The Efficacy of Massage and Reflexology Applications in Children With Cerebral Palsy

The study aims to compare the effectiveness of classical massage, connective tissue massage, and reflexology in children with cerebral palsy.

The universe of the study will consist of children aged 4-18 years with a diagnosis of CP and chronic constipation who were admitted to the Duha Special Education and Rehabilitation Center. As a result of the power analysis, the minimum number of participants was determined as 20 for each group. Measurement and evaluation will be made to the groups three times, before the study, after the study (8th week), and follow-up at the 12th week.

Evaluations will be made by another physiotherapist who has no knowledge of the research topic and research groups. Children participating in the study will be determined by randomization using the closed-envelope method. The study is a randomized controlled experimental study.

In the study, the effects of treatments on the level of constipation, participation inactivity, and patient-parent sleep quality will be questioned. The sociodemographic data of the participants will be recorded in the general evaluation form. Gross Motor Function Classification System (KMFSS) to classify motor function levels, Gross Motor Function Scale-88 (KMFF-88) to assess functional status, and Functional Independence Measure= FIM to assess spasticity, Modified Ashworth Scale to assess constipation, Bristol for constipation assessment The Poo Scale and Constipation Severity Scale (BSS), and the Child Sleep Form (CUF) and the Pittsburgh Sleep Quality Index (PUKI) will be used for sleep assessment.

1. Group - Classical Abdominal Massage Group: After the physical therapy applied to the patient by the physiotherapist in the special education center, 3 days a week for 8 weeks, once a day for approximately 15-20 minutes. Classic abdominal massage will be applied. To families; Training will be given on sleep hygiene, nutritional recommendations, and lifestyle changes.
2. Group- Connective Tissue Massage Group: After the physical therapy applied to the patient by the physiotherapist in the special education center for 8 weeks, 3 days a week, once a day for approximately 15-20 minutes. Connective tissue massage will be applied. To families; Training will be given on sleep hygiene, nutritional recommendations, and lifestyle changes.
3. Group- Reflexology Group: After the physical therapy applied to the patient by the physiotherapist in the special education center for 8 weeks, 3 days a week for approximately 15-20 minutes. reflexology will be practiced. To families; Training will be given on sleep hygiene, nutritional recommendations, and lifestyle changes.

Eligibility Criteria:
Inclusion Criteria:

* Having been diagnosed with cerebral palsy
* According to Gross Motor Function Test III, IV. and level V.
* Constipation in the last 6 months
* Age range is 4-18 years old
* Absence of any cardiopulmonary disease that will prevent exercise
* Patients who were informed about the study and whose families gave written consent to participate in the study will be included in the study.

Exclusion Criteria:

* Having undergone surgery involving intestinal health
* Having a chronic infectious bowel disease
* Having a congenital intestinal anomaly
* To have received Botox treatment in the last 6 months
* Absence of constipation in the last 6 months
* Levels I and II according to Gross Motor Function Test
* Having uncontrolled epileptic seizures
* Not signing the voluntary information and consent form
* Not continuing to work regularly