Potential effects of traditional massage on spasticity and gross motor function in children with spastic cerebral palsy: A randomized controlled trial.

Qamar Mahmood,Dr Shaista Habibullah,Prof Dr Muhammad Naveed Babur

doi:10.12669/pjms.35.5.478

Abstract

Objective:To evaluate the effects of traditional massage (TM) on spasticity and gross motor function in children with cerebral palsy (CP).Methods:This randomized control trial (RCT) was conducted with recruitment of 86 children (Dropped out= 11; Analyzed= 75) with spastic CP (diplegia) allocated randomly through sealed envelope method to intervention and control group with ages between 2-10 years from September 2016 to August 2018. Both groups received conventional physical therapy (CPT) once daily, five times a week for a period of three months. However, intervention group received TM additionally. Modified Ashworth Scale (MAS), Gross Motor Function Measure (GMFM-88) and Gross Motor Function Classification System (GMFCS) were used to evaluate spasticity and gross motor function at the beginning, after six and 12 weeks of intervention. Data were compared and analyzed through SPSS-20.Results:Mean age in control and intervention group was 6.81±2.31 and 7.05±2.47 years respectively. No statistically significant differences in MAS, GMFM and GMFCS scores were found at base line. The children in intervention group showed statistically significant reduction in MAS scores in all four limbs after six and 12 weeks of intervention (p < 0.05) in comparison with the control group. However, GMFM scores and GMFCS levels did not change significantly in intervention group as compared to control group.Conclusion:It is concluded that TM can effectively reduce the spasticity, does not have harmful effects, so can be administered safely by mothers at home and making it suitable for the management of spastic CP. However, in order to achieve better gross motor function, it should be practiced in conjunction with CPT, functional skills and task oriented approaches.

Highlights

Cerebral palsy (CP) is considered as the most common type of physical disability presenting in pediatric population across the globe.[1]
Traditional massage (TM) which is practiced in its own way in each society without special training, education or certification
In Pakistan, traditional massage (TM) is mostly performed by mothers or care givers in a way quite different to Swedish massage which is considered as a standard amongst the professionals

Summary

Introduction

Cerebral palsy (CP) is considered as the most common type of physical disability presenting in pediatric population across the globe.[1] Worldwide population-based studies have reported its prevalence estimates which range from 1.5 to 4 per 1,000 live births.[2] CP produces disorders of tone, movement and posture. Many interventions are in use to manage the disabling and lifelong effects of CP. Novak et al categorized 64 such interventions which are in current use for the management of CP and amongst these massage is included.[4] Practice of massage shows different and unique forms across the globe for which masseurs are educated, trained and certified.[5] traditional massage (TM) which is practiced in its own way in each society without special training, education or certification. In Pakistan, TM is mostly performed by mothers or care givers in a way quite different to Swedish massage which is considered as a standard amongst the professionals

Methods

Results

Conclusion