Role of Physiotherapy Intervention in Adult Moya Moya Disease - A Single Case Study

Abstract

Moya Moya disease is a progressive stenotic occlusive disease of the bilateral carotid bifurcations with the formation of fine collateral networks with an angiographic diagnosis. These abnormal blood vessels at the base of the brain were first described by the Japanese Takeuchi and Shimizu in 1957 as a cloudy cloudy plume of smoke leading to the term Moya Moya. To date the structured rehabilitation program for the patients with Moya Moya disease has not been well documented. This case report illustrates the effectiveness of the structured eight-week intensive rehabilitation program SEIRP in an individual rehabilitating with Moya Moya disease. A participant who was diagnosed with Moya Moya disease presented to us at the age of 33 years. The patient was evaluated using the shoulder pain and disability index SPADI Disability of arm shoulder and hand DASH Wolf motor test Berg balance scale and One Min-Step test. Physiotherapy intervention was done based on the impairments to improve motor function. The participant was given an intensive physiotherapy program which included a strengthening and functional exercise program for a period of eight weeks. Each treatment session lasted for about 60-90 minutes per day five days per week. SPADI DASH and Wolf motor test were administered two times in eight weeks. Pre-test total score of 101 46 were observed for SPADI and DASH respectively whereas Wolf motor test showed a score of 50 and 70 for the right and left hands respectively. Post the eight-week intervention SPADI and DASH total scores improved to 35 and 22 respectively. Wolf motor test score was 65 for the right hand and 74 for the left hand. This case report highlighted the importance and efficacy of a tailor-made structured protocol which is feasible and beneficial in improving the functional abilities of patients with Moya Moya disease.