Physiotherapy Rehabilitation in Erythema Nodosum Leprosum Associated with Leprosy: A Case Report

Abstrak

Background: Erythema nodosum leprosum (ENL) is a type 2 leprosy reaction that may affect the skin, peripheral nerves, and musculoskeletal system, causing pain, sensory and motor impairment, restricted range of motion (ROM), and functional limitations. Evidence on physiotherapy management during active ENL remains limited.
Objective: To describe the clinical changes following physiotherapy management in a patient with active ENL associated with leprosy.
Methods: A 32-year-old man with ENL associated with leprosy was hospitalized at Dr. Tadjuddin Chalid General Hospital, Makassar. Assessment included pain, muscle strength, ROM, sensory function, static balance, and functional independence using the Visual Analogue Scale, Manual Muscle Testing, Semmes-Weinstein Monofilament, Single Leg Stand Test, and Barthel Index. The patient received three physiotherapy sessions comprising ROM exercises, stretching, strengthening, bridging, sensory re-education, grasping, sitting balance, and activities of daily living training.
Results: Pain decreased at rest (2 to 0), pressure (8 to 5), and movement (6 to 4). Improvements were observed in left wrist flexion (40° to 60°), extension (20° to 50°), right ankle dorsiflexion (7° to 15°), and plantarflexion (20° to 25°). The Barthel Index increased from 72 to 91. Single Leg Stand duration increased from 8 to 13 seconds on the right and 11 to 20 seconds on the left. MMT and sensory findings remained unchanged.
Conclusion: Clinical improvements were observed after three physiotherapy sessions; however, effectiveness cannot be established due to the single-case design, short observation period, and concurrent medical treatment.