Manajemen fisioterapi untuk meningkatkan performa olahraga boccia pada anak dengan cerebral palsy diplegia: sebuah laporan kasus

Abstract

Background: Cerebral palsy (CP) diplegia is a neurological condition that occurs in infancy or early childhood, and permanently affects muscle control and coordination, with lower limb conditions more severe than upper limb. Symptoms can be an increase in muscle tone that causes spasticity in the feet. The arm muscles are generally less affected or not affected at all. Symptoms in addition to motor disorders can be accompanied by sensory and cognitive disorders. Management of physiotherapy with passive stretching (PS), peripheral joint mobilization (PJM), myofascial release technique (MRT), neurodevelopmental technique (NDT), boccia rehabilitation program (BRP) and aquatic exercise increase boccia sports performance in children with cerebral palsy diplegia. Case Report: A 16-year-old male patients with complaints of unable to stand upright, both legs experience stiffness, and hunchbacked body posture (kyphosis) and forward head. Complaints in patients cause limitations and disorders of motion and function, such as stiffness in both feet, decreased balance capability, decreased gross motor skills and decreased precision ability in throwing. The physiotherapy program was conducted in four meetings in four weeks and patients get physiotherapy programs in the form of PS, PJM, MRT, NDT, BRP and aquatic exercise. Physiotherapy programs get the results of an increase in functional abilities of balance and increase precision capabilities in the throw. Conclusion: Provision of PS, PJM, MRT, NDT, BRP and aquatic exercise programs increases the ability of functional balance and increase precision capabilities in throwing.   Latar Belakang: Cerebral palsy (CP) diplegia merupakan suatu kondisi neurologis yang terjadi pada masa bayi atau anak usia dini, dan secara permanen mempengaruhi kontrol dan koordinasi otot, dengan kondisi ekstremitas bawah lebih berat daripada ekstremitas atas. Gejalanya bisa berupa peningkatan tonus otot yang menyebabkan spastisitas di kaki. Otot lengan umumnya kurang terpengaruh atau tidak terpengaruh sama sekali. Gejala selain gangguan motorik bisa disertai gangguan sensori maupun kognitif. Penanganan fisioterapi dengan passive stretching (PS), peripheral joint mobilization (PJM), myofascial release technique (MRT), neurodevelopmental technique (NDT), boccia rehabilitation program (BRP) dan aquatic exercise meningkatkan performa olahraga boccia pada anak dengan diagnosa CP diplegia. Laporan Kasus: Pasien laki-laki berusia 16 tahun dengan keluhan belum bisa berdiri dengan tegak, kedua kaki mengalami kekakuan, dan postur tubuh bungkuk (kifosis) serta forward head. Keluhan pada pasien menyebabkan timbulnya keterbatasan dan gangguan gerak dan fungsi antara lain seperti kekakuan pada kedua kaki, penurunan kemampuan keseimbangan, penurunan kemampuan motorik kasar serta penurunan kemampuan presisi dalam lemparan. Program fisioterapi dilakukan sebanyak empat kali pertemuan dalam empat minggu dan pasien mendapatkan program fisioterapi berupa PS, PJM, MRT, NDT, BRP dan aquatic exercise. Program fisioterapi mendapatkan hasil adanya peningkatan kemampuan fungsional keseimbangan dan peningkatan kemampuan presisi dalam lemparan. Kesimpulan: Pemberian program PS, PJM, MRT, NDT, BRP dan aquatic exercise meningkatkan kemampuan keseimbangan fungsional serta meningkatkan kemampuan presisi dalam lemparan.