Gait Changes Following Myofascial Structural Integration (Rolfing) Observed in 2 Children With Cerebral Palsy

Abstract

Children with spastic cerebral palsy experience difficulty with ambulation. Structural changes in muscle and fascia may play a role in abnormal gait. Myofascial structural integration (Rolfing) is a manual therapy that manipulates muscle and soft tissues to loosen fascia layers, reposition muscles, and facilitate alignment. This study aimed to document (1) gait characteristics of 2 children with cerebral palsy and (2) effects of myofascial structural integration on their gait. Children received 3 months of weekly therapy sessions by an experienced practitioner. Gait parameters were recorded at baseline and after treatment using an electronic walkway. Children with cerebral palsy demonstrated abnormal velocity and cadence, decreased step length and single support times, and increased double support time. After treatment, both children demonstrated improvement for 3 months in cadence and double support time. The objective gait analyses demonstrated temporary improvements after myofascial structural integration in children with spastic cerebral palsy.

Myofascial Structural Integration Therapy on Gross Motor Function and Gait of Young Children with Spastic Cerebral Palsy: A Randomized Controlled Trial

“…Because of our small sample size, we did not analyze our ambulatory children separately based on CP severity, and, therefore, we may not have picked up on any differences within individual severity subgroups as the earlier study did. A recent case series using similar methodology as the current study in two older children with spastic CP found improvements in cadence and double support time after a course of MSI ( 17 ). Unlike the previous study, we analyzed only passes over the mat in which one foot was on the mat at all times in order to eliminate runs.…”

“…A recent preliminary randomized crossover design trial of MSI in young children with CP showed greater improvements after a course of MSI than after a comparable number of control play sessions, though some children improved throughout the entire study ( 16 ). A case report found improvements in cadence and double support time in two children with spastic CP after MSI ( 17 ). MSI is distinct from massage, another movement-based complementary practice, which has been shown to have variable effects on adolescents with CP ( 18 ).…”

Body-Centered Interventions for Psychopathological Conditions: A Review

“…Rolfing involves the myofascial structural integration or manipulation of muscle and soft tissue with the goal of loosening fascia layers, reposition muscles and aid body alignment (Hansen et al, 2014). Few studies have investigated the therapeutic effectiveness of Rolfing.…”

“…Other Tactile Decrease in mood, stress-induced somatoform disorders, behavioral and personality disorders; schizophrenia; major depression and anorexia nervosa Gyllensten et al, 2003Gyllensten et al, , 2009Hedlund and Gyllensten, 2010;Catalan-Matamoros et al, 2011;Danielsson et al, 2014 Non-movement Acupuncture Other Tactile Reduces tension headaches/migraines, Parkinson's disease symptoms, fibromyalgia, chronic neck and back pain, osteoarthritis pain Middlekauff et al, 2001;Qin et al, 2008;Harris et al, 2009 Functional Relaxation Self Non-tactile Reduces non-specific chest pain, asthma, and tension headaches Loew et al, 2000Loew et al, , 2001Lahmann et al, 2008aLahmann et al, , 2009 Massage Other and Self Tactile Increased weight and growth in pre-term infants, decreased cortisol and dopamine, increased serotonin, increased positive mood, decreased negative emotions, decrease in stress, increase in immunological response, increase in vagal tone Field et al, 2005Field et al, , 2010bField, 2010 Reflexology Other and Self Tactile Decreases anxiety and stress Wang et al, 2008;Miller et al, 2013 Rolfing Other Tactile Decreases anxiety, improved gait in children with spastic cerebral palsy Weinberg and Hunt, 1979;Hansen et al, 2014 types of metrics which assess the effectiveness of BAT: the body awareness scale and the resource oriented body examination which measure body posture, muscle tension, respiration and heart palpitations (Eriksson et al, 2007). BBAT has been effective at reducing physiological conditions such as fibromyalgia, chronic pain, irritable bowel syndrome and non-specific musculoskeletal problems (Gard, 2005;Eriksson et al, 2007) and more recent studies demonstrate potential mood altering effectiveness as well.…”

Complementary and Alternative Medicine in Cerebral Palsy

“…There were no adverse effects associated with treatment. Further, a case study of two children with cerebral palsy showed some improvements in cadence and double support time after treatment, but these improvements were short-lived and returned to baseline at 6 months after completion of treatment (Hansen et al 2014). Larger studies with longer follow-up are needed to assess the role of Rolfing in children with cerebral palsy.…”