Efficacy of massage and stretching for controlling hamstring muscle spasticity in children with diplegic spastic cerebral palsy: A comparative study
Resumen
Background: Massage therapy is utilized to alleviate muscle spasticity in children with cerebral palsy, typically lasting at least 15 min per muscle group, which may result in lower family compliance with the home program. Objective: This study aimed to explore the impact of stretching alone or in combination with short-term massage on reducing hamstring muscle spasticity and enhancing knee range of motion (ROM) in children with diplegic spastic cerebral palsy. Methods: Twelve children diagnosed with diplegic spastic cerebral palsy (6–12 years old) were randomly divided into two groups: the first received massage and stretching exercises, and the second received stretching exercises only on the hamstring muscle. The Modified Ashworth Scale was used to measure the stiffness of the hamstring muscle, and the ROM of knee flexion was measured using a manual goniometer. ROM and modified Ashworth scale (MAS) were measured at baseline and after 1 and 2 weeks of treatment, respectively. Both legs of each participant received treatment for 2 weeks, with the duration of massage being 5 min and the duration of stretching being 30s with three repetitions. Results: Both methods reduced hamstring spasticity after two weeks; however, ROM improved after the first week and more significantly after the 2nd week. Conclusion: Stretching exercises, whether performed alone or in combination with short-term massage, have been found to be equally effective for treating spastic muscles. Although there was an improvement in spasticity after the first week of short-term massage, the difference was not statistically significant.
Descargas
Citas
Abusharkh, H. A., Reynolds, O. M., Mendenhall, J., Gozen, B. A., Tingstad, E., Idone, V., Abu-Lail, N., & Van Wie, B. J. (2021). Combining stretching and gallic acid to decrease inflammation indices and promote extracellular matrix production in osteoarthritic human articular chondrocytes. Experimental Cell Research, 408, 112841. https://doi.org/10.1016/j.yexcr.2021.112841
Akinpelu, A. O., Bakare, U., & Adegoke, B. O. A. (2005). Influence of age on hamstring tightness in apparently healthy Nigerians. Journal of the Nigeria Society of Physiotherapy, 15(2), 35.
Almalty, A. R., Abdelnour, H. M., Hawamdeh, M., & Alkhob, S. A. (2023). Physiotherapists' understanding of shortwave diathermy contraindications: A questionnaire survey. Risk Management and Healthcare Policy, 16, 1171–1185. https://doi.org/10.2147/RMHP.S413806
Bandy, W. D., & Iron, J. M. (1994). The effect of time on static stretch on the flexibility of the hamstring muscles. Physical Therapy, 74(4), 295–300.
Bar-On, L., Aertbeliën, E., Wambacq, H., Severijns, D., Van Campenhout, A., Molenaers, G., & Desloovere, K. (2015). Spasticity and its contribution to hypertonia in cerebral palsy. BioMed Research International, 2015, 317047.
Bingöl, H., & Yılmaz, H. (2018). Effects of functional massage on spasticity and motor functions in children with cerebral palsy: A randomized controlled study. Journal of Exercise Therapy and Rehabilitation, 5(3), 135–142.
Bingöl, H., Akaras, E., & Kocaman, H. (2020). The effects of massage therapy on symptoms related to cerebral palsy in children: A systematic review. Journal of Clinical Medicine of Kazakhstan, 4(58), 6–14.
Bohannon, R. W., & Smith, M. B. (1987). Interrater reliability of a modified Ashworth scale of muscle spasticity. Physical Therapy, 67(2), 206–207. https://doi.org/10.1093/ptj/67.2.206
Bouffard, N. A., Cutroneo, K. R., Badger, G. J., White, S. L., Buttolph, T. R., Ehrlich, H. P., Stevens-Tuttle, D., & Langevin, H. M. (2008). Tissue stretch decreases soluble TGF-β1 and type-1 procollagen in mouse subcutaneous connective tissue: Evidence from ex vivo and in vivo models. Journal of Cellular Physiology, 214(2), 389–395. https://doi.org/10.1002/jcp.21219
Bryant, J., Cooper, D. J., Peters, D. M., & Cook, M. D. (2023). The effects of static stretching intensity on range of motion and strength: A systematic review. Journal of Functional Morphology and Kinesiology, 8(2), 37. https://doi.org/10.3390/jfmk8020037
Chaouachi, A., Padulo, J., Kasmi, S., Ben Othmen, A., Chatra, M., & Behm, D. G. (2015). Unilateral static and dynamic hamstrings stretching increases contralateral hip flexion range of motion. Clinical Physiology and Functional Imaging, 37, 23–29.
Chappell, F., & Williams, B. (2002). Rates and reasons for non-adherence to home physiotherapy in pediatrics. Physiotherapy, 88(3), 138–147.
Cloodt, E., Caird, M. S., Roye, D. P., Bosker, B., & Carrino, J. A. (2018). Demographic and modifiable factors associated with knee contracture in children with cerebral palsy. Developmental Medicine & Child Neurology, 60(4), 391–396.
Das, S. P., & Ganesh, G. S. (2019). Evidence-based approach to physical therapy in cerebral palsy. Indian Journal of Orthopaedics, 53(1), 20–34.
Duong, B., Low, M., Mosley, A. M., Lee, R., & Herbert, R. D. (2001). Time course of stress relaxation and recovery in human ankles. Clinical Biomechanics, 16, 601–607. https://doi.org/10.1016/S0268-0033(01)00026-6
Dursun, N., Gokbel, T., Akarsu, M., Bonikowski, M., Pyrzanowska, W., & Dursun, E. (2021). Intermittent serial casting for wrist flexion deformity in children with spastic cerebral palsy: A randomized controlled trial. Developmental Medicine & Child Neurology, 63(6), 743–747.
Farrow, A. C., Blinch, J., Harry, J. R., & Palmer, T. B. (2023). Short-term effects of static stretching on hamstring passive stiffness in young and older women. Journal of Musculoskeletal and Neuronal Interactions, 23(3), 290–298.
Fede, C., Angelini, A., Stern, R., Macchi, V., Porzionato, A., Ruggieri, P., De Caro, R., & Stecco, C. (2018). Quantification of hyaluronan in human fasciae: Variations with function and anatomical site. Journal of Anatomy, 233, 552–556.
Fosdahl, M. A., Jahnsen, R., Kvalheim, K., & Holm, I. (2019). Stretching and progressive resistance exercise in children with cerebral palsy: A randomized controlled trial. Pediatric Physical Therapy, 31(3), 264–271.
Garcia, L. C., Alcântara, C. C., Santos, G. L., Monção, J. V. A., & Russo, T. L. (2019). Cryotherapy reduces muscle spasticity but does not affect proprioception in ischemic stroke: A randomized sham-controlled crossover study. American Journal of Physical Medicine & Rehabilitation, 98(1), 51–57. https://doi.org/10.1097/PHM.0000000000000990
Giller Gajdosik, C. (1991). Issues of parent compliance: What the clinician and researcher should know. Physical & Occupational Therapy in Pediatrics, 11(3), 73–87.
Gracies, J. M. (2001). Physical modalities other than stretch in spastic hypertonia. Physical Medicine and Rehabilitation Clinics of North America, 12(4), 769–792.
Graham, H. K., Thomason, P., Willoughby, K., Hastings-Ison, T., Van Stralen, R., Dala-Ali, B., Wong, P., & Rutz, E. (2021). Musculoskeletal pathology in cerebral palsy: A classification system and reliability study. Children, 8, 252.
Greve, K. R., Joseph, C. F., Berry, B. E., Schadl, K., & Rose, J. (2022). Neuromuscular electrical stimulation to augment lower limb exercise and mobility in individuals with spastic cerebral palsy: A scoping review. Frontiers in Physiology, 13, 951899. https://doi.org/10.3389/fphys.2022.951899
Groppe, M., Baxter, K., & Davenport, T. E. (2012). Passive stretching and its effect on spasticity and range of motion in children with cerebral palsy: A systematic review. Journal of Student Physical Therapy Research, 5(1), 11–22.
Hallman-Cooper, J. L., & Rocha Cabrero, F. (2023). Cerebral palsy. StatPearls.
Ko, I. H., Kim, J. H., Lee, B. H., & You, J. S. (2013). Relationships between lower limb muscle architecture and activities and participation of children with cerebral palsy. Journal of Exercise Rehabilitation, 9(3), 368–374.
Konno, R. N., Nigam, N., Wakeling, J. M., & Ross, S. A. (2022). The contributions of extracellular matrix and sarcomere properties to passive muscle stiffness in cerebral palsy. Frontiers in Physiology, 12, 804188. https://doi.org/10.3389/fphys.2021.804188
Lee, G. P., & Ng, G. Y. (2008). Effects of stretching and heat treatment on hamstring extensibility in children with severe mental retardation and hypertonia. Clinical Rehabilitation, 22(9), 771–779.
Lee, J. H., Jang, M., Kim, E., Rhim, H. C., & Kim, D. (2020). Effects of static and dynamic stretching with strengthening exercises in patients with patellofemoral pain who have inflexible hamstrings: A randomized controlled trial. Sports Health, 13(1), 49-56.
Lieber, R. L., & Friden, J. (2002). Spasticity causes a fundamental rearrangement of muscle-joint interaction. Muscle & Nerve, 25, 265–270.
Lillo-Navarro, C., Medina-Mirapeix, F., Escolar-Reina, P., Montilla-Herrador, J., Gomez-Arnaldos, F., & Oliveira-Sousa, S. L. (2015). Parents of children with physical disabilities understand the characteristics of home exercises and the influence of physiotherapists on their adherence: A qualitative study. Journal of Physiotherapy, 61(2), 81–86.
Lillo-Navarro, C., Montilla-Herrador, J., Escolar-Reina, P., Oliveira-Sousa, S. L., García-Vidal, J. A., & Medina-Mirapeix, F. (2019). Factors associated with parents’ adherence to different types of exercises in home programs for children with disabilities. Journal of Clinical Medicine, 8(4), Article 507.
Louka–Lazouri, I., Hristara-Papadopoulou, A., Stavropoulou, M., Emmanouil, T., Anna, C., & Ilias, K. (2020). Investigation of parents’ compliance in physical therapy at home with toddlers diagnosed with cerebral palsy. International Research Journal of Public and Environmental Health, 7(3), 52–59.
Macgregor, R., Campbell, R., Gladden, M. H., Tennant, N., & Young, D. (2007). Effects of massage on the mechanical behavior of muscles in adolescents with spastic diplegia: A pilot study. Developmental Medicine & Child Neurology, 49(3), 187–191.
McCarthy, J. J., & Betz, R. R. (2000). The relationship between tight hamstrings and lumbar hypolordosis in children with cerebral palsy. Spine, 25(2), 211–213.
McIntyre, S., Goldsmith, S., Webb, A., Ehlinger, V., Hollung, S. J., McConnell, K., Arnaud, C., Smithers-Sheedy, H., Oskoui, M., Khandaker, G., Himmelmann, K., & Global CP Prevalence Group. (2022). Global prevalence of cerebral palsy: A systematic analysis. Developmental Medicine & Child Neurology, 64(12), 1494–1506.
McNair, P. J., Dombroski, E. W., Hewson, D. J., & Stanley, S. N. (2000). Stretching at the ankle joint: Viscoelastic responses to holds and continuous passive motion. Medicine and Science in Sports and Exercise, 33, 354–358.
Moyer, C. A., Rounds, J., & Hannum, J. W. (2004). A meta-analysis of massage therapy research. Psychological Bulletin, 130(1), 3–18.
Mumford, S. (2007). The New Complete Guide to Massage (1st ed.). Plume.
Page, P. (2012). Current concepts in muscle stretching for exercise and rehabilitation. International Journal of Sports Physical Therapy, 7(1), 109–119.
Picelli, A., Munari, D., Serina, A., Filippetti, M., Baricich, A., Santamato, A., Guerrazzi, F., Modenese, A., & Smania, N. (2023). Short-wave diathermy for spastic equinus foot in chronic stroke patients: A proof-of-concept pilot study. Minerva Medica, 114(4), 469–475.
Prentice, W. E., William, Q., & Underwood, F. (2005). Therapeutic Modalities in Rehabilitation (3rd ed.). McGraw-Hill Medical.
Rasool, F., Memon, A. R., Kiyani, M. M., & Sajjad, A. G. (2017). The effect of deep cross-friction massage on spasticity in children with cerebral palsy: A double-blind randomized controlled trial. Journal of the Pakistan Medical Association, 67(1), 87–91.
Sadowska, M., Sarecka-Hujar, B., & Kopyta, I. (2020). Cerebral palsy: Current opinions on definition, epidemiology, risk factors, classification, and treatment options. Neuropsychiatric Disease and Treatment, 16, 1505–1518.
Skoutelis, V. C., Kanellopoulos, A. D., Kontogeorgakos, V. A., Dinopoulos, A., & Papagelopoulos, P. J. (2020). The orthopedic aspect of spastic cerebral palsy. Journal of Orthopaedics, 22, 553–558.
Smith, L., Paredes, J., Safa, N., & Moon, J. (2012). Transcriptional abnormalities of hamstring muscle contractures in children with cerebral palsy. PLoS ONE, 8, e40686.
Stecco, C., Pirri, C., Fede, C., Yucesoy, C. A., De Caro, R., & Stecco, A. (2021). Fascial or muscle stretching? A narrative review. Applied Sciences, 11(1), 307.
Stuberg, W. A., & Dunkle, P. A. (2005). Effects of manual stretching on hamstring flexibility in children with spastic cerebral palsy. Pediatric Physical Therapy, 17(1), 64–65.
Theis, N., Korff, T., Kairon, H., & Mohagheghi, A. A. (2013). Does acute passive stretching increase muscle length in children with cerebral palsy? Clinical Biomechanics, 28(9–10), 1061–1067.
Tohidnezhad, M., Zander, J., Slowik, A., Kubo, Y., Dursun, G., Willenberg, W., Zendedel, A., Kweider, N., Stoffel, M., & Pufe, T. (2020). Impact of uniaxial stretching on both gliding and traction areas of tendon explants in a novel bioreactor. International Journal of Molecular Sciences, 21(8), 2925.
Van Pelt, D. W., Lawrence, M. M., Miller, B. F., Butterfield, T. A., & Dupont-Versteegden, E. E. (2021). Massage as a mechanotherapy for skeletal muscle. Exercise and Sport Sciences Reviews, 49(2), 107–114.
Wallen, M., & Stewart, K. (2013). The evidence for abandoning upper limb stretch interventions in pediatric practice. Developmental Medicine & Child Neurology, 55(3), 208–209.
Wang, Y., Zhu, W. L., & Dong, Y. F. (2008). Massage manipulation of supplementing marrow and kneading tendon in treating 30 children with spastic cerebral palsy. Chinese Journal of Integrated Traditional and Western Medicine, 28(4), 363–365.
Zaidi, S., Ahamad, A., Fatima, A., Ahmad, I., Malhotra, D., Al Muslem, W. H., Abdulaziz, S., & Nuhmani, S. (2023). Immediate and long-term effectiveness of proprioceptive neuromuscular facilitation and static stretching on joint range of motion, flexibility, and electromyographic activity of knee muscles in older adults. Journal of Clinical Medicine, 12(7), 2610. https://doi.org/10.3390/jcm12072610
Zhao, H., Zhao, H., Ni, S., Guo, Q., Zhou, H., & Zhang, X. (2011). Changes of calf muscle-tendon biomechanical properties induced by passive-stretching and active-movement training in children with cerebral palsy. Journal of Applied Physiology, 111(2), 435–442.
Las obras que se publican en esta revista están sujetas a los siguientes términos:
1. El Servicio de Publicaciones de la Universidad de Murcia (la editorial) conserva los derechos patrimoniales (copyright) de las obras publicadas, y favorece y permite la reutilización de las mismas bajo la licencia de uso indicada en el punto 2.
© Servicio de Publicaciones, Universidad de Murcia, 2013
2. Las obras se publican en la edición electrónica de la revista bajo una licencia Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España (texto legal). Se pueden copiar, usar, difundir, transmitir y exponer públicamente, siempre que: i) se cite la autoría y la fuente original de su publicación (revista, editorial y URL de la obra); ii) no se usen para fines comerciales; iii) se mencione la existencia y especificaciones de esta licencia de uso.
3. Condiciones de auto-archivo. Se permite y se anima a los autores a difundir electrónicamente las versiones pre-print (versión antes de ser evaluada) y/o post-print (versión evaluada y aceptada para su publicación) de sus obras antes de su publicación, ya que favorece su circulación y difusión más temprana y con ello un posible aumento en su citación y alcance entre la comunidad académica.
