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

Shraddha J. Diwan, Ankita B. Bansal, Hetal Chovatiya, Dhara Kotak, Neeta Vyas

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.


Keywords


Spastic cerebral palsy, Myofascial release, Chest expansion

Full Text:

PDF

References


Rosenbaum P, Paneth N, Leviton A. A report: the definition and classification of cerebral palsy April 2006. Develop Med Child Neurol. 2007;109:8-14.

Stanley FJ. Cerebral palsies: epidemiology and causal pathways. In: Stanley FJ, Blair E, Alberman E, eds. Clinics in Developmental Medicine No. 151. London: MacKeith Press; 2000: 22-39.

Smith LR, Ponten E, Hedstrom Y. Novel transcriptional profile in wrist muscles from cerebral palsy patients. Biomed Cent Med Genom. 2009;2(1):44.

Lance JW. Symposium synopsis. In: Feldmann RG, Young RR, Koella WP, eds. Spasticity: Disordered Motor Control. 2nd ed. Chicago: Year Book Medical Publishers; 1980:485-95.

Lieber RL. Spasticity causes a fundamental rearrangement of muscle-joint interaction. Muscle and Nerve. 2002;25(2):265-70.

Eun Sook Park, Jung Hyun Park, Dong-Wook Rha, Chang Il Park, Chan Woo Park. Comparison of the ratio of upper to lower chest wall in children with spastic quadriplegic cerebral palsy and normally developed children; Yonsei Med J. 2006;47(2):237-42.

Ersoz M, Selçuk B, Gündüz R, Kurtaran A, Akyüz M. Decreased chest mobility in children with spastic cerebral palsy. Turk J Pediatr. 2006;48(4):344-50.

Sherman KJ, Dixon MW, Thompson D, Cherkin DC. Development of taxonomy to describe massage treatments for musculoskeletal pain. BMC Complement Altern Med. 2006;6:24.

Barnes J. Myofascial Release: the missing link in traditional treatment. In: Davis CM, eds. Complimentary Therapies in Rehabilitation: Holistic Approaches for Prevention and Wellness. 2nd ed. Thorofare, NJ: Slack Inc; 2004: 59-81.

Cathie A. Selected writings. In: Cathie A, eds. Academy of Applied Osteopathy. 2nd ed. Maidstone, England: Academy of Applied Osteopathy Yearbook; 1974: 15-126.

Barnes MF, Gronlund RT, Little MF, Personius WJ. Efficacy study of the effect of a myofascial release treatment technique on obtaining pelvic symmetry. J Bodywork Mov Ther. 1997;1:289-96.

Schleip R. Fascial plasticity-a new neurobiological explanation: part 1. J Bodywork Mov Ther. 2003;7:11-9.

Papastamelos C, Panitch HB, England SE, Allen JL. Developmental changes in chest wall compliance in infancy and early childhood. J Appl Physiol. 1995;78:179-84.

Benditt JO. Management of pulmonary complications in neuromuscular disease. Phys Med Rehabil Clin North Am. 1998;9:167-85.

Redstone F. The effects of seating position on the respiratory patterns of pre-schoolers with cerebral palsy. Int J Rehabil Res. 2004;27:283-8.

Muller H. Speech. In: Finnie NR, eds. Handling the Young Child with Cerebral Palsy at Home. 3rd ed. Oxford: Butterworth-Heinemann; 1997: 112-117.

Stamer MH. Posture and movement of the child with cerebral palsy. In: Stamer MH, eds. Congenital Hemiplegia. 2nd ed. San Antonio, Texas: Therapy Skill Builders; 2000: 79.

Leopando MT, Moussavi Z, Holbrow J, Chernick V, Pasterkamp H, Rempel G. Effect of a soft Boston orthosis on pulmonary mechanics in severe cerebral palsy. Pediatr Pulmonol. 1999;28:53-8.

Bach JR, Bianchi C. Prevention of pectus excavatum for children with spinal muscular atrophy type 1. Am J Phys Med Rehabil 2003;82:815-9.

Stamer MH. Posture and movement of the child with cerebral palsy. In: Stamer MH, eds. Congenital Hemiplegia. 1st ed. San Antonio, Texas: Therapy Skill Builder; 2000: 9-16.

Manhein CJ. The myofascial release. In: Manhein CJ, eds. Manual. 3rd ed. Thorofare, NJ: Slack Publications; 2001: 1-36, 123-131, 180-185.

Cantu RI, Grodin AJ. Myofascial manipulation: theory and clinical application. In: Cantu RI, Grodin AJ., eds. Aspen Book. 2nd ed. Maryland: Aspen publication; 2001: 15-90.

Suman Kuhar, Khatri Subhash, Jeba Chitra. Effectiveness of myofascial release in treatment of plantar fasciitis: a RCT. Indian J Physiother Occupat Ther. 2007 July-Sept;1(3):3-9.

Michael Stanborough. Direct release myofascial technique. In: Michael Stanborough, eds. Book Manual. 3rd ed. United States: Elsevier Publishers; 2001: 3-23.