Tailored Physiotherapy Management of Motor Neuron Disease with Predominant Lower Motor Neuron Involvement in a Young Adult: A Case Report

Background: Motor neuron disease (MND) is a progressive neurodegenerative disorder involving degeneration of upper and/or lower motor neurons, resulting in muscle weakness and functional decline. Progressive muscular atrophy (PMA) represents a lower motor neuron–predominant phenotype within the MND spectrum and commonly presents with distal limb weakness and progressive disability. Objective: To describe the clinical, electrophysiological, and functional outcomes of a young adult with lower motor neuron–predominant motor neuron disease managed with tailored physiotherapy rehabilitation. Methods and Materials: A middle aged male with progressive bilateral lower limb weakness for one year and tingling sensations for six months was evaluated clinically and electrophysiologically. He had a prior history of lumbar laminectomy following a road traffic accident and was a known case of MND. Assessment included neurological examination and electromyography, which demonstrated a neurogenic pattern consistent with predominant lower motor neuron involvement. A structured, goal-oriented physiotherapy program focusing on strength maintenance, balance training, gait re-education, and functional mobility was implemented. Results: Post-rehabilitation assessment revealed improvement in balance, ambulation, functional independence, and activities of daily living, with stabilization of muscle strength and improved gait safety. Conclusion: Early diagnosis and individualized physiotherapy intervention play a crucial role in preserving functional abilities and improving quality of life in patients with lower motor neuron–predominant motor neuron disease.