Abstract
To explore the perceptions about traditional massage and its modified techniques among clinicians and families of the patients with spastic cerebral palsy. The qualitative, cross-sectional study was conducted from November 2019 to August 2020 in Sialkot, Pakistan, after approval from the ethics review committee of Riphah College of Rehabilitation Sciences, Islamabad, and comprised neuro paediatricians and paediatricians in Group A, parents of children with spastic cerebral palsy aged 8-15 years in Group B, and musculoskeletal physiotherapists and orthopaedic manual physical therapists in Group C. The professionals in groups A and C had a minimum of 5-year paediatric experience in government and teaching hospitals. Data was collected using a semi-structured pilot-tested questionnaire. Qualitative approach and thematic code analysis was used to analyse the collected data. Of the 26 subjects, 10(38.5%) were in Group A, 8(30.7%) in Group B and 8(30.7%) in Group C. Overall, there were 16(61.4%) males and 10(38.5%) females. Among the professionals, experience ranged 5-38 years in Group A, and 5-9 years in Group C. The identified themes were reforms in recommendations, and application of massage techniques, with the participants overwhelmingly favouring termination markers to prevent increase in hypertonicity in spastic cerebral palsy. Termination markers of massage should be considered in interventions to improve outcomes in children with spastic cerebral palsy.
Highlights
The documented prevalence rate of cerebral palsy (CP) is 1.5 to 4 per 1,000 live births [1]
Termination markers of massage should be considered in interventions to improve outcomes in children with spastic cerebral palsy
The results show that non-tested lubricants lead to skin allergic reactions in CP children
Summary
The documented prevalence rate of cerebral palsy (CP) is 1.5 to 4 per 1,000 live births [1]. In Pakistan, it was 1.22/1000 births reported in Swabi [2]. Affects 70-75% of the cases [3, 4] It is caused by multiple gestational risk factors [5]. It effects cognition impairment, behavioural changes, hyperreflexia and activity limitations ending up with musculoskeletal malformations [6]. Management options in practice include maximising the functional potentials of the affected child. One such intervention being traditionally practised is massage with a variety of techniques[7], such as Swedish massage, [8] deep friction massage [9], traditional
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