Submit Manuscript | http://medcraveonline.com Introduction West syndrome (WS) is an epileptic syndrome of the infant occurring between the 3rd and 12th months of life. 1 Its incidence varies between 2.9 and 4.5per 10,000 live births. 2–5 The prevalence is approximately 1/4000 -1/6000[6], and in 70% of cases, patients are male. 2,3 West syndrome is caused by a brain dysfunction whose origins can be prenatal, neonatal and postnatal. 6 It is an epileptic encephalopathy in which the deterioration of brain functions (cognitive, sensory and motor) is due to seizure. 7 Sensory integration (SI) theory was originally developed by A. Jean Ayres to focus on the neurological processing of sensory information. 8 SI theory is based on the understanding that interferences in neurological processing and integration of sensory information disrupt the construction of purposeful behaviors. 9 Interventions based on the classic SI theory use planned, controlled sensory input in accordance with the needs of the child and are characterized by an emphasis on sensory stimulation and active participation of the client and involve client-directed activities. 10 The Neuro Developmental Treatment (NDT) method is currently perceived as one of the leading methods in the rehabilitation. 11,12 A key role in the method is played by the neural plasticity of the central nervous system (CNS): its ability to be changed (in both structure and functions) in response to stimuli such as various activities, changes in the environment etc. 1 It is now well known that gross motor movements are heavily dependent on sensory system. 14 Hence the purpose of this study is to combined sensory integration approach with NDT to enhance the home and community participation of a child. Case description This is a follow-up cases study of 5 years old male child across his life from 1 year to 5 years. Rohit (changed name) was delivered by normal vaginal delivery and had a history of cry immediately after birth. Rohit’s gross motor development was normal till 9 month of age he was sitting independently at 9 month. According to parent report he had a history of seizures at the 10 month of age. There after he lost his sitting balance.He was then diagnosed as a case of West syndrome. Rohit at the age of 1 year Rohit was brought to our therapy center by his parents with the chief concerns of inability to transit from supine to sit, sit independently, stand, and walk. When assisted to sit (against a wall or furniture), he could maintain sitting for a few minutes under supervision. For mobility he had to be carried manually or in a wheelchair. He was completely dependent on parents for his activity of daily leaving. Rohit had poor ability to visually focus and orient himself to the environment. His also did not respond to sound and name when called. He showed poor somatosensory, kinaesthetic and proprioceptive awareness throughout his body. He showed avoidance of touching objects in his hands and dislike feet touching hard surface and grass. Rohit also used to become aggressive and irritated on moving surfaces such as a simple swing, car. Rohit had diffculty in understanding basic commands and his age appropriate cognitive abilities were also challenged. In the neuromuscular system, Rohit had diffculty in recruiting postural muscles during various activities. Rohit could initiate postural muscle activity in sitting better than he could in standing but had diffculty sustaining it. His alignment and ability to sustain posture was poor in vertical postures. He could perform concentric and to some extent isometric muscle work, but he had extreme diffculty performing eccentric muscle work, with the trunk more affected than the extremities, and the lower extremities more affected than the upper extremities. Rohit demonstrated decreased co-activation of abdominal and back extensors, thus making it hard to assume and maintain vertical postures. As for the musculoskeletal system, he had poor strength generally in all postural muscles of the body.Tone of extremity and trunk muscles was towards lower side. Int Phys Med Rehab J. 2017;2(3):214‒216 214 © 2017 Kunde et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Combined sensory motor approach to enhance participation of a child with west syndrome: a follow-up case study Volume 2 Issue 3 - 2017 Chetana Ashok Kunde, 1 Suvarna Shyam Ganvirs 2 1 Assistant Professor in Department of PT in Neurosciences, DVVPF’s College of Physiotherapy, India 2 Professor and HOD in Department of PT in Neurosciences, DVVPF’s College of Physiotherapy, India Correspondence: Chetana Ashok Kunde, Assistant Professor in Department of PT in Neurosciences, DVVPF’s College of Physiotherapy Ahmednagar, India, Tel 9766874322, Email chetanakunde3@gmail.com Received: May 28, 2017 | Published: November 21, 2017 Abstract This is a follow up case report of male child with West Syndrome, brought to Physiotherapy department at the age of 1 year with a chief complaint of unable to transit to sitting, standing and walking. He had poor ability to focus and orient to environment and poor somatosensory, kinesthetic, and proprioceptive awareness throughout his body. Parents also complained that he becomes aggressive and irritated on moving surfaces. Treatment strategies were targeted towards specific impairments of the sensory, neuromuscular, and musculoskeletal systems to improve his gross motor abilities. At the early age of 1 year the score of GMFM was 3.98% and GMFCS level was V. At the age of 5 years there was increase in score of GMFM with 84.07% and GMFCS changed to level II indicating level of independence is also improved. This suggest that participation of a child with West Syndrome can be improved with combine sensory motor approach. Keywords: west syndrome, sensory-motor approach, community participation International Physical Medicine & Rehabilitation Journal Case Report Open Access