The feasibility and effectiveness of functional neurorehabilitation combined with cognitive-behavioral framework, on an adult patient with cerebral palsy: A case report.

Abstract

Introduction: Adults with cerebral palsy (CP) may have reduced motivation or interest in exercising, whereas exercise or even an active lifestyle could provide them the greatest possible degree of independence and functionality. It is proposed that patient-centered intervention can increase adherence to exercise and as a result change the patient's lifestyle. Cognitive and Behavioral Therapy (CBT) is a task-oriented approach that deals with cognitive beliefs and behaviors, and it is considered to be effective in lifestyle changes. This case report examined the effect of a functional physiotherapy intervention with cognitive and behavioral principles treatment, on an adult with CP.

Case description: The patient was a 52-year-old male with bilateral (diplegia) spastic cerebral palsy (level 3 according to Gross Motor Function Classification System - GMFCS) and prolonged inactivity. The patient engaged in a combination of a functional exercise program with cognitive and behavioral approach treatment. A tailored program of progressive exercises for 20 weeks was used to address patient's functional limitations. A combination of functional tests was used in order to monitor the progress.

Outcomes: The patient presented a gradual improvement in values of balance and strength at 6 and 20 weeks as well as of fear of fall at 20 weeks.

Discussion: The positive outcomes from this new combination therapy for this patient are encouraging the opinion that a patient-centered intervention with enjoyable sessions and meaningful program based on CBT principles can increase adherence to exercise program, and as a result change the lifestyle.