The Effect of Chiropractic Spinal Manipulation on the H-reflex and Muscle Strength in Children With Cerebral Palsy: A Feasibility Study

Background: Children with cerebral palsy (CP) have deficits in various aspects of motor control, including motor neuron excitability, which can affect muscle strength, gait, and ability to perform activities of daily living. Previous research on chiropractic spinal manipulation in healthy adults, athletes, and a brain-injured population has indicated improvements in motor neuron excitability, muscle strength, and various aspects of motor control. Thus, chiropractic spinal manipulation may improve motor control in children with CP.

Methods: Children with spastic diplegic CP, aged 8-13 years, were recruited for a randomized, controlled feasibility study. Feasibility was assessed in terms of recruitment strategy and rate, data collection procedures, equipment, intervention, and compliance.

Results: Three children completed the data collection comprising pre- and post-measurements of the H reflex, V-wave, and muscle strength. The recruitment strategy and rate were not feasible. The data collection procedures were appropriate and complied with, except for the V-wave measurements. The H-reflex threshold decreased and s50 and slope increased in the participants who received chiropractic spinal manipulation; the opposite was seen in the control group. The changes in MVC force were inconsistent between subjects.

Conclusion: This study answered some important feasibility questions regarding conducting a large-scale randomized controlled study with the same design. Some aspects proved feasible, such as H-reflex recordings, and some aspects, such as recruitment methods and V-wave recordings, need to be altered for future research in this area.