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

Abstract

Though the cause of motor abnormalities in cerebral palsy is injury to the brain, structural changes in muscle and fascia may add to stiffness and reduced function. This study examined whether myofascial structural integration therapy, a complementary treatment that manipulates muscle and fascia, would improve gross motor function and gait in children <4 years with cerebral palsy. Participants (N = 29) were enrolled in a randomized controlled trial (NCT01815814, ) or Open Label Extension. The main outcome was the Gross Motor Function Measure-66 assessed at 3-month intervals. Gait (n = 8) was assessed using the GAITRite® electronic walkway. Parents completed a survey at study conclusion. Comparing Treatment (n = 15) and Waitlist-Control groups (n = 9), we found a significant main effect of time but no effect of group or time × group interaction. The pooled sample (n = 27) showed a main effect of time, but no significantly greater change after treatment than between other assessments. Foot length on the affected side increased significantly after treatment, likely indicating improvement in the children’s ability to approach a heel strike. Parent surveys indicated satisfaction and improvements in the children’s quality of movement. MSI did not increase the rate of motor skill development, but was associated with improvement in gait quality.

Effects of myofascial release with tennis ball on spasticity and motor functions of upper limb in patients with chronic stroke: A randomized controlled trial

“…[34] Loi et al have shown that myofascial structural integration therapy is a unique and complementary approach to loosening and realigning muscles and improving motor functions. [35]…”

“…[34] Loi et al have shown that myofascial structural integration therapy is a unique and complementary approach to loosening and realigning muscles and improving motor functions. [35] Chandan et al suggested that the most likely mechanism for improving spasticity is the neuroreflexive modification that occurs when manual force is applied to the musculoskeletal system when performing myofascial release. [36] The hands-on method provides afferent stimulation via receptors, then processed centrally at the spinal cord and brain levels.…”

O significado da fisioterapia para cuidadores de crianças com paralisia cerebral

“…O tratamento fisioterapêutico para crianças com PC tem foco o desenvolvimento neurofisiológico, biomecânico, sensorial, a educação condutiva e o uso de dispositivos ortopédicos. Várias técnicas podem ser utilizadas pela fisioterapia no tratamento de crianças com PC, dentre elas: técnicas de terapia manual, mobilizações, alongamentos, estimulação elétrica, treino de deambulação e de atividades de vida diária (BRANDÃO et al, 2015;LIN et al, 2011;LOI et al, 2015;FERRE et al, 2015;POOL et al, 2015).…”

Complementary and Alternative Medicine in Cerebral Palsy

“…More contemporary researchers were unable to verify quantitative improvements after Rolfing in a randomized control trial of patients <48 months of age with spastic cerebral palsy (Loi et al 2015). They did not show any effect on rate of Gross Motor Function Measure-66 (GMFM-66) advancement and little change in gait parameters but for possible improved heal strike in treated patients.…”