Therapeutic effects on spastic cerebral palsy in children - Acupuncture and massage at the Shu and He acupoints versus routine acupoints

BACKGROUND: Based on clinical findings and syndromes, it has been previously shown that therapeutic methods for cerebral palsy can be greatly improved by selecting fewer, but more accurate acupoints. Therefore, greater therapeutic efficacy for cerebral palsy could be obtained by Selecting the five Shu acupoints. which are located at the qi-intersecting point of the twelve meridians below the elbow and knee. OBJECTIVE: To treat children with spastic cerebral palsy using acupuncture and massage at the Shu and He points through a combination of rehabilitative training, and to compare the effects With routine acupuncture and massage. DESIGN: A randomized controlled clinical trial. SETTING: Rehabilitation Center for Cerebral Palsy, Department of Pediatrics, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine. PARTICIPANTS: Sixty children with spastic cerebral palsy were selected from the Rehabilitation Center for Cerebral Palsy, Department of Pediatrics. Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from May 2003 to February 2006. There were 38 boys and 22 girls, aged 10 months to 4 years old. muscle strength ranging from grade I to grade IV. The children were randomly divided into a treatment group (n =30) and a control group (n =30). Informed consent for the therapeutic program was obtained from the relatives of all enrolled children. The study was approved by the Hospital's Ethical Committee. METHODS: All children were given exercise and occupational therapy based on standard treatments. (1) In the control group, the children were additionally treated with routine acupuncture and massage during the one-month basic rehabilitative training. The acupuncture needles were manipulated alternately at the acupoints of Jianyu, Shousanli, Binao, Hegu, Huantiao, Xuanzhong, and Biguan. They were treated once per day, 6 days a week, followed by one day of rest. The children's limbs were first massaged by pressing, stretching, rolling, and kneading. Then, the same acupuncture points were pressed with the thumb for 30 minutes each time, once a (lay, 6 days a week, followed by one day of rest. The treatment continued for 1 month. (2) In the treatment group, the children were administered acupuncture and massage at the Slut and He points during the one-month basic rehabilitative treatment. For acupuncture of the upper limbs, the following acupoints were used: Sanjian and Quchi of the Large Intestine Meridian of Hand-Yangming, and Houxi and Xiaohai of the Small Intestine Meridian of Hand-Taiyang. The acupoints were acupunctured alternately every other day. For acupuncture of the lower limbs, the following acupoints were used: Zulinqi and Yanglingquan of the Gall bladder Meridian of Foot-Shaoyang, Taibai and Yinlingquan of the Spleen Meridian of Foot-Taiyang, or Xiangu and Zusanli of the Stomach Meridian of Foot-Yangming. The acupoints were acupunctured alternately every other day. Three needles were for the medial malleolus and three needles for the lateral malleolus. They were treated once a day, 6 days a week, followed by one day of rest. The children's limbs were first massaged by means of pressing, stretching, rolling, and kneading. The same acupuncture points were then pressed with the thumb for 0.5-1 minute at each point, 30 minutes each time, once a day, 6 days a week, followed by one day of rest. MAIN OUTCOME MEASURES: Therapeutic efficacy was evaluated using gross motor function measurements, as well as activity of daily living scale before and after treatment. RESULTS: All 60 enrolled children with spastic cerebral palsy were included in the Final analysis of results. (1) Comparison of gross motor function scores: The gross motor function score after treatment was significantly higher in both the treatment group and control group than before treatment (t = -3.86 and -8.882, respectively, P < 0.05). The scores in the treatment group were significantly higher than the control group scores (t = -7.166 P < 0.01). (2) Changes in activity of daily living scores: The scores for activity of daily living in the treatment group Was Significantly higher after treatment than before treatment. (t = -3.933, P < 0.01). and was also significantly higher than the control group (t = -0.671, P < 0.05). CONCLUSION: Acupuncture and massage at the Shu and He acupoints can significantly ameliorate motor function deficits and movement disabilities in children with spastic cerebral palsy. The therapeutic efficacy at these acupoints is better than routine acupunture and massage.