Multimodal Physiotherapy for Functional Improvement in Spastic Diplegic Cerebral Palsy: A Case Report

Abstract

Background: Spastic diplegic cerebral palsy is characterized by motor impairment, spasticity, and limitations in functional activities. Evidence regarding the effectiveness of combining multiple physiotherapy modalities remains limited.
Objective: To evaluate the clinical outcomes of a multimodal physiotherapy program consisting of myofascial release, stretching exercise, strengthening exercise, and functional exercise in a child with spastic diplegic cerebral palsy.
Methods: This case report involved a 16-year-old male with spastic diplegic cerebral palsy classified as Gross Motor Function Classification System (GMFCS) level III. The patient underwent six physiotherapy sessions over three weeks at YPAC Prof. Dr. Soeharso Surakarta. Outcomes were assessed using the Gross Motor Function Measure-88 (GMFM-88), Modified Ashworth Scale (MAS), Barthel Index (BI), and GMFCS.
Results: Gross motor function improved, with the GMFM-88 score increasing from 66.0% at baseline to 70.0% after intervention. Improvement was primarily observed in standing ability, with Dimension D increasing from 33% to 38%, whereas walking, running, and jumping performance remained unchanged (Dimension E = 13.8%). Spasticity showed minimal change, while functional independence remained stable with a BI score of 90. GMFCS classification remained at level III.
Conclusion: Multimodal physiotherapy was associated with improved gross motor function and maintenance of functional independence in a child with spastic diplegic cerebral palsy. However, changes in spasticity were limited, and the findings cannot be generalized beyond this single case.