Studi Kasus : Program Fisioterapi Pada Pasien Cerebral Palsy Spastic Quadriplegia Dengan Konsep Pendekatan Orientasi Tengah Tubuh

Objective : to determine the effectiveness of the physiotherapy program using soft tissue
manipulation techniques, massage, positioning and cortical level stimulation on the
mid-body orientation ability of spastic quadriplegia cerebral palsy patients.
Methods : This article uses a case study design on a 2.5 year old spastic quadriplegia cerebral palsy patient. The study was conducted at the clinic for 1 month with 3x per week
for 1 hour of exercise per meeting. The tools used are mattresses, olive oil, toys with colors
and sounds that attract the patient. The variables measured were changes in posture
symmetry by photographic observation, the ability to move in the middle of the body
with the GMFM measuring instrument in sector A only and parental story related to
postural tone and children's sleep patterns at night by interview. Measurements were
made at the first meeting and the last meeting (12th meeting).
Results : After 12th meeting we can see directly that In the supine position, head and
body in 1 line, eye contact appears very well, facial expressions show that the child's
cognition and understanding of the environment begins to emerge). In the GMFM
measurement increasing from 0% to 5.8%, descriptively the child began to have initiation to the middle of the body, both hands began to be interested in holding the toy. The
results of interviews with parents also showed that the child's stiffness began to decrease,
the child was more relaxed, unlike the first meeting which was dominated by a stiff
body. On the quality of sleep at night, it was found that the child slept more soundly,
and at a regular time.
Conclusion : Physiotherapy programs : soft tissue manipulation, positioning and cortical level exercises for spastic quadriplegia CP children with problems with mid-body
asymmetry, tone and sleep patterns have been shown to increase mid-body symmetry,
reduce postural tone, improve hand movement and improve sleep quality.