Intensive physiotherapy with subsequent community-based rehabilitation: two cases of cerebral malaria in rural areas of Malawi

Abstract

[Purpose] This study aimed to elucidate the effect of intensive physiotherapy and community-based rehabilitation on motor function for patients with cerebral malaria in the rural areas of Malawi. [Participants and Methods] The participants were 10- and 9-year-old children with cerebral malaria. At ages 8 and 6 years, they contracted malaria, and their motor function decreased to Gross Motor Function Classification System level III. They underwent intensive physiotherapy for 2 weeks administered by their mothers and volunteers, who were taught rehabilitation exercises. The improvements in the participants' motor functions were assessed after completion of therapy and 2 months later. [Results] In case 1, no improvement was observed in the 88-item Gross Motor Function Measure (GMFM-88) score after intensive physiotherapy. However, after 2 months of intensive physiotherapy, the total score improved by 6% from 61% to 67%, and the scores for the target areas improved from 12% to 20%. In case 2, the total GMFM-88 score improved from 66% to 68% during physiotherapy and further improved from 68% to 78% after 2 months. The score for the target areas improved from 25% to 26% and further improved from 26% to 49% after 2 months. [Conclusion] The participants in this study achieved improvements in GMFM-88 score after receiving intensive rehabilitation by community members. The effect was more pronounced after 2 months than immediately after intensive physiotherapy.