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From the Department of Pediatrics (Drs Duncan, Andrews, and Meaney) and the Department of Medicine (Dr McDonough-Means) at the University of Arizona Health Sciences Center in Tucson; the Department of Osteopathic Manipulative Medicine at Midwestern University/Arizona College of Osteopathic Medicine in Glendale (Dr Worden); and the Osher Institute at Harvard Medical School in Boston, Mass, and the New England School of Acupuncture in Newton, Mass (Dr Schnyer).

Address correspondence to Burris Duncan, MD, 1501 N Campbell Ave, Tucson, AZ 85724-0002. E-mail: brduncan{at}email.arizona.edu.

Context: Case reports and clinical trials have indicated that osteopathic manipulative treatment (OMT) may improve motor function and quality of life for children with cerebral palsy.

Objective: To assess the effectiveness of osteopathy in the cranial field, myofascial release, or both versus acupuncture in children with moderate to severe spastic cerebral palsy, as measured by several outcomes instruments in a randomized controlled trial.

Methods: Children between the ages of 20 months and 12 years with moderate to severe spastic cerebral palsy were enrolled in a single-blind, randomized wait-list control pilot study. There were three arms in the study: OMT (ie, osteopathy in the cranial field, myofascial release, or both, using direct or indirect methods), acupuncture, and control (ie, nontherapeutic attention). Children who were initially randomly assigned to the control arm were subsequently randomly reassigned to the intervention arms, increasing the sample size. Outcome measures included standard instruments used in the evaluation of children with cerebral palsy. Less traditional measures were also used, including serial evaluations by an independent blind osteopathic physician and visual analog scale assessments by an independent osteopathic physician and the parents or guardians. A total of 11 outcome variables were analyzed.

Results: Fifty-five patients were included in the study. Individual analyses of the 11 outcome variables revealed statistically significant improvement in two mobility measures for patients who received OMT—the total score of Gross Motor Function Measurement and the mobility domain of Functional Independence Measure for Children (P<.05). No statistically significant improvements were seen among patients in the acupuncture treatment arm.

Conclusions: A series of treatments using osteopathy in the cranial field, myofascial release, or both improved motor function in children with moderate to severe spastic cerebral palsy. These results can be used to guide future research into the effectiveness of OMT or acupuncture in treating children with spastic cerebral palsy.