Research Piece: The use of Cranial Sacral Therapy (CST) in a physically impaired population in a disability service in Southern Ireland from Maggie Gliksten

This is the summary of a piece of reseach carried out a few years ago by Maggie Gliksten and Vicki McManus relating to using CST in a population of disabled children. Maggie has been working in the disability sector in Ireland for the past 15 years, 10 of which has been using CST. It was published as a letter in the Journal of Complementary and Alternative Medicine – the original article was deemed too long. She has been working on a rewrite of the original so I can let anywone know when that is available.  We thought some of you might be interested!

The use of Cranial Sacral Therapy (CST) in a physically impaired population in a disability service in Southern Ireland

Authors

Vicki Mc Manus (BA, RGN, RCN) Research coordinator, Enable Ireland, Cork Services, Cork

Maggie Gliksten (BCMA, IACST, NHII, CST-T, NRRI) Complimentary therapist, Enable Ireland, Cork Services, Cork

Contact details for both authors 00 353 21 4294803 extension 278

Key words: physically disabled children, cranial sacral therapy

Dear Editor,

The use of complementary and alternative medicine (CAM) is increasing in

children (Nickel 1996). The use of Cranio sacral therapy (CST) is common in

children with special needs for relief from daily or weekly symptoms (Sinha et al

2005, Hurvitz et al 2003). Carlson and Krahn found that their sample of people

with physical disabilities used CAM including CST because it fitted their lifestyles

and because they perceived it to be more effective than conventional medicine

for treating symptoms or treating decreased function (Carlson et al 2006).

CST is a gentle, non invasive manipulative hands-on technique, a whole

body method of releasing restrictions around the brain and spinal cord to

enhance central nervous system performance and allow the body to self-correct

(Upledger). It was developed by John Upledger after eight years of clinical

research at Michigan State University. He developed an understanding or system

of diagnosis and treatment aimed at mobilizing cranial sutures which were

determined to be abnormally restricted to physiologic motion (Sutherland 2001).

We describe here families’ reasons for using CST and their perceptions of its

effectiveness. The sample of forty six families of children was drawn from service

users aged between 0-18 attending a disability service from the year 2004. A

questionnaire was developed using both qualitative and quantitative methods.

The 20 item survey was handed or posted to the parents of children attending

the CST practitioner after they were attending the service for one year. The

questionnaire explored areas of daily living functions; chest, general-health,

elimination, sleep pattern, appetite, flexibility, vocalization, relaxation, muscle

tone, circulation and alertness. The questionnaire asked parents to tick one

of the following for a range of bodily functions; no change in condition, some

improvement, apparent improvement, significant change, gross improvements in

condition.

CST was chosen as a method of treatment to aid children gain more flexibility,

minimize the effects of the spasticity of the CP diagnosis, help reduce

seizures and assist in the conventional treatment of the physical diagnosis.

Ethical approval was not required as this was a service evaluation.

From 46 surveys posted 46 (100%) were returned. The mean child age was

8.32years. Of the group 54% were boys. Details of conditions see table 1 (bottom of page). The

factors most frequently stated as important were symptom control or minimizing,

adding to the conventional treatments and avoiding side effects. All parents

reported some improvement. No parent reported any worsening in their children’s

condition. All of families reported less stress between siblings and in the family

set up. All families requested more therapy in the future. On average the clients

received 15 to 20 hours therapy per annum.

Activities were ranked in order of reported effectiveness (see table 2 – bottom of page). Parents

reported chest improvements as first, elimination as second, appetite as third,

concentration as fourth, sleep patterns as fifth, circulation improvements as sixth,

general health as seventh, vocalization as eight, muscle tone as ninth, flexibility

as tenth, relaxation as eleventh and finally alertness as twelfth. The full detailed

report is available from the authors.

Comments from families were very informative: with regard to relaxation one

parent reported –‘My child was always so calm and relaxed after their sessions.

During the holidays the anxiety would start to rise again. We would all be anxious

for the holidays to be over!’ One parent spoke of how her child was ‘more tolerant

of her siblings during treatment, and another said ‘She doesn’t cry as much

anymore since starting treatment’. With regard to concentration parents

mentioned that teachers had noticed that ‘the sessions improved on his

coordination and concentration. This allows his siblings to have a normal

relationship with him.’ And on bodily functions it was reported that one child ‘has

a regular bowel habit for the first time in her life and sleeps as a normal child

would’. A significant reduction in seizure duration and severity was noted; though

anecdotal, parents felt strongly that their child was ‘like a different child… her

seizures have diminished!’ Other client’s seizures have disappeared totally and

one client has gone from having several seizures daily lasting 50 minutes to 3-4

seizures per week lasting 5-8 minutes. The factors most frequently stated as

important were symptom control or minimizing, adding to the conventional

treatments and avoiding side effects. All families reported some improvement in

all areas of daily functioning and their children’s symptoms.

No comprehensive studies have been done on this side of the world on either

CAM or CST. In order to complement conventional medicine more information

should be available on CST to the general public as to the reported benefits.

Our study shows that families perceive improvements in all areas of daily

functioning after using CST, anecdotal evidence like this cannot be discounted.

Acknowledgements – The completion of this work would not have been possible
without the support of the service users and staff of Enable Ireland Cork
Services.

References

1. Nickel RE. Controversial therapies for young children with developmental

disabilities. Infants Young Child 1996; 8: 29-40.

2. Sinha D, Efron D Complementary and alternative medicine use in children

with attention deficit hyperactivity disorder. J Pediatr Child Health. 2005

Jan-Feb; 41 (1-2): 21-22.

3. Hurvitz EA, Leonard C. Ayyangar R. Nelson VS. Complementary and

alternative medicine use in families of children with cerebral palsy. Dev

Med Child Neurol. 2003 Jun; 45 (6):364-70.

4. Carlson MJ, Krahn G. Use of complementary and alternative medicine

practitioners by people with physical disabilities: estimates from a National

US Survey. Disabil Rehabil. 2006 Apr 30; 28 (8): 505-13.

5 .Upledger J. (D.O., O.M.M) Craniosacral Therapy- Touchstone for Natural

Healing. ISBN: 1556433689 North Atlantic Books USA

6. Sutherland W. cited in Kern Michael, Wisdom in the body – The

craniosacral approach to essential health. Published by Thorsons, London

(2001). ISBN 0-7225-3708-5.

Table 1

Table 1 Details of service users receiving treatment –
Total  = 46 children

Cerebral Palsy     21  

Muscular dystrophy     1  

Erbs palsy    3

Spina Bifida   4

Anomalies (digeorge syndrome x 1, lissencephaly x 1)     2

Neurological deficits (corpus collosum x 2, prader willi x1, neuro x 8)    11

Acquired motor impairment (neuroblastoma x 2, hypotonic x 1)    3

Visual impairment     1
 

Table 2 – Ranking of Activities Parent reported improvement in

Concentration

Chest

General

Health

Sleep pattern

Elimination

Appetite

Flexibility

Vocalisation

Relaxation

Muscle tone

Circulation

Alertness