Efficacy of Chinese reflex therapy in the comprehensive rehabilitation of infants with cerebral palsy

Traditional Chinese Medicine methods such as acupuncture, reflexology massage, and others, as independent interventional measures, demonstrate a positive effect in improving muscle tone, motor functions, and adaptation to daily living conditions in children with cerebral palsy.

The aim of the study. To enhance the effectiveness of comprehensive rehabilitation for children with spastic forms of cerebral palsy by incorporating Gua Sha therapy and reflexotherapy into the medical rehabilitation program during the inpatient stage of medical care.

Results: Of the 81 children with cerebral palsy included in the study groups, 44 (54.3%) were boys and 37 (45.7%) were girls. The children's ages ranged from 1 year to 6.5 years. The children were divided into two groups: the study group and the comparison group. To assess effectiveness, the Ashforth Spasticity Scale, the Gross Motor Function Measure (GMFM-88), goniometry, coordination testing, the Harkavi Index, and the WeeFIM were used. The study group utilized modern rehabilitation methods in combination with traditional Chinese medicine (Gua Sha and reflexology), while the comparison group utilized modern rehabilitation methods alone.

Results: To assess adaptation using the Harkavi Index, it was found that rehabilitation interventions did not negatively impact the adaptive capacity of children in either group. After completion of rehabilitation measures and six months after their completion, the study group showed a persistent improvement in GMFM-88 scores (p=0.001), decreased tone on the Ashworth scale (p=0.001), improved balance (p=0.003), and improved functional independence (p=0.001). No clear improvements were observed in the comparison group.

Conclusion. Thus, incorporating Traditional Chinese Medicine methods into the rehabilitation program for children with cerebral palsy is advisable.

1. Moiseeva K.E., Suslova G.A., Zastupova A.A., Glushhenko V.A., Bolotskih V.M., Kolotova A.S., Mikirtichan G.L., Zaslavskij D.V. Medical and social problems of the prevalence of cerebral palsy (literature review). Sovremennye problem zdravoohraneniya i medicinskoj statistiki. 2024; (5): 907-924 (in Russ) DOI: 10.24412/2312-2935-2024-5-907-924

2. Sokolov P. L. Cerebral palsy: dysontogenesis and rehabilitation treatment. M., 2012; 217 (in Russ)

3. Galjukov I.A., Bykov E.V. On the assessment of motor impairments during adaptive physical activity. Nauchno-sportivnyj zhurnal. 2023; 1(1): 64-74 (in Russ)] DOI: 10.51936/1994-5639_2021_4_13

4. Klochkova E. Introduction to Physical Therapy: Rehabilitation of Children with Cerebral Palsy and Other Neurological Movement Disorders. Moscow; Litres. 2016; 284 (in Russ)

5. Gazdieva B.M., Milovanova O.A.,Vitkovskaja S.V., Puzin S.S., Araphanova H.A. Cerebral palsy is a pressing problem in modern society (literature review). Vestnik Vserossijskogo obshhestva specialistov po mediko-social'nojj ekspertize, reabilitacii i reabilitacionnoj industrii. 2022; (3): 99-116 (in Russ) DOI: 10.17238/issn1999-2351.2022.3.99-116

6. Pak L.A., Braun O.Ju., Fisenko A.P., Orbu A.M., Chibisova K.V., Romanova L.A., Vehova N.V. Alternative approachs to treating cerebral palsy in children. Kremlevskaya medicina. Klinicheskij vestnik. 2017; (4-1): 50-56 (in Russ)

7. Wang J., Shi W., Khiati D., Shi B., Shi X., Luo D., Wang Y., Deng R., Huang H., Li J., Yan W. Acupuncture treatment on the motor area of the scalp for motor dysfunction in children with cerebral palsy: study protocol for a multicenter randomized controlled trial. Trials. 2020; 21(1): 29. DOI: 10.1186/s13063-019-3986-z

8. Сheng Y.Y., Huang Y.Y., Yang T.H., Chang Y.J., Fu R.H., Chen H.Y. Acupuncture and Acupoints for Managing Pediatric Cerebral Palsy: A Meta-Analysis of Randomized Controlled Trials. InHealthcare. 2024; 12(17): 1780. DOI: 10.3390/healthcare12171780

9. Guo T., Zhu B., Zhang X., Xu N., Wang H., Tai X. Tuina for children with cerebral palsy: A protocol for a systematic review. Medicine (Baltimore). 2018; 97(4): e9697. DOI: 10.1097/MD.0000000000009697

10. Chen L.A., Liu H.T., Huang C., Zhang L., Zeng F., Xie B. Effectiveness and safety of warm needle acupuncture on children with cerebral palsy: Protocol for a systematic review and meta-analysis. Medicine. 2019; 98(13):e14959. DOI: 10.1097/MD.0000000000014959

11. Tang Y., Cao Z., Xia Y., Liu Y., Zhang W. Effectiveness and safety of pure acupuncture and moxibustion in the treatment of children with cerebral palsy: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2021; 100(4):e23907. DOI: 10.1097/MD.0000000000023907

12. Chen K., Shu S., Yang M., Zhong S., Xu F. Meridian acupuncture plus massage for children with spastic cerebral palsy. Am J Transl Res. 2021; 13(6): 6415-6422. PMID: 34306381

13. Wang X., Teh S.H., Du X.G., Wang X.H. Acupuncture and Tuina Treatment for Gross Motor Function in Children with Spastic Cerebral Palsy: A Monocentric Clinical Study. Neuropsychiatr Dis Treat. 2023; 19: 1875-1886. DOI: 10.2147/NDT.S424102

14. Xue Y., Shi S., Zheng S., Yang Z., Xu J., Gong F. Therapeutic effect of scalp-based acupuncture and moxibustion as an adjunctive treatment on children with cerebral palsy comparing to conventional rehabilitation therapy: a systematic review and meta-analysis of randomized controlled trials. Transl Pediatr. 2022; 11(5): 631-641. DOI: 10.21037/tp-22-85

15. Chen Z., Huang Z., Li X., Deng W., Gao M, Jin M. et al. Effects of traditional Chinese medicine combined with modern rehabilitation therapies on motor function in children with cerebral palsy: A systematic review and meta-analysis. Front Neurosci. 2023; 17: 1097477. DOI: 10.3389/fnins.2023.1097477

16. Li L.X., Zhang M.M., Zhang Y., He J. Acupuncture for cerebral palsy: A meta-analysis of randomized controlled trials. NeuralRegenRes. 2018; 13(6): 1107-1117. DOI 10.4103/1673-5374.233455

17. Rostacheva E.A., Suslova G.A., Rostacheva A.A.Optimal methods of reflexotherapy in the rehabilitation of patients with spastic cerebral palsy. Vestnik fizioterapii i kurortologii. 2023; 29(2): 104-104 (in Russ)] DOI: 10.33920/med-14-2401-04

18. Wang X. The S.H., Du X.G., Wang X.H. Acupuncture and tuina treatment for gross motor function in children with spastic cerebral palsy: A monocentric clinical study. Neuropsychiatric Disease and Treatment. 2023: 1875-1886. DOI: 10.2147/NDT.S424102

19. Novak I., Morgan C., Fahey M., Finch-Edmondson M., Galea C., Hines A. et al. State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy. Current neurology and neuroscience reports. 2020; 20(2): 3. DOI: 10.1007/s11910-020-1022-z

20. Xue Y., Shi S., Zheng S., Yang Z., Xu J., Gong F. Therapeutic effect of scalp-based acupuncture and moxibustion as an adjunctive treatment on children with cerebral palsy comparing to conventional rehabilitation therapy: a systematic review and meta-analysis of randomized controlled trials. TranslPediatr. 2022;11(5):631-641. DOI: 10.21037/tp-22-85

21. Sadowska M., Sarecka-Hujar B., Kopyta I. Cerebral palsy: current opinions on definition, epidemiology, risk factors, classification and treatment options. Neuropsychiatr Dis Treat. 2020;16:1505-1518. DOI: 10.2147/NDT.S235165

22. Bukreeva E.A., Sednenkova T.A., Kalyuzhnyj A. V., Osipova G.A., Sokolov P.L., Sergeenko E.Yu. et al. Rehabilitation of young children with movement disorders and epilepsy: rational approach and efficacy. Annaly klinicheskoj i eksperimental'noj nevrologii. 2022; 16(1): 24-31 (in Russ)]. DOI: 10.54101/ACEN.2022.1.3