Multidisciplinary physical rehabilitation program of individuals with spinal muscular atrophy in an inclusive school setting.
Faruq Ahmed, Asma Islam, Suria Akter and 4 others
PMID 38007681WHAT IT FOUND
A nine-year-old girl with type 2 SMA improved in sitting and rolling after a year of combined physiotherapy and hippotherapy.
She sustained sitting for five minutes and gained strength, but could not walk. This single case cannot prove the treatment works.
Key findings
01After one year of a combined physiotherapy and hippotherapy program, the child's overall Gross Motor Function Measure-88 score increased from 29.24% to 37.70%, with improvements in lying/rolling, sitting, crawling/kneeling, and standing dimensions, but no change in walking/running.
02The child progressed from needing assistance to sit to sustaining an independent sitting position for five minutes, and her Hammersmith Functional Mobility Scale score improved from 10/66 to 26/66.
03Muscle strength improved in both upper and lower extremities, with notable gains in elbow extension (Grade 3- to 4) and finger flexion (Grade 2+ to 4) on manual muscle testing.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a single case report, so the results cannot be generalized to other children with SMA. The child received two different treatments (physiotherapy and hippotherapy) at the same time, so it is impossible to tell which one caused the improvement. There was no control group, so natural development or other factors could have contributed to the changes. The child did not gain the ability to walk, and the walking/running dimension of the GMFM-88 showed no change. The authors noted that the school staff lacked proper knowledge about SMA, which may have influenced the care environment.
Declared interests
The study was supported by Non-U.S. Government funding. No other conflicts of interest were declared in the provided text.
The easy way to misread this
Do not conclude that physiotherapy alone caused the improvement, as the child also received hippotherapy simultaneously. Additionally, do not expect this level of motor gain in all children with type 2 SMA, as this is a single case report without a control group.