Review of effects of spinal manipulative therapy on neurological symptoms.

BACKGROUND: Neurological disorders are the leading cause of disability in the world. Neurological symptoms significantly affect the well-being of the individual. Spinal manipulative therapy (SMT) is a complementary method often used for people with neurological disorders. OBJECTIVE: This study aimed to review the existing literature on the effects of SMT on common clinical symptoms of neurologic disorders and the quality of life. METHODS: Narrative review was conducted through the literature published between January 2000 and April 2020 in English. The search was performed across four databases: PubMed, Google Scholar, PEDro, and Index to Chiropractic Literature. We used combinations of keywords related to SMT, neurological symptoms, and quality of life. Studies on both symptomatic and asymptomatic populations of different ages were included. RESULTS: 35 articles were selected. Evidence for the administration of SMT for neurological symptoms is insufficient and sparse. Most studies focused on the effects of SMT on pain, revealing its benefits for spinal pain. SMT may increase strength in asymptomatic people and populations with spinal pain and stroke. SMT was reported to affect spasticity, muscle stiffness, motor function, autonomic function, and balance problems, but these studies were limited in number to make conclusions. An important finding was the positive influence of SMT on the quality of life in people with spinal pain, balance impairments, and cerebral palsy. CONCLUSION: SMT may be beneficial for the symptomatic treatment of neurological disorders. SMT can positively affect the quality of life. However, limited evidence is available, and further high-quality research is required.

Intensive Neurophysiological Rehabilitation System for children with cerebral palsy: a quasi-randomized controlled trial.

BACKGROUND: Recent research indicates that intensive rehabilitation tends to be effective for children with cerebral palsy (CP). Intensive Neurophysiological Rehabilitation System (INRS) is a multi-component approach that combines various interventions and addresses different functional goals.. This study aimed to examine the effectiveness of the INRS treatment in children with bilateral CP. METHODS: In this quasi-randomized controlled study, 48 children with spastic bilateral CP (age 5-12 years, GMFCS Levels I-IV, MACS Levels I-IV) were assigned to an experimental or control group in order they have been enrolled. The experimental group underwent INRS treatment in the tertiary care facility for about four hours daily for ten days and continued routine home treatment for four weeks. After the first evaluation, participants from the control group stayed on the waiting list for four weeks receiving home treatment and then starting the INRS treatment. Thereby, all participants were assessed three times. The primary outcome measure was a Gross Motor Function Measure 66 Item Set (GMFM). The secondary outcome measures included the Jebsen-Taylor Hand Function test, Box and Blocks test, ABILHAND-Kids Questionnaire, Self-care and Mobility domain of the Pediatric Evaluation of Disability Inventory, and the ankle dorsiflexion passive range of motion. RESULTS: There was a statistically significant increase in the GMFM score after the INRS treatment in both the experimental group (mean difference (MD) 2.0, P < 0.01) and control group (MD 1.5, P < 0.05), with a large size effect (partial eta squared (η2) = 0.21 and η2 = 0.14). The mean difference between groups during the first study period was 2.89 points (p < 0.01) in the GMFM score with a medium effect size (η2 = 0.12). Statistically significant superiority of the INRS treatment over home treatment was also obtained by Jebsen-Taylor Hand Function Test and the Box and Blocks Test in both dominant and non-dominant hands. CONCLUSIONS: The study indicates that the INRS treatment can be beneficial for improving both gross motor functions and hand function in children with bilateral CP. Further longitudinal studies are required to evaluate the effects of the INRS treatment on the participation level of children with CP. TRIAL REGISTRATION: The study protocol was registered on ClinicalTrials.gov under the identifier: NCT04093180 on 17/09/2019.

[Changes of motor function in patients with cerebral palsy during the treatment using the intensive neurophysiological rehabilitation system].

Changes in gross motor function during the intensive neurophysiological rehabilitation were studied in 61 patients, aged from 2 to 15 years, with spastic forms of cerebral palsy. All patients were examined before and at the end of a two-week course of treatment using the Gross Motor Function Measurement GMFM-66 Item Sets test to calculate motor development scores. Statistical analysis indicates a significant increase in the level of motor development of children after treatment from 45.1 to 47.6 (p > 0.01). The most significant progress was noted in patients at level II of Gross Motor Function Classification System. The score of motor development has increased from 66.2 to 69.6 (p < 0.01). The results suggest the effectiveness of the Intensive Neurophysiological Rehabilitation System for the improvement of gross motor functions in patients with cerebral palsy. It is necessary to continue this study according to the requirements of evidence-based medicine.