Towards Shared Protocols in AMC Physiotherapy: Developing Personalized Models Based on Multidimensional Functional Assessment

Abstract

Arthrogryposis Multiplex Congenita (AMC) is a rare, non-progressive condition marked by congenital joint contractures and varying degrees of neuromuscular impairment. Its clinical heterogeneity poses significant challenges for physiotherapists in designing effective, consistent rehabilitation pathways. A recent systematic review highlighted the fragmented nature of existing interventions and the urgent need for structured yet adaptable treatment models.

This article proposes a shared and modular physiotherapy protocol for individuals with AMC, grounded in multidimensional functional assessment. The approach integrates key domains such as joint mobility, muscle strength, posture, respiratory function, daily living activities, and psychosocial context. By segmenting rehabilitation into age- and severity-specific modules, the proposed model enables clinicians to tailor interventions while maintaining coherence across care settings.

Techniques including kinesitherapy, hydrotherapy, respiratory training, orthotic support, and occupational therapy are incorporated within flexible modules. Clinical goals are defined through SMART criteria, fostering measurable outcomes and patient-centered progression. A consensus-building process, such as Delphi methodology, is suggested to validate the model among experts.

Expected benefits include enhanced treatment efficacy, reduced clinical variability, improved adherence, and greater caregiver engagement. The model aims to transform AMC rehabilitation from a case-by-case challenge into a replicable and scalable practice. Future research directions include pilot implementation studies, multicentric validations, and the integration of digital monitoring tools.

This article marks a transition from evidence synthesis to operational design, offering a practical framework for standardized, personalized care in AMC physiotherapy.