Is scalp-based acupuncture and moxibustion better than conventional rehabilitation therapy for children with cerebral palsy?
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ABSTRACT:
SUBMITTER: Feng Q
PROVIDER: S-EPMC9636454 | biostudies-literature | 2022 Oct
REPOSITORIES: biostudies-literature
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Is scalp-based acupuncture and moxibustion better than conventional rehabilitation therapy for children with cerebral palsy?
Feng Qingbo Q Liu Xiaoyin X Ren Qiuping Q Liao Wenwei W Li Jiaxin J
Translational pediatrics 20221001 10
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Project description: Not available
| S-EPMC9636451 | biostudies-literature
Project description:BackgroundCerebral palsy (CP) in children is a predominantly congenital developmental disease with complex causes and diverse symptoms. Chinese medicine mainly uses acupuncture for the treatment of CP; as the disease site is in the brain, emphasis is placed on scalp acupuncture therapy. There were studies about the treatment but different studies had very different results. In this study, we performed a systematic review and meta-analysis of the recent reports on scalp acupuncture in the treatment of CP in children, providing evidence for clinical diagnosis and treatment.MethodsThe databases of PubMed, Chinese Biomedical Literature (CBM), China National Knowledge Infrastructure (CNKI), and VIP were searched for randomized controlled trials (RCTs) on scalp acupuncture treatment of pediatric CP published from January 2000 to December 2021. The inclusion criteria of studies were made according to the Participants, Intervention, Control, Outcomes, Study design (PICOS) principles. The Cochrane risk of bias 2.0 was used to evaluate the bias of the included literature. Meta-analysis was performed using the effective rate, Mental Development Index (MDI), Psychological Development Index (PDI), and Gross Motor Function Measure (GMFM-88 scale) as outcome indicators for the efficacy, and the safety of scalp acupuncture was assessed.ResultsInitially, 332 articles were retrieved; after screening, 11 articles were included in the selection, including a total of 731 children, with 369 and 362 children for the experimental group and control group respectively. Meta-analysis showed that scalp acupuncture significantly improved the symptoms of children with CP [odds ratio (OR) =3.73, 95% confidence interval (CI): 2.49-5.58, Z=6.41, P<0.00001], could significantly improve their mental development [mean difference (MD) =15.58, 95% CI: 11.74-19.43, Z=7.95, P<0.00001] and psychological development (MD =13.23, 95% CI: 6.17-20.28, Z=3.67, P=0.0002) of children, and significantly improved the motor ability of CP children (MD =17.45, 95% CI: 8.19-26.72, Z=3.69, P=0.0002).DiscussionThe curative effect of scalp acupuncture is better than that of conventional rehabilitation. Scalp-based acupuncture therapy can effectively improve the symptoms of pediatric CP, promote the mental and psychological development of children, and improve their gross motor function, the treatment is safe.
| S-EPMC9173885 | biostudies-literature
Project description:BackgroundCerebral palsy (CP) has a serious impact on children's multiple motor functions and life behavior. Rehabilitation therapy or pharmacotherapy alone has been proven to have a good effect on patients' strength and gait. However, the efficacy of rehabilitation combined with pharmacotherapy for CP in children needs to be further explored. This study is aimed at assessing the effectiveness of this combined method on life function and social behavior in children with CP.MethodsPubMed, China National Knowledge Infrastructure, WanFang Data, EMBASE, and Web of Science databases were searched for all kinds of literature related to the treatment of pediatric CP published between 2000 and 2021. Basic information and experimental data from the literature were screened and extracted, and a meta-analysis was performed using Stata 16.ResultsA total of 605 studies were retrieved, and finally, 10 studies involving 805 pediatric patients were included in the analysis. The analysis results showed that rehabilitation combined with pharmacotherapy could improve the treatment effective rate in children with CP compared with the control group using either alone (RR = 1.184, 95% CI (1.102, 1.273), P < 0.001). In addition, in terms of social behavior, the combined therapy could significantly improve activities of daily living (SMD = 2.94, 95% CI (1.66, 4.22), P < 0.001), motor ability (SMD = 1.86, 95% CI (0.75, 2.96), P = 0.001), adaptability behavior (SMD = 2.82, 95% CI (0.45, 5.18), P = 0.019), language behavior (SMD = 3.08, 95% CI (0.95, 5.22), P = 0.005), social behavior (SMD = 3.78, 95% CI (2.22, 5.35), P < 0.001), and fine motor behavior (SMD = 3.52, 95% CI (1.17, 5.86), P = 0.003).ConclusionThe current study shows that rehabilitation combined with pharmacotherapy can effectively improve the recovery, quality of life, and social behavior of children with CP.
| S-EPMC9288332 | biostudies-literature
Project description:BackgroundCerebral palsy (CP) is a prevalent cause of physical disability in children, often resulting from hypoxic-ischemic encephalopathy, with current therapies often failing to address the underlying pathophysiology. This study aimed to investigate the potential synergistic effects of human amnion-derived mesenchymal stem cells (hAMSCs) combined with scalp acupuncture in a rat model of CP.MethodsTwenty male Sprague-Dawley rats were randomly divided into four groups: Sham, CP, hAMSCs, and hAMSCs+scalp acupuncture (hAMSCs+AP). The CP model was induced via left common carotid artery ligation. hAMSCs were administered through tail vein injection, followed by scalp acupuncture at Baihui (GV20) and Qubin (GB7) points. Neurobehavioral function was assessed using the Bederson score, and brain tissues were analyzed using hematoxylin and eosin (H&E) staining, TUNEL staining, and RT-qPCR for apoptosis-related genes.ResultsThe CP group exhibited significant neurobehavioral deficits and increased apoptosis. Both hAMSCs and hAMSCs+AP treatments improved neurobehavioral function and reduced apoptosis. The combination therapy further decreased apoptosis levels, normalized mRNA expression of Bax, Caspase 9, and Caspase 3, and alleviated histological damage.ConclusionsThe combination of hAMSCs and scalp acupuncture provides a promising treatment for CP, potentially alleviating brain damage through apoptosis regulation. Further studies are required to elucidate the detailed mechanisms and assess clinical feasibility and safety.
| S-EPMC11810711 | biostudies-literature
Project description:ObjectiveThe objective of this study was to assess the rehabilitation status and factors associated with rehabilitation service utilisation among children with cerebral palsy (CP) in Bangladesh.Materials and methodsThis is a population-based surveillance study conducted among children with CP registered in the Bangladesh CP Register (BCPR), the first population-based register of children with CP aged <18 years (y) in Bangladesh. Children with CP were identified from the community using the key informant method and underwent a detailed neurodevelopmental assessment. Socio-demographic, clinical and rehabilitation status were documented. Unadjusted and adjusted analyses with a 95% confidence interval (CI) were used to identify potential predictors of rehabilitation service uptake.ResultsBetween January 2015 and December 2019, 2852 children with CP were registered in the BCPR (mean (standard deviation, SD) age: 7 y 8 months (mo) (4 y 7 mo), 38.5% female). Of these, 50.2% had received rehabilitation services; physiotherapy was the most common type of service (90.0%). The mean (SD) age at commencement of rehabilitation services was 3 y 10 mo (3 y 1 mo). The odds of not receiving rehabilitation was significantly higher among female children (adjusted odds ratio (aOR) 1.3 [95% CI: 1.0-1.7], children whose mothers were illiterate and primary level completed (aOR 2.1 [95% CI: 1.4-3.1] and aOR 1.5 [95% CI: 1.1-2.1], respectively), fathers were illiterate (aOR 1.9 [95% CI: 1.3-2.8]), had a monthly family income ~US$ 59-118 (aOR: 1.8 [95% CI: 1.2-2.6]), had hearing impairment (aOR: 2.3 [95% CI: 1.5-3.5]) and motor severity (i.e. Gross Motor Function Classification System level III (aOR: 0.6 [95% CI: 0.3-0.9]) and level V (aOR: 0.4 [95% CI: 0.2-0.7])).ConclusionsRehabilitation status was poor among the majority of the children with CP in the BCPR cohort, limiting their opportunities for functional improvement. A community-based rehabilitation model focusing on socio-demographic and clinical characteristics should be a public health priority in Bangladesh.
| S-EPMC8092763 | biostudies-literature
Project description:IntroductionCerebral palsy (CP) is a group of permanent disorders of movement development that may cause activity limitations. In this context, robot-assisted therapy might play a key role in clinical management. This comprehensive systematic review aimed to investigate the efficacy of robotic systems in improving upper limb (UL) functions in children with CP.MethodsPubMed, EMBASE, Scopus, and PEDro were searched from inception to February 2024. The risk of bias was assessed with the Joanna Briggs Institute critical appraisal tools battery.ResultsOf 756 articles identified, 14 studies involving 193 children with CP with a judged to be of good methodological quality, but with a lack in the study design, were included in the final synthesis. In the included studies a wide range of devices was used, both exoskeletons and end-effectors, both wearable and non-wearable. The CP children who underwent robot-assisted therapy reported a significant overall increase in clinical assessment, specifically in UL movements and manual dexterity. The clinical improvement was often accompanied by a gain also in instrumental assessments (i.e., kinematic analysis, EMG).DiscussionThe present review suggested that robot-assisted therapy can improve UL motor functions in children with CP. Moreover, the availability of different devices with adjustable parameters can represent an important resource in proposing patient-centered-personalized rehabilitation protocols to enhance the efficacy of rehabilitation and integration into daily life. However, the limited sample size and lack of standardized and clearly reproducible protocols impose to recommend the use of robot-assisted therapy as an integration to usual rehabilitation and not as a replacement.Systematic review registrationhttps://osf.io/a78zb/.
| S-EPMC11743387 | biostudies-literature
Project description:BACKGROUND:Scalp acupuncture has been widely used as treatment for motor dysfunction in children with cerebral palsy in China. Previous studies have failed to provide high-quality evidence to demonstrate the effectiveness of this treatment in children with cerebral palsy. No high-quality randomized controlled trials on scalp acupuncture have been published. The aim of this study is to evaluate the effectiveness of Jiao's scalp acupuncture when combined with routine rehabilitation treatment versus routine rehabilitation treatment alone for motor dysfunction in children with cerebral palsy. METHODS/DESIGN:This is a four-centre randomized controlled trial. One hundred cerebral palsy patients with motor dysfunction were enrolled. Patients will be allocated in a 1:1 ratio into either an acupuncture treatment group or a control group. Cerebral palsy patients in the control group will receive conventional rehabilitation treatment, whereas patients in the acupuncture group will receive a combination of scalp acupuncture and conventional rehabilitation treatment. Thirty-six treatment sessions will be performed over a 12-week period. The Gross Motor Function Measure and the Fine Motor Function Measure Scale will be assessed as the primary outcome measures. The Paediatric Evaluation of Disability Inventory and the Cerebral Palsy Quality of Life Questionnaire for Children will be selected as secondary outcome measures. All assessments will be conducted at baseline, week 4 (treatment 12), week 8 (treatment 24), week 12 (treatment 36) and week 24 (follow-up). DISCUSSION:This is the first trial evaluating the efficacy and safety of scalp acupuncture as a treatment for motor dysfunction in children with cerebral palsy. The results of this trial are expected to provide relevant evidence demonstrating that scalp acupuncture can be used as an effective rehabilitation treatment method for improving motor dysfunction in children with cerebral palsy. TRIAL REGISTRATION:ClinicalTrials.gov, NCT03921281. Registered on 19 April 2019.
| S-EPMC6945653 | biostudies-literature
Project description:BackgroundRespiratory dysfunctions are an important cause of morbidity and death in cerebral palsy (CP) populations. Respiratory exercises in addition to conventional rehabilitation have been suggested to improve respiratory status in CP patients. The objective of this systematic review and meta-analysis was to verify the effects of the addition of respiratory exercises to conventional rehabilitation on pulmonary function, functional capacity, respiratory muscle strength, gross motor function and quality of life in children and adolescents with CP.MethodsWe searched for randomized controlled clinical trials in PubMed/Medline, Lilacs, SciELO, EMBASE and Physiotheraphy Evidence (PEDro) from their inception until July 2022 without language restrictions. Studies that included respiratory exercises (breathing exercise program; feedback respiratory training; incentive spirometer exercise; inspiratory muscle training; and combination of respiratory exercises + incentive spirometer exercise) in combination with conventional rehabilitation for children and adolescents with CP were evaluated by two independent reviewers. The mean difference (MD) and 95% confidence interval (CI) were estimated by random effect models.ResultsTen studies met the eligibility criteria, including 324 children aged from 6 to 16 years. The meta-analysis showed an improvement in inspiratory muscle strength of 22.96 cmH2O (18.63-27.27, n = 55) and pulmonary function of 0.60 (0.38-0.82, n = 98) for forced vital capacity (L); 0.22 (0.06-0.39, n = 98) for forced expiratory volume at 1 second (L); and 0.50 (0.05-0.04, n = 98) for peak expiratory flow (L/min). Functional skills in daily living activities improved in the intervention group. Caregivers' assistance of daily living activities, functional capacity, gross motor function and expiratory muscle strength showed a nonsignificant improvement. Social well-being and acceptance and functioning domains improved in only one study.ConclusionsEmerging data show significant enhancements in inspiratory muscle strength and pulmonary function in CP patients after respiratory training in addition to conventional rehabilitation. There is no consensus on the frequency, type or intensity of respiratory exercises for children with and adolescents with CP.
| S-EPMC9663285 | biostudies-literature
Project description:AimTo identify challenges of combining robotic upper extremity rehabilitation with tDCS in children with upper extremity bilateral cerebral palsy (CP) by assessing feasibility, tolerability and safety.MethodsThis was an unblinded, open-label, pilot clinical trial. Participants completed 10 × 1 h sessions of robotic rehabilitation combined with motor cortex anodal tDCS. Feasibility, acceptability and practicality, were assessed including the number of participants completing the protocol, factors limiting participation, time required for sessions, and completion of functional assessments and tolerability scales. To assess safety, standardized clinical and robotic measures of sensorimotor function were performed. The trial was registered at clinicaltrials.gov (NCT04233710).ResultsEight children were recruited (mean age 8y ± 1.8y, range 6-11 years) and 5 completed the intervention. There were no serious adverse events. One child developed focal seizures 6 weeks after the trial that were deemed to be unrelated. Barriers to completion included time and scheduling demands and patient factors, specifically cognitive/behavioral impairments and dyskinesia. No decline in clinical function was appreciated.ConclusionsRobotic upper extremity rehabilitation combined with tDCS may be feasible in children with bilateral CP. Careful participant selection, family engagement, and protocol adaptations are recommended to better understand the feasibility and tolerability of future trials.
| S-EPMC9397997 | biostudies-literature
Project description:Cerebral palsy (CP) is the most common childhood motor disability. The dose of usual care for rehabilitation therapies is unknown. The purpose of this study was to describe current dosage of rehabilitation services for children with CP recruited from a paediatric hospital system in the USA. 96 children with CP were included in this cross-sectional survey. Parents reported frequency, intensity, time and type of therapy services. Weekly frequency was the most common. Children with CP received 0.9-1.2 hours/month of each discipline in the educational setting and 1.5-2.0 hours/month in the clinical setting, lower than the recommendations for improvements in motor skills.
| S-EPMC8011711 | biostudies-literature