There’s good news for patients who are struggling with cerebral palsy: clinical trials suggest that spinal manipulation may be effective when it comes to reducing muscle contractions, also known as spasticity. Spinal manipulation is primarily used by chiropractors as a form of physical therapy that focuses on realigning the spine and reactivating spinal articulations.
Chiropractors may be able to help cerebral palsy patients in the short term, according to the study called “Influence of Spinal Manipulation on Muscle Spasticity and Manual Dexterity in Participants with Cerebral Palsy: Randomized Controlled Trial”. The study was published by the Journal of Chiropractic Medicine.
Spinal Manipulation and Muscle Spasticity
Muscle spasticity is a symptom of cerebral palsy, as well as other neurological diseases resulting from upper motor neuron lesions. This limits the motor development of children with cerebral palsy. It also limits their natural motor functioning.
Reducing spasticity is therefore a major therapeutic goal for improving motor performance for patients with this condition.
During the randomized trial, researchers at the International Clinic of Rehabilitation in Ukraine evaluated the short term impact of spinal manipulation on wrist muscle spasticity. They also studied the manual dexterity of children with cerebral palsy.
The randomized test included a total of 79 children between the ages of 8 and 18 years. The participants were assigned to receive either spinal manipulation or a sham physical therapy.
All participants retained hand function up to having some difficulties handling objects, corresponding to levels I to III on the Manual Ability Classification System or MACS.
The trial’s primary outcome measure was muscle spasticity in the wrist muscles. The researchers measured the spasticity of the wrists at the beginning and at the end of the therapy. Spasticity was assessed using a NeuroFlexor device which is designed to quantify the different components of wrist muscle tone response based on the resistance to passive movements of the wrist, performed with different velocity by a computer-controlled step monitor.
Spinal manipulation was performed by an orthopedic medical doctor. They focused on the thoracic, lumbar, and cervical regions. Just like most chiropractic sessions, the doctor applied forced and low-amplitude rapid muscle movement to relieve pressure on the spinal joints and improve nerve function.
On the other hand, the sham therapy was applied by the same practitioner. They used the same chiropractic techniques, but did not apply substantial force.
Once the participants were evaluated, the researchers found that the spinal therapy reduced the wrist spasticity of the children who underwent spinal manipulation. It created a positive effect just 15 minutes after the therapy. They also had less wrist spasticity compared to those who received sham therapy.
It’s worth mentioning that there were no changes reported regarding the non-neural proprieties of muscle and tendon response. However, the researchers already anticipated this because such an effect on muscle structure is not supposed to occur within such a short period of time.
The researchers then took it a step further and evaluated hand functionality using the Box and Block test. The children were asked to move small blocks from one place to another within 60 seconds.
The spinal manipulation allowed the participants to move a mean of 4.1 blocks more per second than they did before therapy. In the control group, they moved an average of 3.01 blocks more.
While this was not considered statistically significant, the researchers still acknowledged that spinal manipulation may decrease muscle spasticity temporarily in patients with disordered muscle tone regulation.
Chiropractic treatment shows promise in terms of helping patients with cerebral palsy, but right now additional studies need to be made to explore the long term effects of spinal manipulation.
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