THE EFFECTS OF OSTEOPATHIC TREATMENT ON CONSTIPATION IN CHILDREN WITH CEREBRAL PALSY: A PILOT STUDY

Objective: This pilot study was designed to investigate the effectiveness of osteopathic treatment in children with cerebral palsy and chronic constipation. Methods: This study included 13 children with cerebral palsy diagnosed as having chronic constipation by a gastroenterologist. The subjects were separated into 2 groups. Group 1 was treated with osteopathic methods and group 2 underwent both medical and exactly the same osteopathic treatments of group 1. Osteopathic treatments included fascial release, iliopsoas muscle release, sphincter release, and bowel mobilizations. Gross Motor Functional Classification System, Functional Independence Measure for Children, and Modified Ashworth Scale were used to determine the level of disability, functional independence, and muscle tonus, respectively. In addition, Constipation Assessment Scale was administered to the subjects to determine the severity of constipation. The satisfaction from the treatment was measured using a Visual Analogue Scale at 3 and 6 months. Results: Most of the children included in this study were determined as level IV or V according to Gross Motor Functional Classification System. The satisfaction of the subjects or the families with the treatments was not different when the groups were compared (P > .05). Constipation Assessment Scale scores decreased significantly in both groups (P < .05). Pretreatment (initial evaluation) and posttreatment (follow-ups at 3 and 6 months) results revealed no difference between the groups in either aspects (P > .05). However, both groups showed significant improvements compared with baseline evaluations (P < .05). Conclusion: Osteopathic methods were as effective as osteopathic methods in addition to medical care for both treatment groups. The results of this study suggest that osteopathic methods may be helpful as an alternative treatment in constipation. Additional advanced studies should be conducted. (J Manipulative Physiol Ther 2009;32:648-653)