Effects of traditional Chinese medicine combined with modern rehabilitation therapies on motor function in children with cerebral palsy: A systematic review and meta-analysis

Zhengquan Chen; Zefan Huang; Xin Li; Weiwei Deng; Miao Gao; Mengdie Jin; Xuan Zhou; Qing Du

doi:10.3389/fnins.2023.1097477

Effects of traditional Chinese medicine combined with modern rehabilitation therapies on motor function in children with cerebral palsy: A systematic review and meta-analysis

Front Neurosci. 2023 Feb 8:17:1097477. doi: 10.3389/fnins.2023.1097477. eCollection 2023.

Authors

Zhengquan Chen¹, Zefan Huang¹, Xin Li¹, Weiwei Deng¹, Miao Gao¹, Mengdie Jin¹, Xuan Zhou¹, Qing Du^{1

2}

Affiliations

¹ Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
² Chongming Hospital, Shanghai University of Medicine and Health Sciences, Shanghai, China.

Abstract

Objective: Traditional Chinese Medicine (TCM) has considerable experience in the treatment of cerebral palsy (CP), but little evidence shows the effect of a combination of TCM and modern rehabilitation therapies on CP. This systematic review aims to evaluate the effect of integrated TCM and modern rehabilitation therapies on motor development in children with CP.

Methods: We systematically searched five databases up to June 2022, including PubMed, the Cumulative Index to Nursing and Allied Health, Cochrane Library, Embase, and Web of Science. Gross motor function measure (GMFM) and Peabody Development Motor Scales-II were the primary outcomes to evaluate motor development. Secondary outcomes included the joint range of motion, the Modified Ashworth scale (MAS), the Berg balance scale, and Activities of Daily living (ADL). Weighted mean differences (WMD) and 95% confidence intervals (CIs) were used to determine intergroup differences.

Results: A total of 2,211 participants from 22 trials were enrolled in this study. Among these, one study was at a low risk of bias and seven studies showed a high risk of bias. Significant improvements were found in GMFM-66 (WMD 9.33; 95% CI 0.14-18.52, P < 0.05, I ² = 92.1%), GMFM-88 (WMD 8.24; 95% CI 3.25-13.24, P < 0.01, I ² = 0.0%), Berg balance scale (WMD 4.42; 95% CI 1.21-7.63, P < 0.01, I ² = 96.7%), and ADL (WMD 3.78; 95% CI 2.12-5.43, P < 0.01, I ² = 58.8%). No adverse events were reported during the TCM intervention in the included studies. The quality of evidence was high to low.

Conclusion: Integrated TCM and modern rehabilitation therapies may be an effective and safe intervention protocol to improve gross motor function, muscle tone, and the functional independence of children with CP. However, our results should be interpreted carefully because of the heterogeneity between the included studies.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022345470.

Keywords: acupuncture; cerebral palsy; motor function; systematic review; traditional Chinese medicine.

Publication types

Systematic Review

Grants and funding

This study was funded by the Shanghai Three-Year Action Plan to Further Accelerate the Development of Chinese Medicine Inheritance and Innovation (2021–2023) Project, No. ZY(2021-2023)-0201-05.