Purpose:
Limited research exists regarding use of Astym® therapy with neurologic conditions. The purpose of this case was to describe using Astym therapy in treating spastic diplegic cerebral palsy (CP).
Case description:
A 6-year-old female was treated more than 9 months (36 sessions) for decreased flexibility, muscle weakness, spasticity, and abnormal gait.
Examination findings:
Gait performed with articulated ankle-foot orthoses (75% of the time) or foot orthosis (25%); lack of active dorsiflexion (DF); lack of heel strike during gait; spasticity in hamstrings, gastrocnemius, hip adductors; hamstring flexibility (90/90 test position) 50° right and 60° left; gastrocnemius flexibility neutral bilaterally; and Peabody Developmental Motor Scales, second edition (PDMS-2) age equivalence (in months) 23 locomotion, 25 object manipulation, and 21 stationary tasks. Therapeutic interventions included Astym therapy, stretching, strengthening, neuromuscular reeducation, and gait training.
Outcomes:
At 6 months, flexibility improved bilaterally to 10° past neutral in gastrocnemius and 0° in hamstrings. The PDMS-2 age equivalence scores were 27 locomotion, 32 object manipulation, and 28 stationary tasks. At discharge, patient ambulated full-time with foot orthosis, exhibiting improved stride length bilaterally with active ankle DF to initiate heel strike. Spasticity was unchanged.
Discussion:
Astym therapy was effective in treating a child with spastic diplegic CP, resulting in enhanced strength, flexibility, and gait.