Function Measure (GMFM-88). Outcomes were recorded across five time points (T1–T5) and analyzed descriptively.

Results: Spasticity decreased from grade 3 to 2 in the knee and ankle joints, while remaining stable at grade 2 in the hip. No changes were observed in muscle strength, which remained dominated by reflex and passive tone patterns. The GMFM total score increased from 34.3% to 36.6%, with improvements across all dimensions, particularly in standing and mobility-related activities.

Conclusion: Multimodal physiotherapy demonstrated gradual improvements in spasticity and gross motor function; however, no transition from reflexive to voluntary motor control was observed. These findings should be interpreted cautiously due to the single-case design and limited generalizability.