The effect of early physical therapy rehabilitation on functional motor ability in a child with a type of Dandy-Walker syndrome associated with blindness

Abstract

This study aimed to identify the impact of early rehabilitation through physical therapy in improving functional motor ability in a child diagnosed with Dandy-Walker syndrome accompanied by blindness, by monitoring the development of motor and functional performance throughout a long-term rehabilitation period. The researchers employed an experimental approach using a case study design, involving a single child diagnosed with Dandy-Walker syndrome accompanied by blindness, who was purposively selected from among children attending the Physical Therapy Department at Al-Fahd Physical Therapy Center in Cairo, Egypt. The rehabilitation program was implemented over a period from November 21, 2023, to July 15, 2025, and was based on task-oriented functional therapeutic activities focusing on improving postural control, balance, motor coordination, muscle strengthening, and training in motor transitions and walking. The Manual Muscle Testing (MMT), a functional mobility assessment form, clinical observation, and pre- and post-evaluations were used to assess performance levels.

The results showed gradual and significant improvement in the child's motor and functional abilities; he progressed from an inability to control his head or sit independently to achieving better trunk control and balance, followed by independent standing and walking, running, climbing stairs, and safely negotiating obstacles. Muscle strength also improved from grade (3/5) to grade (5/5) according to the Manual Muscle Testing (MMT), which positively reflected on the level of functional independence despite the child's blindness.

The study concluded that early and continuous rehabilitation through physical therapy represents an effective intervention in improving functional motor ability in children with Dandy-Walker syndrome, even in cases accompanied by severe sensory impairments. It also emphasizes the importance of early initiation of rehabilitation programs, their continuity, and their design according to the individual needs of each case, while enhancing collaboration between the rehabilitation team and the family to achieve the best functional outcomes.