Changes in Muscle Spasticity in Patients With Cerebral Palsy After Spinal Manipulation: Case Series

Objective: The purpose of this case series was to report quantitative changes in wrist muscle spasticity in children with cerebral palsy after 1 spinal manipulation (SM) and a 2-week course of treatment. Methods: Twenty-nine patients, aged 7 to 18 years, with spastic forms of cerebral palsy and without fixed contracture of the wrist, were evaluated before initiation of treatment, after 1 SM, and at the end of a 2-week course of treatment. Along with daily SM, the program included physical therapy, massage, reflexotherapy, extremity joint mobilization, mechanotherapy, and rehabilitation computer games for 3 to 4 hours' duration. Spasticity of the wrist flexor was measured quantitatively using a Neuroflexor device, which calculates the neural component (NC) of muscle tone, representing true spasticity, and excluding nonneural components, caused by altered muscle properties: elasticity and viscosity. Results: Substantial decrease in spasticity was noted in all patient groups after SM. The average NC values decreased by 1.65 newtons (from 7.6 +/- 6.2 to 5.9 +/- 6.5) after 1 SM. Another slight decrease of 0.5 newtons was noted after a 2-week course of treatment. In the group of patients with minimal spasticity, the decrease in NC after the first SM was almost twofold-from 3.93 +/- 2.9 to 2.01 +/- 1.0. In cases of moderate spasticity, NC reduction was noted only after the 2-week course of intensive treatment. Conclusions: In this sample of patients with cerebral palsy, a decrease in wrist muscle spasticity was noted after SM. Spasticity reduction was potentiated during the 2-week course of treatment.