Farkhanda Shaheen, Waqar Ahmed Awan.
The role of stretching exercises in relieving constipation in the spastic cerebral palsy.
Int J Rehab Sci Jan ;01(01):35-40.

Objectives: To examine the effect of stretching exercises for the improvement of constipation in spastic cerebral palsy patient. Methods and Measures: A seven year’s old child with spastic quardriplegia due to cerebral palsy referred to physical therapy department of armed Forces Institute of rehabilitation medicine for the management of the cerebral palsy. During evaluation the therapist found that child was also the patient of chronic constipation. For constipation patient was treated with enema before the stretching exercises. The subject was treated daily at physiotherapy department with stretching exercises, home stretching exercises program was also given to perform three times a day along with reflex inhibiting posture after the stretching exercises. Stretching of the calves, hamstrings, illiopsos, adductors of hip and trunk rotator were performed. Modified Ashworth Scale was used to determine the level of spasticity. In addition, Constipation Assessment Scale was administered to the subject to determine the severity of constipation. The satisfaction from the treatment was measured using modified Ashworth scale, Constipation Assessment Scale and parent’s feedback about the behavior and attitude of child after treatment. Results: After the first week of the treatment, the stretching exercises decreased the spasticity on Modified Ashworth Scale (MAS) from 3/4 to 2/4 and improved subject’s Constipation Assessment Scale (CAS) from an average of 14/16 to 10/16. After a month, subject achieved a Modified Ashworth Scale (MAS) 1/4 and Constipation Assessment Scale (CAS) 5/16. These results were maintained at a long-term follow-up performed with treatment. Conclusion: stretching exercises were effective as for both spasticity and constipation in spastic cerebral palsy. The results of this study suggest that stretching may be helpful in constipation. Additional advanced studies should be conducted to confirm the effect of stretching in constipation in spastic cerebral palsy.

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