Efficacy of fascial manipulation compared to stretching for rehabilitation of children with cerebral palsy: study protocol for a randomised controlled trial (Preprint)

BACKGROUND Maintaining and improving motor function is essential in the rehabilitation of children with cerebral palsy (CP). Fascial manipulation (FM) is increasingly used and has shown promise in the rehabilitation of movement difficulties caused by CP. However, evidence supporting FM efficacy remains limited. This study protocol assesses the efficacy of FM by comparing the outcome of FM versus stretching in children with CP. OBJECTIVE The aim of the study is to compare the effects of FM and stretching on functional mobility in children with CP. The primary objective is to investigate the effect FM and stretching have on joint ROM, spasticity and walking in children with CP. The secondary objective is to investigate the impact of FM or stretching on daily activities. METHODS This randomised controlled trial will include 20 children aged 7–14 years with spastic CP, divided into an FM intervention group (n=10) and a stretching group (n=10). Each child in both groups will receive one treatment session per week over an 8-week period. The primary outcome will be the 6-minute walk test, which assesses functional walking capacity. Secondary outcomes will include walking economy, gait biomechanics, ankle spasticity, muscle activity, joint stiffness and function in daily life. Assessments will be conducted before and after the intervention. In addition to quantitative measures, a qualitative component will be included involving semi-structured interviews with caregivers and the child’s regular physiotherapist following the intervention to explore perceived changes in function and the reported experience of the treatment. RESULTS This is a protocol for a ongoing study and no results have yet been reported CONCLUSIONS This is the first version of the trial protocol. With this study, we aim collect valuable information to improve rehabilitation strategies for children with CP. To our knowledge, only a few studies have been published that directly examine the effect of FM intervention on walking in children with CP. CLINICALTRIAL The study has been approved by the Regional Ethics Committee of Helsinki and Uusimaa (HUS/8556/2023) and HUS New Children’s Hospital (permit HUS/564/2024). Trial registration number: ClinicalTrials.gov ID NCT06837025, retrospectively registered February 20, 2025. https://clinicaltrials.gov/study/NCT06837025