Effectiveness of infantile tuina for improving motor dysfunction in children with spastic cerebral palsy: A systematic review and meta-analysis of randomized controlled trials

Abstract

Introduction

Infantile cerebral palsy (ICP) is a disease that causes cognitive and motor dysfunction in children, severely affecting their growth and mental health. Infantile tuina is a prominent treatment modality in traditional Chinese medicine (TCM). However, the effectiveness of infantile tuina remains uncertain. This systematic review aimed to assess the efficacy of infantile tuina in enhancing motor dysfunction in ICP through randomized controlled trials (RCTs).

Methods

We completed the meta-analysis according to the PRISMA 2020 checklist. Randomized controlled trials (RCTs) were searched for in seven databases including Medline, Ovid EMBASE, Cochrane Library, Web of Science, China national knowledge infrastructure, Chinese biomedical literature, and Wan Fang from the establishment of the database until November 7, 2023. The effectiveness of infantile tuina to treat motor dysfunction in children with spastic cerebral palsy was evaluated using outcome indexes such as effective rate, Gross motor function measure (GMFM), Modified Ashworth Scale (MAS), and ankle passive dorsiflexion angle.

Results

A total of 12 RCTs were included in this systematic review, which included 950 patients. Meta-analysis of the results indicated that infantile tuina combined with conventional rehabilitation treatment for ICP produced better results than conventional rehabilitation treatment alone. The experimental group intervention had a significant effect on the improvement of ICP treatment efficiency [Relative Risk (RR) = 1.21; 95% Confidence Interval (CI) = 1.10, 1.33], GMFM [MD = 4.76, 95% CI = 3.23, 3.29], MAS [Mean difference (MD) = -0.83, 95% CI = -1.02, -0.64], and ankle dorsiflexion angle [MD = -4.82, 95% CI = -7.45, -2.18]. The results were statistically significant (P < 0.05).

Conclusions

As a complementary therapy to conventional rehabilitation therapy, infantile tuina produced significant improvements in ICP treatment effectiveness in this systematic review. The main limitation in the evidence was a lack of high-quality studies and many studies had small sample sizes.

Registration

PROSPERO ID: CRD42023446889.