Aculaser Therapy for the Treatment of Cerebral Palsy

Laser

A single, open and non comparative study was conducted at Anwar Shah’s First C.P. & Paralysis Clinic and Research Center in collaboration with the Departments of Neurology and Neurosurgery, Children Hospital Lahore, Pakistan to evaluate the effects of ACULASER THERAPY in children suffering from Cerebral Palsy (CP) and associated Neurological Disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, paraplegia, monoplegia, sensory-neural deafness and speech disorders. In all 100 children were treated and the data was gathered during a period of 18 months from December 2003 till June 2005.

By Dr Shahzad Anwar M.B.B.S (Pb.), Dip. A/C (Pak.), Lic. A/C (China). shahzadtirmzi@hotmail.com Medical Acupuncturist and Director, Anwar Shah’s First C.P. & Paralysis Clinic and Research Center, 2-A, Abbok Block New Garden Town Lahore, Pakistan.

In Collaboration with Prof. Dr. Malik Muhammad Nazir Khan M.B.B.S, F.C.P.S., Fellow in Pediatric Neurology (U.K), Head Department of Neurology, Children’s Hospital & Institute of Child Health, Lahore, Pakistan and Dr. Malik Mohammad Nadeem Khan, M.B.B.S, M.S, Pediatric Neurosurgeon & Assistant Professor, Children’s’ Hospital & Institute of Child Health, Lahore, Pakistan. Assisted by Dr. Faiza Munir Qazi M.B.B.S (Pb), FCPS (I) Anwar Shah’s First C.P. & Paralysis Clinic and Research Center Lahore, Pakistan. Imtiaz Ahmed, B.S.P.T (Pak.), Post Grad. Diploma in Physiotherapy (A.K.U), Senior Physiotherapist, Sheikh Zayed Hospital, Lahore, Pakistan and Abid Hareef Awan B.S.P.T (Pb.), M.P.P.S (Pak.) Physiotherapist Anwar Shah’s First C.P. & Paralysis Clinic and Research Center 17 C, Main Boulevard Faisal Town Lahore, Pakistan

Abstract:

A single, open and non comparative study was conducted at Anwar Shah’s First C.P. & Paralysis Clinic and Research Center in collaboration with the Departments of Neurology and Neurosurgery, Children Hospital Lahore, Pakistan to evaluate the effects of ACULASER THERAPY in children suffering from Cerebral Palsy (CP) and associated Neurological Disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, paraplegia, monoplegia, sensory-neural deafness and speech disorders. In all 100 children were treated and the data was gathered during a period of 18 months from December 2003 till June 2005.

This article shows results of the treatment with ACULASER THERAPY in CP children who were treated for minimum 6 weeks and more or had minimum of 10 treatment sessions and more. This paper also shows that those children who were given a break in the treatment for 4 -12 weeks did not show any reversal of the symptoms. These children were classified according to the associated Neurological Disorders.

Analysis of the data showed that out of 81 children with Spasticity and Stiffness 69 showed marked improvement showing 85% improvement rate, out of 54 children with Epileptic fits there was a significant reduction in the intensity, frequency and duration of Epileptic fits in 34 children showing 63% success rate, out of 18 children with Cortical Blindness 13 children showed improvement accounting for 72% efficacy rate, out of 45 children with Hearing Difficulties, 31 showed marked improvement accounting for 69% improvement rate, out of 100 children with Speech Disorders 67 showed improvement reflecting 67 % improvement rate, out of 46 children with Hemiplegia 32 showed improvement in movement, tone and power accounting for 69% improvement rate, out of 36 children with Quadriplegia 25 showed improvement in gross and fine motor functions showing 69% success rate and out of 18 children with Paraplegia of lower limbs 12 showed improvement in weight bearing, standing and movement accounting for 67% improvement rate.

Key Words:

Cerebral Palsy, Laser acupuncture, Aculaser therapy, CP Children, Cortical blindness, Epilepsy, Spasticity, Stiffness, Sensory neural deafness, Speech disorders, Hemiplegia, Quadriplegia, Paraplegia.

Objectives:

To evaluate the effects of ACULASER THERAPY (Laser Acupuncture, Physiotherapy, Color therapy, Magneto therapy) in children suffering from cerebral palsy and associated neurological disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, sensory-neural deafness and speech disorders. In addition to this, to evaluate when this treatment is stopped; is there any regression of the development or reversal of the symptoms.

Background:

It is difficult to estimate exactly how many people have CP. Many people with mild CP are never diagnosed, while others may have multiple disabilities which overshadow their CP. Today, more people have cerebral palsy than any other developmental disability, including Down syndrome, epilepsy, and autism. The incidence of CP is 7 per 1000 live births (Nelson, Essentials of Pediatrics 1998 (1)).

In general there is not any single treatment which addresses physical, mental and cognitive aspects of CP children. This research study is based on the principal of combining and using different treatment modalities like laser acupuncture (Scalp, Auricular & Body Acupuncture) (LLLT), physiotherapy, magneto therapy, color therapy and reflex massage for the treatment of children suffering from CP.

Source and Criteria:

These children were included randomly as they presented at the center. These children were referred to us by the Department of Neurology and the Department of Neurosurgery, Children Hospital & Institute of Child Health Lahore, Pakistan. Those CP children who were treated for minimum 6 weeks and more, or who had minimum of 10 treatment sessions and more were included in the study.

Introduction:

Cerebral palsy (CP) is a term used to describe a group of disorders effecting body movement and muscle co-ordination. The medical definition of CP is “a non-progressive but not unchanging disorder of movement and/or posture, due to an insult or anomaly of the developing brain”. Because cerebral palsy influences the way children develop, it is known as a developmental disability.

Causes of Cerebral Palsy:

Any damage to the developing brain, whether caused by genetic or developmental disorders, injury or disease, may cause CP.

During pregnancy:

Anything which tends to produce a low birth weight baby will increase the likelihood of CP. Factors during pregnancy which may cause CP include:

  • multiple births (twins or triplets)
  • a damaged placenta which may interfere with fetal growth
  • infections
  • poor nutrition
  • exposure to toxic substance, including nicotine and alcohol
  • maternal diabetes, hyperthyroidism or high blood pressure
  • biochemical genetic disorders
  • chance malformations of the developing brain

During labour:

  • premature delivery
  • abnormal positioning of the baby (such as breech or transverse lie) which makes delivery difficult
  • rupture of the amniotic membranes leading to fetal infection

In early childhood:

CP can occur if a young child suffers brain damage due to:

  • infection such as meningitis
  • brain hemorrhages
  • head injury following falls, car accidents or abuse
  • a lack of oxygen (asphyxia) due to accidents such as drowning
  • seizures

What is ACULASER THERAPY?

AcuLaser therapy is a combination of the following treatment modalities:

  • Laser Acupuncture (LLLT), (Scalp, Auricular & Body Acupuncture).
  • Physiotherapy.
  • Magneto therapy.
  • Color therapy.
  • Vitamins & Nutritional advice.
  • Reflex Massage.In this study we used Laser acupuncture (body points, scalp areas and auricular points) Physiotherapy, Color-therapy and Magneto therapy as main treatment modalities. Other treatment modalities were used an adjuvant to these.

    Acupuncture is one of the oldest treatment modalities which have been successfully practiced in China for the last 4000 years (George T. Lewith (2)). Traditionally acupuncture has been used for various mental and physical disabilities. Especially in the last 35 years with the development of different forms of SCALP ACUPUNCTURE by Dr. Jiao Shunfa (Jiao Shunfa 1997 (3)), Dr Zhu’s Scalp Acupuncture (Zhu Mingqing 1992 (4)) and YNSA (Yamatomo’s New Scalp Acupuncture 1998 (5)) use of acupuncture in neurological and developmental disorders has increased to a greater extent. World Health Organization reviewed and standardized Scalp acupuncture in 1984. In 1988 WHO published the first standard pamphlet on Scalp acupuncture (WHO 1991 (6)). Many studies done all over the world on humans and animals show that Scalp acupuncture is very effective in treating developmental and neurological diseases in children and adults. Research shows that level of certain hormones in the body and cerebral blood flow improves (Xiang L (7)), (Gerhard Litscher (8)).

    Low Level Laser Therapy (LLLT) is the use of low power therapeutic lasers to treat various diseases. Many research studies show that LLLT has various effects on cells and nervous tissue (Tunér, J. 2002 (9). LLLT is used to stimulate wound healing and tissue regeneration (J. Pineal Res. 2003 (10)). Some studies demonstrate that LLLT can be used safely on acupuncture points and different zones or areas on scalp (Harry Lazoura (11)).

    Physiotherapy is widely used as an integral part of the treatment for C.P. all over the world. Hundreds of studies show that physiotherapy helps to a major extent in the treatment of C.P. (J. Parkes, 2000 (12)).
    Magneto therapy is the use of magnets or magnetic fields to treat various diseases. Recent studies show a positive effect of magnet therapy in various neurological and developmental diseases like epilepsy (Seizure. 2003 (13)).

    Color therapy is based on the fact that physiologic functions respond to specific colors. Using colored light for therapy has been in practice a very long time and we see it happening every day, whether we realize it or not. Research was also done to test the effects of colored light on muscles. When subjects were using a hand grip and exposed to blue light, their grip lightened, while other tests have shown that when muscles were exposed to red light the electrical activity in them increased (Therese M Donnelly 2000 (14)).

    Methods & Materials Used:

    This study was conducted at Anwar Shah’s First CP & Paralysis Clinic and Research Center in collaboration with the Department of Neurology Children Hospital Lahore, Pakistan and the Department of Neurosurgery Children Hospital Lahore, Pakistan for a period of 18 months from December 2003 till June 2005. In all 100 children with different types and etiology were treated. There were 54 boys and 46 girls. Their mean age was 3.2 years.

    The history of every child was taken and a primary clinical assessment with initial measurements was done which included Head Circumference (H.C), Height and Weight.

    CT scan and MRI were conducted to rule out surgical lesions in some cases. After primary assessment and initial measurements, the children were treated twice a week with ACULASER THERAPY.

    In this study we used Laser acupuncture (body points, scalp areas and auricular points) Physiotherapy, Color-therapy and Magnetotherapy as main treatment modalities. Other treatment modalities were used an adjuvant to these.

    We stimulated scalp areas first, (scalp areas may vary in size from 1 cm to 3 cm); this was followed by stimulation of body points (body points are small areas on the body measuring almost 1 cm) and auricular points. This study was conducted in very young children who had few and very thin head hair, older children who had thick head hair their parents were asked to shave their heads regularly so we could stimulate their scalp areas properly. We did not follow any single method or school of acupuncture. We actually combined 5-element acupuncture, auricular acupuncture and scalp acupuncture (Jiao Shunfa, YNSA and Dr Zhu) to treat many different cases of CP and associated neurological disorders.

    In classical acupuncture treatment there is no specific formula or set of points to treat any disease and treatment may vary for the same patient on subsequent sessions depending on the response. However, there are some generalizations which could be applied like for spasticity Liver 3 and Gall Bladder 34, for irritability and restlessness Heart 7, 5 (also for the improvement of speech) and Du 20, to increase cerebral blood flow Du 26, 16, 14, etc. On scalp we mainly stimulated motor areas, speech areas, visual areas, brain point, etc. On auricles we stimulated shenmen, sub cortex, back, limbs, etc.

    We used 2 types of soft lasers with different wavelengths. For the stimulation of body and auricular points, we used red HJZ3A He-Ne laser with a wavelength of 632.8 nm 30 mW from the tube and estimated 20 mW at the tip. This laser is manufactured by Guoguang Electric Co of Chengdu, China. For scalp areas we used diode laser with a wavelength of 675 nm, 50 mW manufactured by Wen Zhou Electric Appliance Company Xinke province, China.

    Each body and auricular point was stimulated for 25 seconds (4 J) while scalp areas were stimulated for 45 seconds (18 J).

    In addition to the LLLT every child had a full session of physiotherapy. We used blue light for 20 minutes on face and body in epileptic cases and yellow light for 20 minutes on face and body in non epileptic cases during each treatment session.

    We placed North Pole of 300 gauss magnet under right foot and South Pole under left foot for 5 minutes. South Pole of 300 gauss magnet was placed under the pillow (occipital lobe) for 5 minutes.

    The response of every child was recorded on every visit to the center and physical measurements were done at 6 weeks interval. Photograph of each child with physical dysfunction were taken before, during and after treatment.

    In addition to the treatment at the center their parents were taught the reflex massage which they performed daily at home.

    Total No. of Children Treated:

    In all 100 C.P. children with associated neurological disorders were treated:

    • Children with Spasticity & Stiffness: 81
    • Children with Epilepsy: 54
    • Children with Cortical blindness: 18
    • Children with Hearing difficulties: 45
    • Children with Speech Disorder: 100
    • Children with Hemiplegia: 46
    • Children with Quadriplegia: 36
    • Children with Paraplegia: 18

    Male: female sex ratio:

    Baby boys: 54

    Baby girls: 46

    Male: female sex ratio was 1.27:1

    Age Distribution:

    AGE: No. of Children:
    Less than 1 year 13
    1 to 3 years 47
    3 to 5 years 24
    5 years and older 16

    Minimum Age: 04 Months

    Maximum Age: 16 years

    Mean Age: 3.2 years

    Response of C.P Children with Different Neurological Disorders

    Response of C.P Children with Spasticity & Stiffness:

    Out of 81 C.P. children with spasticity and stiffness 69 showed marked improvements as both stiffness and spasticity improved. This accounts for 85% success rate.

    Response of C.P Children with Epilepsy:

    Out of 54 C.P. children with epilepsy 34 showed marked improvements as both the frequency and intensity of epileptic fits decreased. This accounts for 63% success rate.

    Response of C.P Children with Cortical Blindness:

    Out of 18 C.P. children with cortical blindness 13 children showed improvement accounting for 72% efficacy rate.

    Response of C.P Children with Hearing Difficulties:

    Out of 45 C.P. children with hearing difficulties 31 showed marked improvements. This accounts for 69% improvement rate.

    Response of C.P Children with Speech Disorder:

    Out of 100 C.P. children with speech disorder 67 children improved showing 67 % improvement rate.

    Response of C.P Children with Hemiplegia:

    Out of 46 C.P. children with hemiplegia 32 children improved showing 69 % improvement rate.

    Response of C.P Children with Quadriplegia:

    Out of 36 C.P. children with quadriplegia 25 children improved showing 69 % improvement rate.

    Response of C.P Children with Paraplegia:

    Out of 18 C.P. children with paraplegia of the lower limbs 12 children improved showing 67 % improvement rate.

    Possible Side Effects

    Generally we did not experience any adverse effects of ACULASER Therapy like aggravation of epileptic fits or increase in spasticity and rigidity.

    Few minor temporary complications occurred in C.P. children getting ACULASER Therapy. These temporary complications are:

    1. Hyperactivity and Restlessness:
    2. Disturbed Sleep:
    3. Irritability:

    All of these complications were probably related with increased cerebral blood flow. These complications settled in 2 weeks time.

    Discussion

    Cerebral Palsy (CP) is caused by ischemic insult to the developing brain during pregnancy, delivery, perinatal period and first few years of life ( Futagi Y, Shimizu H, 1982 (15)). A very large proportion of CP children suffer from associated neurological disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, sensory-neural deafness and speech disorders. Any one or multiple neurological disorders may affect CP children and compromise the quality of their life.

    ACULASER Therapy aims at improving the blood flow to brain and other affected parts of the body. This is done by stimulating different body acupoints, ear points and scalp areas. In response when these acupoints and scalp areas are stimulated blood flow to brain and various affected parts of the body increases (this is demonstrated with the help of functional MRI or f MRI of the brain) (J. D. Lee , J. S. Chon, H. K. Jeong, 2003 (16)). In addition to this when Low Level Lasers (wavelength 632.5 nm – 915 nm) are applied on skin, this results in biostimulation of the body tissues resulting in increased blood flow and rapid healing of the tissues (Tunér, J. 2002 (8)). The combined effect of LLLT, acupoints and scalp areas stimulation results in increased blood flow to brain and different body parts thus improving the CP and its associated neurological disorders ( Jiao Shunfa 1997 (3), Zhu Mingqing 1992 (4), Tunér, J. 2002 (8), J. Pineal Res. 2003 (9), Parkes, 2000 (12)).

    Studies conducted in different parts of the world involving unconventional treatment modalities like Acupuncture, Acupressure, Laser Acupuncture and Scalp Acupuncture show a very good success rate for the treatment of CP and other Neurological disorders. (Jiao Shunfa 1997 (3), Dr Liang 1984 (17), Dr Petra Fila 1997 (18), Dr Majid Fadaie 2002 (19)).

    In our study, ACULASER Therapy was safe, effective, painless and aseptic; it gave rapid results in most cases. Most children complied easily with the treatment. Changes were observable almost in the first 2 -3 weeks of therapy. In some cases that were coming from far areas, we gave a break in the treatment for 4-12 weeks because of very severe heat in summer. These children maintained the degree of improvement during the break which they achieved with the treatment. We did not observe any regression or reversal of improvement in these children. The best results were in children <2 years of age and the second best group were <5 years of age which signifies that ACULASER THERAPY when instituted earlier gives better results. This is because the weight of the brain of a new born baby is 250 grams and it grows to 1000 grams at 1 year and then till the age of 7 years it reaches around 1300 – 1400 grams maximum. If the treatment is started at an early age when brain size is increasing rapidly, the chances of improvement and recovery are high.

    Conclusion & Recommendations:

    This study concludes that ACULASER Therapy is effective for the treatment of children suffering from CP of various types and associated neurological disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, sensory-neural deafness and speech disorders.

    ACULASER Therapy not only addresses and improves the physical aspect in CP children but also the mental and cognitive aspects.

    ACULASER Therapy if applied at proper time can improve the quality of life of the children suffering from CP and associated neurological disorders associated neurological disorders like epilepsy, cortical blindness, spasticity, hemiplegia, paraplegia, quadriplegia, sensory-neural deafness and speech disorders.

    We strongly recommend that further larger studies should be conducted to evaluate the effects of ACULASER Therapy and this should be adopted as a treatment option for CP along with other modalities.

    References:

    1. Nelson. Essentials of Pediatrics. Third edition, Behrman Kliegman. (1998),
    2. George T. Lewith M.A., M.R.C.G.P., M.R.C.P. (Acupuncture-Its Place in Western Medical Science, Thorsons Publishing Group)
    3. Jiao Shunfa. Scalp acupuncture and clinical cases. Foreign Languages Press, Beijing, (1997).
    4. Zhu Mingqing. Zhu’s Scalp Acupuncture 1992 Eight Dragons Publishing Hong Kong.
    5. Tashikatsu Yamatomo M.D., Ph.D. (Yamtomo New Scalp Acupuncture “YNSA” 1998 Axel Springer Japan Publishing Inc.)
    6. World Health Organization (WHO), Regional Office for Western Pacific, Manila, Philippines Standard Acupuncture Nomenclature, Part 2 revised edition, , (1991)
    7. Xiang L, Wang H. Li Z, TCD observation on cerebral blood flow dynamics inference of cerebral palsy with scalp therapy, Article in Chinese, Shuguang hospital attached to Shaghai University of TCM. PMID: 9388310 (Pub MED-index for MEDLINE)
    8. Effects of acupuncture on oxygenation of cerebral tissue: Gerhard Litscher, Schwarz G, Source: Neurological Research 1998; 20 (Suppl. 1): 28 – 32.
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    11. Harry Lazoura and Irena Cosic – Bioelectronics Group,Dept. Electrical & Computer Systems Engineering, Monash University Victoria, Australia.
    12. What physiotherapy use by children with cerebral influences palsy? J. Parkes, N. Hill, H. Dolk and M. Donnelly. Child Care Health Dev. 2004 Mar;30(2):151-60. Health and Social Care Research Unit and School of Nursing and Midwifery, The Queen’s University of Belfast, Northern Ireland, UK. j.parkes@qub.ac.uk (Pub MED-index for MEDLINE)
    13. Seizure. 2003 Sep;12(6):373-378. Usefulness of magnetic motor evoked potentials in the surgical treatment of hemiplegic patients with intractable epilepsy. KAMIDA T, BABA H, ONO K, YONEKURA M, FUJIKI M, KOBAYASHI H. Department of Neurosurgery, Oita Medical University, 1-1 Idaigaoka, Hasama-machi, 879-55, Oita, Japan.
    14. Color Therapy by Therese M Donnelly in the Clinician’s Complete Reference to Complementary & Alternative Medicine by Donald W Novey MD, published by Mosby, 2000.
    15. Internal carotid blood flow velocity in children with cerebral palsy by Doppler Ultrasound method. Futagi Y, Shimizu H, Mimaki T, Abe J, Onoe S, Tagawa T, Kajiura I, Sumi K, Yabuuchi H. Brain Dev. 1982;4(1):27-33.
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