Mahmood Qamar, Habibullah Shaista, Babur Muhammad Naveed
Dr. Qamar Mahmood, National Institute of Rehabilitation Medicine, Islamabad Pakistan.
Dr. Shaista Habibullah, PhD, National Institute of Rehabilitation Medicine, Islamabad Pakistan.
Pak J Med Sci. 2019 Sep-Oct;35(5):1210-1215. doi: 10.12669/pjms.35.5.478.
To evaluate the effects of traditional massage (TM) on spasticity and gross motor function in children with cerebral palsy (CP).
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.
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.
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.
评估传统按摩（TM）对脑瘫（CP）患儿痉挛状态及粗大运动功能的影响。
本随机对照试验（RCT）于2016年9月至2018年8月进行，招募了86例痉挛型CP（双瘫）患儿（退出=11例；分析=75例），通过密封信封法随机分配至干预组和对照组，年龄在2至10岁之间。两组均接受常规物理治疗（CPT），每日1次，每周5次，为期3个月。然而，干预组额外接受TM治疗。在干预开始时、干预6周和12周后，使用改良Ashworth量表（MAS）、粗大运动功能测量（GMFM - 88）和粗大运动功能分类系统（GMFCS）评估痉挛状态和粗大运动功能。通过SPSS - 20对数据进行比较和分析。
对照组和干预组的平均年龄分别为6.81±2.31岁和7.05±2.47岁。基线时MAS、GMFM和GMFCS评分无统计学显著差异。与对照组相比，干预组患儿在干预6周和12周后四肢的MAS评分均有统计学显著降低（p < 0.05）。然而，与对照组相比，干预组的GMFM评分和GMFCS水平无显著变化。
得出结论，TM可有效降低痉挛状态，无有害影响，因此母亲可在家中安全实施，使其适用于痉挛型CP的管理。然而，为了获得更好的粗大运动功能，应与CPT、功能技能和任务导向方法联合应用。
