Cerebral palsy (CP) is the most common childhood disability, affecting movement, posture, and muscle control due to a brain injury that occurs during pregnancy, birth, or shortly after. While it’s prevalence has decreased over the last 25 years, dropping from 2.4 per 1000 live births to 1.5 per 1000, it still remains a leader in childhood disability. While the brain injury itself does not progress over time, the challenges it creates are lifelong. Many people with CP also experience other difficulties, such as hearing, vision, communication, and learning issues, as well as conditions like epilepsy or nutritional problems. Thus, care for people with CP is often multimodal, still chiropractic care has not been explored to the fullest extent as an option for people who suffer from the condition.
A key feature of CP is muscle spasticity, or muscles that remain tight and rigid with exaggerated reflexes. This can make movement and daily activities extremely challenging. Research into chiropractic care for CP is still in its early stages, but some initial studies suggest it may help reduce spasticity. One small case series found measurable improvements in wrist muscle tone after two weeks of care. Another trial showed short-term benefits in spasticity and manual dexterity, though further research is needed to fully understand these effects.
The New Case
This case report followed a 52-year-old woman with lifelong CP, who used a motorised wheelchair and relied on carers for almost all daily tasks, including dressing and toileting. She also experienced chronic back, neck, and shoulder pain, balance issues, and incontinence. Her main goal was to stay in her own home and remain as independent as possible, avoiding placement in a care facility.
At her first visit, her spine was extremely contracted and twisted, with severe muscle spasms. She could not lie flat on the table, and even small movements were difficult. Using a modified Advanced Biostructural Correction™ (ABC™) protocol, the chiropractor worked with her twice a week for three months, later adjusting to a schedule supported by NDIS funding. The patient’s support workers were also trained to help with posture and ergonomics in her daily environment.
The changes over six months were significant, to a degree the patient did not expect when commencing care. While she initially sought care for back and neck pain, and which significantly reduced over the course of her chiropractic care, she also experienced other improvements that greatly contributed to her increased quality of life. Her balance improved, and she became more able to sit more comfortably and transfer more safely using her hoist. She experienced a notable reduction in muscle spasms and rigidity, which in turn allowed her to lie flatter and sit upright with greater ease. An improvement contributing greatly to increased quality of life was continence improvements, with a 70% reduction in urinary and faecal incontinence, greatly reducing her reliance on carers
The patient described these changes as “life-changing.” Importantly, when care frequency dropped below weekly visits, her symptoms began to return, highlighting the need for ongoing regular chiropractic care.
Why This Matters
While we don’t yet know exactly why these changes occurred, research has shown that chiropractic care can influence pelvic floor function, muscle control, and sensorimotor integration in the brain.These findings provide a scientific basis for exploring chiropractic as a supportive therapy for people with CP.
For this patient, the improvements meant more than reduced pain. They allowed her to maintain independence and dignity, and to continue living at home. This case highlights the potential value of chiropractic care for people with complex neurological conditions – and the need for further research to understand how chiropractic adjustments might help improve quality of life for those living with cerebral palsy.
We need more research, of course, as a single case study does not allow us to generalise. But this case report is perhaps rationale for further investigation. We can’t wait to see what evolves.
References:
- Sadowska, M., Sarecka-Hujar, B., & Kopyta, I. (2020). Cerebral Palsy: Current Opinions on Definition, Epidemiology, Risk Factors, Classification and Treatment Options. Neuropsychiatric Disease and Treatment, 16, 1505–1518. https://doi.org/10.2147/NDT.S235165
- Kachmar, O., Voloshyn, T., & Hordiyevych, M. (2016). Changes in Muscle Spasticity in Patients With Cerebral Palsy After Spinal Manipulation: Case Series. Journal of chiropractic medicine, 15(4), 299–304. https://doi.org/10.1016/j.jcm.2016.07.003
- Kachmar, O., Kushnir, A., Matiushenko, O., & Hasiuk, M. (2018). Influence of Spinal Manipulation on Muscle Spasticity and Manual Dexterity in Participants With Cerebral Palsy: Randomized Controlled Trial. Journal of chiropractic medicine, 17(3), 141–150. https://doi.org/10.1016/j.jcm.2018.03.004
- Effect of Spinal Manipulation on Pelvic Floor Functional Changes in Pregnant and Nonpregnant Women: A Preliminary Study. Haavik, Heidi et al. Journal of Manipulative & Physiological Therapeutics , Volume 39 , Issue 5 , 339 – 347
- Haavik H, Niazi IK, Jochumsen M, Sherwin D, Flavel S, Türker KS. (2017) Impact of spinal manipulation on cortical drive to upper and lower limb muscles. Brain Sciences. In Press
- Haavik H, Niazi I, Jochumsen M, Ugincius P, Sebik O, Yilmaz G, Samran Navid M, Gorkem Ozyurt M and Turker K (2018), “Chiropractic spinal manipulation alters TMS induced I-wave excitability and shortens the cortical silent period,” Journal of Electromyography and Kinesiology, Volume 42 (2018), pp. 24-35
- Lelic, D, Niazi, IK, Holt, K, Jochumsen, M, Dremstrup, K, Yielder, P, Murphy, B, Drewes, A and Haavik, H (2016), “Manipulation of dysfunctional spinal joints affects sensorimotor integration in the pre-frontal cortex: A brain source localization study,” Neural Plasticity, Volume 2016 (2016).
- Daligadu J, Haavik H, Yielder P, Baarbe J, and Murphy B (2013), “Alterations in Cortical and Cerebellar Motor Processing in Subclinical Neck Pain Patients Following Spinal Manipulation,” JMPT Vol 36, Iss 8, October 2013 pp. 527-537, https://doi.org/10.1016/j.jmpt.2013.08.003
JMPT Vol 36, Iss 8, October 2013 pp. 527-537, https://doi.org/10.1016/j.jmpt.2013.08.003
