Effectiveness of massage therapy for constipation in children with cerebral palsy: A systematic review and meta-analysis.

BACKGROUND Constipation affects 75 % of children with cerebral palsy (CP). While massage is a safe non-invasive intervention, its clinical adoption remains limited due to insufficient evidence of its efficacy.

OBJECTIVE To evaluate the efficacy and safety of massage for CP-related constipation through meta-analysis.

METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched seven databases for randomised controlled trials (RCTs) on pediatric CP-related constipation treated with massage. Eligible RCTs underwent Cochrane risk-of-bias assessment. Meta-analysis using Stata evaluated the overall efficacy, defecation parameters, and heterogeneity sources.

RESULTS A total of 11 RCTs involving 728 patients were included. The results of the meta-analysis showed that, compared with traditional therapy alone, massage was more effective in treating constipation in children with CP. This difference was statistically significant (p < 0.05), as evaluated by the overall effective rate (RR, Relative Risk = 1.23; 95 % CI, 95 % Confidence Interval = 1.14, 1.33), defecation frequency (MD, Mean Difference = 1.57; 95 % CI = 0.40, 2.75), defecation time (MD = -3.23; 95 % CI = -3.82, -2.64), and stool form score (SMD, Standardized Mean Difference = 0.66; 95 % CI = 0.39, 0.94), confirming the superior efficacy of massage over conventional therapy. However, both interventions showed comparable effects on defecation difficulty (p > 0.05). The baseline patient characteristics, duration and techniques of the massage, and efficacy of the control group intervention may be the sources of heterogeneity.

CONCLUSION Massage therapy improves constipation symptoms in children with CP. These results require validation through larger, high-quality RCTs given the sample size limitations of the current study.