Myofascial Structural Integration for Children with Cerebral Palsy
Project Description:
Cerebral Palsy (CP) is a non-progressive neurological disorder that permanently affects movement and coordination. Treatment focuses on reducing spasticity and improving functional abilities. Recent research shows that structural changes in the muscle and surrounding connective tissue (fascia) appear to contribute to the abnormally high muscle tension, stiffness, and exaggerated reflexes of CP. Preliminary results and clinical observations support the effectiveness of treatments targeting peripheral soft tissues; however, there have been few rigorous scientific evaluations of these methods.
In 2009 our team conducted a pilot study evaluating the therapeutic potential of a manual manipulation technique, Myofascial Structural Integration (MSI), as a complementary treatment for spasticity in CP. In MSI, therapists use directed pressure and deep massage, techniques that affect the layers of fascia and muscle and allow the muscles to slide past each other easily. The results from the study are promising, but more research is necessary to evaluate the benefit of this approach as a complementary therapy. The proposed project is a rigorous study that applies well defined protocol and multiple outcome measures to evaluate MSI in young children with CP.
This study will enroll 24 children, ages 2 to 3 years, diagnosed with spastic CP of moderate severity. We are using a randomized control crossover design with an Initial-Treatment group and a Wait-list Control group. During the treatment phase, children undergo 10 sessions of MSI with an advanced certified practitioner over a 12-week period. As outlined below, the primary outcome is gross motor function as measured on the Gross Motor Function Measure (GMFM). Secondary measures evaluate additional aspects of health and function. We hypothesize that:
1. Young children with spastic CP who receive 3-months of Myofascial Structural Integration (MSI) as a complementary treatment will show greater improvements in gross motor function, associated developmental domains, and growth than those who do not receive MSI.
2. Children with spastic CP will show greater improvement in gross motor function, associated developmental domains and growth after the 3-months of treatment than they showed after a 3-months pre-treatment waiting period.
3. Children with spastic CP will maintain their gains in gross motor function for ≥3 months after completion of treatment.
Data will be analyzed primarily using t-tests and paired t-tests on the measures of interest. Additional analyses using linear regression will examine factors contributing to changes in function. If this treatment improves motor function, we contribute substantially to the care of young children with CP and suggest direction for studies of older children with CP and children of all ages with other motor disabilities.
Keyword(s):
cerebral palsy, myofascial structural integration, massage, rolfing
Core Function(s):
Performing Research or Evaluation
Area of Emphasis
Health-Related Activities
Target Audience:
Professionals and Para-Professionals, Family Members/Caregivers, Children/Adolescents with Disabilities/SHCN
Unserved or Under-served Populations:
None
Primary Target Audience Geographic Descriptor:
National
COVID-19 Related Data:
N/A
