Abstract
This case report reports the effects of an 18-week physiotherapy program in children with mitochondrial membrane protein-associated neurodegeneration (MPAN). The study involved two brothers, aged 11 and 12, who had been diagnosed with MPAN. The physiotherapy program was divided into three phases and consisted of 18 weeks of training with a pediatric physiotherapist, including balance, coordination, and strengthening exercises. Muscle strength was assessed using pediatric manual muscle testing, functional balance using the Pediatric Berg Balance Test (PBBT), static balance using the Single-Leg Stance Test, dynamic balance using the Functional Reach Test, postural control using the 5-Time Sit-to-Stand Test, and independence using the Functional Independence Measure for Children (WeeFIM). Positive changes were observed in muscle strength, balance, and independence. After Phase I, PBBT scores (younger sibling +4, 8.1%; older +3, 6.8%) were higher than the minimal clinically important difference (MCID=3.66-5.83). After Phase III, although the PBBT scores improved (younger +2, 4.05%; older +1, 2.3%), the older sibling's score was not higher than the MCID. Thus, the two children showed visible improvements in both body structure and function, as well as activity and participation levels.