Complementary and alternative therapies for cerebral palsy

Cerebral palsy (CP), which manifests as a range of posture and motor impairments, is a common cause of disability in childhood. It is caused by brain damage at an early age and often results from an injury/complication around the time of birth.

Beyond the standard–and often essential–medications, surgeries, and therapies recommended by doctors, some people with cerebral palsy turn to alternative and complementary therapies.  

Alternative therapy for cerebral palsy

Nutrition and diet

One of the mainstays of holistic treatment is healthy eating. Many parents choose to include a dietician in their child’s care team to ensure that the child maintains a beneficial diet (1). Diets designed for people with cerebral palsy  typically emphasize fresh fruits, vegetables, whole grains and legumes, and discourage processed and sugary foods. Children with CP are also encouraged to get enough Vitamin D, Calcium, and Phosphorous to keep their bones strong. A healthy diet can go a long way towards mitigating or reducing symptoms of CP. The advice of an allergist may also help alleviate symptoms.

Equine-assisted therapy (hippotherapy)

Therapeutic horseback riding, or hippotherapy, channels the movements of horses and combines them with many of the principles of physical, occupational, and speech therapy to improve neurological and physical function (2). The rhythmic motion of the horse, with the help of a professional, can improve movement, posture, and balance in individuals with cerebral palsy (3). In a 2004 study, ten children of varying ages received hippotherapy once a week for ten weeks. These children achieved statistically significant improvements in both gross motor/fine motor crawling and kneeling skills as well as pediatric social skills (4).

Acupuncture

In acupuncture, fine needles are inserted into specific points on the body as part of traditional Chinese medicine to help with pain and tension issues and provide many other health benefits. Acupuncture has been used to treat children with CP for over 20 years, and it has achieved some astonishing success. In a trial involving 33 randomly-chosen children with CP, the gross motor function measure (GMFM) improved significantly in those who had undergone the treatment. Learn more here (5).

Bodywork

Bodywork therapies refer to treatments that focus on realignment and manipulation of the body’s structure to improve its function (6). Some popular forms of bodywork include the following:

  • Rolfing: Rolfing works to manipulate the fascia and soft tissue in order to improve bodily alignment. It is also known as Structural Integration.
  • The Alexander Method: This educational method trains the body to work more efficiently through visual observation of the body’s tendency and hands-on guidance to improve movements.
  • Massage therapy: This type of bodywork relaxes and stretches the fascia and underlying layers of tissue.

Massage therapy for cerebral palsy

Dr. Kalyani Premkumar is an advocate for the use of massage in caring for children with cerebral palsy (7). She points out that the goal of health team therapists is to support the child, given that there is no cure for CP. Their job is to find ways to reduce stress and spasticity, prevent contractures, improve posture, and improve circulation to the skin and muscles that are not being used. She writes, “Since any form of stress increases the symptoms, a relaxing massage helps reduce the spasms and involuntary movements. Passive movements and range-of-motion exercises of joints prevent contractures of muscles.”

Dr. Premkumar points out that it is important to keep detailed notes on cerebral palsy clients, “as their spasticity and postural changes can vary from day to day. Keep a meticulous record of physical disability, massage strokes used, and duration of treatment for every individual treated in order to help them maximally.”

Adaptive yoga and stretching

According to Lesley Wiart, MScPT, children and adults with CP commonly do what is referred to as “passive stretching,” or the stretching and working of the muscles that is achieved with the help of a therapist, but without direct participation from the patient (8). People with CP also do isolated active stretches of particular muscle groups. These exercises typically don’t engage the patient, and for this reason, “contemporary approaches to rehabilitation for children with CP are changing to include community participation, fitness, and functional goals.” With this idea at the forefront, “therapists may want to consider activities such as yoga, Tai Chi, horseback riding, ballet, and swimming programs that allow children to stretch and move within a functional, participatory context.”

There are many adaptive yoga centers around the world designed specifically for children with disabilities. Aside from simply offering a more participatory and social activity, yoga offers many benefits for individuals with cerebral palsy. The benefits of yoga may include the following:

  • Enhancing the natural development of the child through a series of gentle and therapeutic exercises
  • Increasing body awareness, flexibility, and strength
  • Reducing hyperactivity and improving concentration by using unique breathing exercises and relaxation techniques.

In a US News story, Ryan McGraw, a Detroit native with cerebral palsy, has been doing adaptive yoga for years and reaping innumerable benefits (9). He has found that yoga has improved his flexibility, coordination, and balance, and, as he states, “it’s helped me become more conscious of my breath.” It has also encouraged in him a more positive outlook on life.

Many individuals with disabilities may feel overwhelmed by yoga. McGraw assures these people, saying, “I think if you’re in a chair, or with any disability, it’s key to know that poses can be adapted to meet your body, and you need to find the right thing for you.” He also notes that the yoga community is an incredibly welcoming one for individuals of all needs and abilities.

Conductive education

Conductive education (CE) holds that coordination and movement can be learned (10). The method engages individuals with damage to the central nervous system in challenges that are specifically designed to apply to routine daily tasks. Conductors provide appropriate guidance and support to promote independent functioning, self-care skills, and social, problem-solving, and motor skills.

Conductive education theoretically promotes the acquisition of age-appropriate play-based and life skills (11). Children and adolescents with cerebral palsy may benefit from conductive education if they enjoy working in a group setting and following instructions.

Threshold electrical stimulation (TES)

Threshold Electrical Stimulation (TES) is a process by which low-intensity electrical stimulation is administered during sleep (12). TES is administered using a small device with electrodes. The electrodes are attached to certain areas of the skin, where small electrical stimuli are applied to the muscles being worked. TES is used to target spastic muscles. It has also treated muscle weakness in a number of different neuromuscular conditions, such as spina bifida, idiopathic scoliosis, and central nervous system injuries (12, 13). The stimulation is said to increase muscle strength and joint mobility, which ultimately improves voluntary motor function (12, 13, 14).

The theory underlying TES is that the stimulation increases the flow of blood to the muscles, which increases muscle strength and bulk. Working with a nightly secretion of trophic hormones, this technique will enlarge the atrophic muscles and thus improve motor function. TES is not intended to be used as the main therapy, but in conjunction with an established physical therapy program (12).

Investigating complementary and alternative therapies

Talk to your child’s medical and care teams to learn more about which complementary and alternative treatment options may be right for your child.


Sources:

  1. Dietary Needs for Kids With Cerebral Palsy. (n.d.). Retrieved October 28, 2018, from https://kidshealth.org/en/parents/diet-cerebral-palsy.html
  2. Mumal, I. (2018, February 21). Hippotherapy in Cerebral Palsy Can Help with Trunk Strength and Control. Retrieved October 28, 2018, from https://cerebralpalsynewstoday.com/2018/02/21/hippotherapy-in-cerebral-palsy-can-help-trunk-strength-and-control/
  3. Therapeutic Horse Riding for Cerebral Palsy. (n.d.). Retrieved October 28, 2018, from https://www.equestriantherapy.com/therapeutic-horse-riding-cerebral-palsy/
  4. Casady, R. L., & Nichols-Larsen, D. S. (2004). The effect of hippotherapy on ten children with cerebral palsy. Retrieved October 28, 2018, from https://www.ncbi.nlm.nih.gov/pubmed/17057544
  5. Sun, J. G., W., & Sun, X. R. (2004, July 01). Randomised control trial of tongue acupuncture versus sham acupuncture in improving functional outcome in cerebral palsy. Retrieved October 28, 2018, from https://jnnp.bmj.com/content/75/7/1054
  6. Bodywork therapies. (n.d.). Retrieved October 28, 2018, from http://www.minddisorders.com/A-Br/Bodywork-therapies.html
  7. Premkumar, K., & Premkumar, K. (2000). Interactive pathology for massage therapists. Baltimore: Lippincott Williams & Wilkins.
  8. Wiart, L., MScPT. (n.d.). Stretching with Children with Cerebral Palsy: What Do We… : Pediatric Physical Therapy. Retrieved October 28, 2018, from https://journals.lww.com/pedpt/Fulltext/2008/02020/Stretching_with_Children_with_Cerebral_Palsy__What.8.aspx
  9. McMullen, L. (n.d.). Yoga with Cerebral Palsy: Ryan McGraw’s Story. Retrieved October 26, 2018, from https://health.usnews.com/health-news/health-wellness/articles/2013/04/30/yoga-with-cerebral-palsy-ryan-mcgraws-story
  10. Home. (2018, September 14). Retrieved October 28, 2018, from https://conductivelearningcenter.org/
  11. Cerebral Palsy Alliance Research Foundation. (n.d.). Conductive education (Interventions & Therapies). Retrieved October 28, 2018, from https://research.cerebralpalsy.org.au/about-cerebral-palsy/interventions-and-therapies/conductive-education/
  12. Threshold Electrical Stimulation as a Treatment of Motor Disorders. (2014, January). Retrieved October 29, 2018, from https://providers.bcbsal.org/portal/documents/10226/1791629/Threshold Electrical Stimulation as a Treatment of Motor Disorders/85c227e7-f84a-41b3-90a8-c0c89e8df577?version=1.0
  13. Walker, J. L., Ryan, S. W., & Coburn, T. R. (2011, May). Retrieved October 28, 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3069301/
  14. Bosques, G., Martin, R., McGee, L., & Sadowsky, C. (2016, February 9). Does therapeutic electrical stimulation improve function in children with disabilities? A comprehensive literature review. Retrieved October 28, 2018, from http://axiobionics.com/wp-content/uploads/2017/01/BosquesDoesTherapeuticNMESImproveFunctioninChildren2016.pdf