ACUTE EFFECTS OF INTRAMUSCULAR STRETCHING AND PASSIVE STRETCHING ON SPASTICITY IN CHILDREN WITH CEREBRAL PALSY

Purpose: Several methods are used to reduce spasticity in cerebral palsy (CP) rehabilitation. One of these methods is stretching. This study aimed to compare the acute effects of intramuscular stretching and passive stretching on spasticity in children with bilateral spastic CP. Methods: The study included a total of 22 children (12 boys and 10 girls) with bilateral CP, between the ages of 5 and 13 years (mean age=6.45 +/- 1.96 years), who had spasticity in the plantar flexor muscle groups. All children were under an individualized physiotherapy program. In addition to the physiotherapy program, intramuscular stretching was applied to the plantar flexor muscles on one side, whereas passive manual stretching was applied to the other side. The Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS), and Silfverskiold test were used to assess the spasticity. Evaluations were performed before and after the applications. Results: There was a significant difference between pre and post-treatment comparisons in the intramuscular stretching side (MAS p=0.024, MTS R2-R1 p<0.001, Silfverskiold test p=0.002) and the passive stretching side (MAS p=0.014, MTS R2-R1 p=0.001, and the Silfverskiold test p=0.003). On the other hand, there was no difference between the intramuscular and passive stretching sides (p>0.05). Conclusion: Both intramuscular and passive stretching are effective methods for reducing spasticity in children with bilateral spastic CP, and their acute effects are similar.