Effect of anterior chest wall myofascial release on thoracic expansion in children with spastic cerebral palsy

Abstract

INTRODUCTION Cerebral Palsy (CP) describes a group of disorders of the development of movement and posture, causing activity limitations that are attributed to non-progressive disturbances that occurred in developing fetal or infant brain. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, cognition, communication, perception and/or behavior and/or a seizure disorders. 1 Cerebral palsy is the most common cause of severe physical disability in childhood. 2 Although CP is non-progressive disease in itself, its motor manifestation often changes due to abnormal tone & overactive muscles that can lead to muscle contractures which in turn, can lead to changes in skeletal alignment during growth. The motor manifestations typically involve a variety of neuromuscular & musculoskeletal problem. These problems include spasticity, dystonia, contractures, abnormal bone growth, poor balance, loss of selective motor control & muscles weakness. 1 The incidence of cerebral palsy is up to 3 cases per 1000 live births. There are an estimated over 25 lakh children & people in India with cerebral palsy. This statistics are ABSTRACT Background: Cerebral Palsy is primarily disorder of development of movement and posture attributed to damage to fetal brain. Children with spastic cerebral palsy are found with decreased chest mobility. Myofascial Release (MFR) is a form of soft tissue therapy used to treat somatic dysfunction and accompanying pain and restriction of motion. Hence some intervention is required to improve chest expansion. So this study was conducted in an effort to improve the chest expansion using MFR techniques to the respiratory muscles. Methods: 12 spastic cerebral palsy children of both genders satisfying inclusion criteria were included for the study. The chest measurements were taken at three levels at axilla, 3 fingers below xiphoid process, and subcostally. These readings were documented as pre-test score. Myofascial release was given to the pectoralis major, intercostals, rectus abdominis and the diaphragm, with the subject in supine position. Post treatment data was taken and statistical analysis was performed. Results: The difference of the pre and post readings of the expansion at the axilla, xiphoid and subcostal shows a mean difference of 0.15, 0.15, 0.20 respectively which is significant statistically, P value being <0.05. Conclusion: The result shows that the chest expansion increased significantly at all the three levels. The expansion improved maximally at the nipple level.

Comparing the acute effect of myofascial release techniques and passive stretching on hind foot dynamic loading in patients with multiple sclerosis: A cohort-blinded study

“…Chest measurements were taken at three levels at the axilla, 3 fingers below the xiphoid process, and subcostal region. The results of this study showed that the chest expansion increased significantly [10]. In our study, while MFR did not decrease spasticity, there were improvements of medial heel pressure distribution and active contact area while walking.…”

“…Previous studies carried out in children with spastic cerebral palsy implied that myofascial release was useful in the management of spasticity [4,10,19,29]. Kumar et al [19] investigated the effect of myofascial release on spastic muscles.…”

Thoracolumbar fascia in children with hemiparesis: analysis of two cases

“…15,16 Its evaluation and intervention involves an integral view that necessarily includes the fascial system, because it is a neurotransmitter, piezoelectric and tensegrite interface, so physiotherapy plays a vital card in the interaction of the child with cerebral palsy when including the fascial system. 17,18 This is a pioneer study not only for involving the assessment and possible diagnosis of the fascia through ultrasound, but also because of its use in the pediatric population, since from our understanding there are no other studies about the evaluation of the TLF in the population pediatric.…”