Tourette syndrome (TS) is a neurobiological disorder characterized by tics, which are repetitive, stereotypical, involuntary movements and vocalizations. Although the causes of TS are not completely understood, previous studies indicated that many children with TS not only experience comorbid conditions such as a lack of concentration, hyperactivity, impulsive behavior, and obsessive-compulsive symptoms, but also demonstrate poorer motor skills than their peers with typical development. There

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... limited information on health-related fitness exercises and/or physical therapy for children with TS. A 12-year-old boy with TS demonstrated below-age appropriate motor function with a less optimal musculoskeletal condition, including pain in the posterior portion of both lower extremities. After performing individualized health-related physical fitness exercises, he demonstrated a better muscu-loskeletal condition and motor function. Unexpectedly, he reported he was able to suppress motor tics occasionally by doing stretching exercises. The results suggest that evaluation and management of health-related fitness may be helpful for children with TS. These promising results warrant further investigation of the impact of health-related physical exercises on children with TS. (Chang Gung Med J 2011;34(6 Suppl):4-9) T ourette syndrome (TS) is a childhood-onset neu-robiological disorder characterized by tics, which are repetitive, stereotypical, involuntary movements and vocalizations. (1,2) TS is more common than was previously estimated; approximately 1% of children aged 5-17 years have TS, and 3-6% have tics but do not have all criteria for a diagnosis of TS. (3) Children with TS frequently experience the negative influences of tics and comorbid conditions , (4,5) and also demonstrate health-related fitness problems with fine motor skills, (6-8) insufficient balance control, (9-11) and physical pain due to tics or other unknown reasons. (12) Despite evidence showing that children with TS demonstrate poor health-related quality of life (13) and physical functioning, (6-11) interventional strategies for these children frequently focus only on decreasing tic severity and/or improving behaviour and emotional control, and pay little attention to the children's health-related physical fitness. There is, to our knowledge, no report that describes the effectiveness of health-related fitness exercises and/or physical therapy in children with TS. Therefore, the aim of this case report is to describe an integrated physical therapy program with an emphasis on health-related physical fitness for a child with TS.