The Effectiveness of Massage for Children With Cerebral Palsy: A Systematic Review.

Context: Massage is a widely used alternative therapy among health professionals and parents for children with cerebral palsy (CP).

Objective: The review intended to determine the effects of massage on the rehabilitation of children with CP.

Design: The research team conducted a literature review that examined the use of massage for children with various types of CP, such as ataxia, using relevant keywords. It included articles published up to December 2019. The research team searched the electronic databases PubMed, MEDLINE, Embase, Scopus, and the Cochrane Central Register of Controlled Trials.

Setting: The study took place at Eastern Mediterranean University in Famagusta, Cyprus.

Participants: Participants in the reviewed studies were children with CP.

Outcome measures: The strength of the research designs was rated using Sackett's Levels of Evidence. The Physiotherapy Evidence Database (PEDro) scale was used to assess the studies' methodological quality. The outcome measures were classified according to the International Classification of Functioning, Disability, and Health (ICF).

Results: Eleven studies that included 297 CP children were reviewed. According to the PEDro scores, 5 studies had high methodological quality; 5 studies had fair quality; and one study had poor quality. No study investigated the effects of massage for all classifications of the ICF. Muscle tone was decreased significantly in the reviewed studies, either between the groups or within the massage group (P < .05). No consensus existed about the other effects of massage due to the limited research.

Conclusions: This study is a first review in this area and can be an important guide for professionals and caregivers who want properly use massage for children with CP. Massage as an adjunct to traditional therapies should be used to reduce muscle tone in spastic-type CP. More clear methods and relevant outcome measures should be used in future studies. Further studies with randomized controlled trials are required to determine massage type, massage applier, and oil for this population and to investigate immediate and long-term effects of massage on all ICF's domains.