Role of Physiotherapy in Adolescent Moyamoya Disease

Abstract

Moyamoya disease (MMD) is a rare, progressive cerebrovascular condition characterized by stenosis of the internal carotid arteries, leading to ischemic and hemorrhagic strokes. Patients often present with motor deficits, balance impairments and reduced functional mobility, necessitating comprehensive rehabilitation to regain independence. This case report involved a 19-year-old female patient with bilateral MMD who underwent encephalo-duroarterio-myo-synangiosis (EDAMS) surgery followed by a two-month postoperative physiotherapy program. Interventions included strength training and balance exercises. Progress was systematically tracked using the Rivermead mobility index and Berg balance scale, with weekly mobility and functional independence assessments.The patient demonstrated significant improvements in mobility and balance. RMI scores improved from 1/15 at baseline to 13/15, while BBS scores increased from 0 to 52 over eight weeks. Structured physiotherapy interventions focusing on balance and strength training have led to marked improvements in postural stability, allowing the patient to regain independent ambulation and perform activities of daily living without assistance.This case report highlighted the critical role of physiotherapy in rehabilitating patients with MMD. Early, individualized interventions can significantly enhance motor recovery, improve balance, and restore functional independence. Continued research is necessary to further optimize rehabilitation protocols for MMD patients.