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“Will massage help strengthen my child’s leg?”

So you have been in contact with the child with cerebral palsy and the family for the first few times and have started getting comfortable with the child and the family members. Suddenly one day the parent asks you, “So, should I massage my child’s legs with oil everyday? Will that help relax his tight muscles?”

These are the questions that we dread and most certainly would refrain from answering or most likely would prefer to say “Go ahead, there is no harm”. Feeling overwhelmed at where to look for the answers for this and plethora of other questions that are raised by the care givers (regarding the treatment options). Wait no more because here is the short version of a very detailed article on Systematic review on best available intervention evidence for children with cerebral palsy. What I like about this study is that it is a systematic review of the systematic reviews of interventions for children with cerebral palsy. Though the idea of it is quite daunting, the paper is very simple to read and understand.  “Evidence alert traffic light system” has been introduced, which makes it comprehensible.

Here is the main theme of the original article:

Evidence alert traffic light system summary

  • Green: Go (Effective therefore do it)
  • Yellow/Orange: Measure (Uncertain effect so measure outcomes to determine if progress is made)
  • Red: Stop (Ineffective, so do not do it)

Evidence Alert SystemFullscreen capture 2132016 60906 PMFullscreen capture 2132016 60918 PM

According to the article, Green Light (absolutely necessary) intervention options for children with cerebral palsy are:

a. Impairment based interventions:

  • Spasticity management option- Botulinum toxin, Diazepam, Selective Dorsal Rhizotomy
  • Contracture management options- Casting lower limbs

b.Function based intervention:

  • Improving motor activities: Constraint Induced Movement Therapy, Goal Directed training, Bimanual training, context focused therapy, Home exercises, Occupational therapy post botulinum toxin
  • Improved function and self care: Goal Directed training, Home programs

Does massage really help strengthen the child’s legs? what should you suggest? If you have not been curious enough to read the original article yourself, next post I will be discussing about the yellow light interventions identified by the authors.

Happy Reading and Happy Shri Panchami everyone!

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Disclaimer: The diagrams provided are from the original article “A systematic review of interventions for children with cerebral palsy: state of evidence” Iona Novak, Sarah MCintyre, Catherine Morgan, Lanie Campbell, Leigha Dark, Natalie Morton, Elise Stumbles, Salli-Ann Wilson, Shona Goldsmith

Reference:

Iona Novak, Sarah MCintyre, Catherine Morgan, Lanie Campbell, Leigha Dark, Natalie Morton, Elise Stumbles, Salli-Ann Wilson, Shona Goldsmith, (2013) Mac Keith Press,Cerebral Palsy Alliance, Sydney; University of Notre Dame Australia, Sydney, Australia. A systematic review of interventions for children with cerebral palsy: state of evidence. Developmental Medicine and Child Neurology,55: 885–910.

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