الفهرس 
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Abstract
Summary
This study is conducted to investigate the effect of laser acupuncture on spasticity and drooling in children with spastic cerebral palsy.
Forty spastic children participated in this study. They were assigned randomly into two groups of equal number, 20 patients each. The ages (mean ± standard deviation) of laser group and control group were (3.1±1.1) and (3.2±1.0) respectively. Comparing means values of the two groups revealed non-significant differences (P value 0.662). The distribution of males and females in laser group were 70% and 30%. While in control group they were 85% and 15% respectively. There was no significant difference between the studied groups regarding demographic characteristics and growth milestones.
Patients in the control group were treated by a selected physical therapy program for 3 sessions per week one hour each. While the patients in the study group were treated by the same physical therapy program given to the control group in addition to laser acupuncture (low-level laser 650 nm with 50 mW power was applied at each acupoint for 30 s giving an energy density of 1.8 J/cm2) at a frequency of 2 sessions per week for successive 6 weeks. Preassessment and post-assessment of muscle tone, the range of motion (ROM), muscle power, drooled saliva and gross motor function were assessed.
The collected data was coded, tabulated, and statistically analyzed using IBM SPSS statistics (Statistical Package for Social Sciences) software version 22.0, IBM Corp., Chicago, USA, 2013 and Microsoft Office Excel 2007. Descriptive statistics was done for quantitative data as minimum& maximum of the range as well as mean±SD (standard deviation) for quantitative normally distributed data, median and 1st& 3rd inter-quartile range for quantitative non-normally distributed data, while it was done for qualitative data as number and percentage.
Comparison between post-treatment measures for the control vs. the laser groups showed significant difference in favor of the laser group.
Goniometer was used for assessment of joint range of motion. As regarding range of motion of ankle plantar flexion, it was significantly increased in both groups, with significantly higher improvement in laser group P <0.001. As regarding range of motion of ankle dorsiflexion, it was significantly increased in both groups, with significantly higher improvement in laser group P <0.001. As regarding range of motion of hip abduction, it was significantly increased in both groups, with significantly higher improvement in laser group P <0.05.
Modified Ashworth scale was used for muscle tone assessment in this study. As regarding the tone of ankle plantar flexors, it was significantly lower in both groups with the favor of laser group P <0.001. As regarding the tone of knee flexors, it was significantly lower in both groups with the favor of laser group P =0.001. As regarding the tone of hip flexors, it was significantly lower in both groups with the favor of laser group P =0.001.
As regarding muscle power it was assessed by using the Medical Research Council (MRC) grading for muscle strength. As regarding the power hip flexors, it was significantly increased after treatment in laser group only P<0.001. As regarding knee extensors, the power was significantly increased after treatment in laser group only P<0.001.
Thomas-Stonnel and Greenberg scale was used as an objective scale for measuring saliva drooling. After treatment, drooling was significantly decreased in laser group only, P <0.001.
Gross motor function was assessed by the Gross Motor Function Classification System. It was non-significantly improved in laser group only p=0.075.
These results showed that Laser acupuncture has a beneficial effect on reducing drooling and spasticity in spastic cerebral palsy and may be helpful in improving their movement