Peer-reviewed article
Fascial Manipulation Compared to Stretching for Rehabilitation of Children With Cerebral Palsy: Protocol for a Pilot Randomized Controlled Trial.
von Smitten-Stubb K, Ring J, Haakana P, Hurri H, Huusko M et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a protocol paper describing a planned pilot randomized controlled trial comparing fascial manipulation with stretching as rehabilitation approaches for children with cerebral palsy. The study aims to test the feasibility of a future larger trial by recruiting 20 children aged 7-14 years and measuring outcomes related to walking performance and mobility over 8 weeks. The paper outlines the study design, recruitment procedures, and planned outcome measures but presents no results or findings, as recruitment was only beginning at the time of publication.
Key points
- The study protocol was designed to test feasibility and acceptability of comparing fascial manipulation versus stretching in children with cerebral palsy
- Sample size is 20 children aged 7-14 years with spastic cerebral palsy, randomized to two groups receiving one treatment session per week for 8 weeks
- Primary outcomes focus on recruitment, retention, adherence, and qualitative experiences; secondary outcomes include gait analysis, spasticity, and functional mobility
- Results are expected in 2027, indicating this is a protocol paper with no outcomes data available
Limitations
This is a protocol paper describing a planned study, not a completed evaluation. No outcomes data, results, or evidence of effectiveness are presented. The small pilot sample size (n=20) limits generalizability.
Abstract
Background Maintaining and improving motor function is essential in the rehabilitation of children with cerebral palsy (CP). Stretching is traditionally used to prevent muscle tightness and contractures to improve movement patterns in children with CP. Fascial manipulation (FM) is an increasingly used manual therapy method for movement difficulties associated with CP. However, evidence for FM remains limited, and its benefits over conventional stretching are unclear. A pilot randomized controlled trial (RCT) is warranted to assess the feasibility and acceptability of a definitive trial comparing FM with stretching. This study protocol describes a pilot randomized controlled feasibility trial comparing FM and stretching in children with CP to inform the design and conduct of a future definitive RCT. Objective The primary objective is to assess the feasibility and acceptability of the trial procedures and interventions. This includes evaluating recruitment and retention rates, intervention adherence, completion rates for outcome assessments, and the perceived impact of the interventions on children's daily functioning and participation. The secondary objective is to explore the preliminary acute and longitudinal effects of FM, compared with traditional stretching, on walking performance, gait biomechanics, joint mobility, and the variability in these outcome measures. Methods This pilot RCT will include 20 children aged 7 to 14 years with spastic CP, randomized to an FM intervention group (n=10) and a stretching group (n=10). Both groups will receive 1 treatment session per week for 8 weeks. Feasibility and acceptability will be assessed using quantitative measures of recruitment and retention, intervention adherence, and completion of outcome assessments, complemented by semistructured interviews with caregivers and the children's regular physiotherapists to explore perceived changes in the children's daily functioning and participation, and their experiences of the interventions. Secondary outcomes include the 6-minute walk test (6MWT), walking metabolic cost, gait biomechanics, ankle spasticity, muscle activity, joint stiffness, and functional mobility in daily life. Acute outcomes will be assessed before and after the first intervention session, while longitudinal outcomes will be assessed at baseline and following the 8-week intervention period. Results Recruitment of participants began in October 2024, with 3 additional participants required to reach the target sample size. Results are expected to be published in 2027. Conclusions This pilot RCT will provide essential feasibility data and preliminary estimates of potential treatment effects to inform the design of a future adequately powered RCT. To our knowledge, evidence regarding the effects of FM on gait, mobility, and function in children with CP remains limited. This study aims to contribute to the development of evidence-based rehabilitation strategies for children with CP.