Efficacy of Physiotherapy in Moya Moya Disease: A Case Report

Abstract

Moyamoya disease (MMD) is a rare, progressive cerebrovascular disorder involving stenosis of the internal carotid arteries and collateral vessel formation, increasing the risk of paediatric ischemic and haemorrhagic strokes. Affected children often exhibit hemiplegia, balance issues, and gait abnormalities, necessitating early physiotherapy rehabilitation. This case study evaluated a 12-week physiotherapy program aimed at improving motor function, balance, and independence in a six-year-old girl with MMD and left-sided hemiplegia.The study followed a single-case therapeutic intervention design. Following baseline assessments, the child underwent a structured 12-week physiotherapy program consisting of electrical stimulation, motor re-education, task-oriented balance training, lower-limb strengthening, and gait training. Outcome measures included the Gross Motor Function Measure (GMFM), Pediatric Balance Scale (PBS), and Modified Ashworth Scale (MAS). Pre- and post-intervention scores were compared to evaluate functional gains and changes in muscle tone. Post-intervention results demonstrated substantial improvement across all domains. GMFM scores increased from 56% to 90%, indicating marked enhancement in gross motor abilities. The PBS score improved from 8/56 to 52/56, reflecting significant gains in postural control and balance. A reduction in MAS grades was observed, suggesting decreased spasticity in the affected extremities. The child demonstrated noticeable improvements in gait stability, day-to-day participation, and independence in mobility activities. This case study highlights the positive impact of a comprehensive, individualized physiotherapy program on motor performance and independence in a child with Moyamoya disease. Early, targeted rehabilitation can play a crucial role in optimizing functional outcomes in paediatric MMD, underscoring the need for sustained therapeutic intervention.