ROLE OF MATRA VASTI IN OPTIMISATION OF CARE IN CEREBRAL PALSY - A CLINICAL STUDY INTRODUCTION “Today‟s children are tomorrows citizens” saying aptly implies that the role of children in building the healthy society. A healthy child can only build the better society. So, the early childhood multifaceted development is most important to their life. As the child‟s overall development entirely depends on their mother, mother and childcare facilities were given top priority in the national health policy. Presently our country is aiming at „ Polio Free India‟. Poliomyelitis is such a condition where childhood disability is the presenting feature with affecting mainly motor functions where as in the conditions like Cerebral palsy all the aspects of development Physical, Sensory, Motor, Psychological, Behavioral, Social etc., were affected severely. Even with advancements in mother and childcare its incidences are increasing and it has become the second cause of disability in children after polio and till today there is no solution for it. And the child has to lead the miserable long life on the mercy of others.
Cerebral palsy is static encephalopathy, which is non-progressive disorder of posture, movement often associated with epilepsy and abnormalities of speech, vision and intellect resulting from a defect or lesion of the developing brain. Cerebral palsy is a common disorder with a prevalence of 2/1000 population. There are 25 lacs of CP children in India. It‟s etiology mainly relates with the antenatal and perinatal causes, but neonatal causes such as septicemia, meningitis, encephalitis, head injury and infections are clinically important. Thus in ayurveda it may be considered as JANMA BALA PRAVRITTA VYADHI. Bhadirya, mookatwa etc presentation of this disease is clearly mentioned under the heading of janmabala pravritta vyadhi.
The disease CP renders the child crippled physically and often mentally too not only the life of that child becomes a misery but the parents also have to suffer from financial loss and social isolation. Because one has to remain with the child to look after him/her. So the management is mainly aimed to improve the function of child, to reduce the dependency, reduction of spasticity, improvement in quality of life.
The present proposed study on the Role of Matra vasti has been found beneficial for the patients of cerebral palsy in the pilot study.
AIMS & OBJECTIVES 1. To prove the efficacy of Matra vasti in the management of Cerebral palsy 2. To improve the function of child, to reduce the dependency, reduction of spasticity, improvement in quality of life (optimization of care). 3. To amalgamate the data on various management approaches followed by other health care professional like Physiotherapist, occupational therapist and speech therapist
DIAGNOSTIC CRITERIA Diagnosed cases of cerebral palsy by pediatricians will be taken for the present study. Following are the common symptomatology presented by the CP patients a. Slow development b. Abnormal muscle tone – either too stiff or too floppy c. Unusual posture d. Abnormal walking – walking on the toes / walking with one foot or leg dragging (Crouched gait or scissored gait)
INCLUSION CRITERIA 1. Patients between the age group of 3 - 15 years of both sexes (as early signs and symptoms of CP develop before 3 yrs of age) 2. Children having mild to moderate physical disability 3. Children with all types of cerebral palsy
EXCLUSION CRITERIA 1. Patients below the age of 3 years and above age of 15 years will be excluded. 2. Children with severe physical disability 3. Children‟s with associated conditions seizures, microcephaly and other infections
STUDY DESIGN Patients are randomly selected and divided into equal groups namely TEST GROUP and CONTROL GROUP, of which test group includes minimum of 40 patients who will be given Matravasti followed by physiotherapy where as Control group also includes minimum of 40 patients who will be only on regular physiotherapy. TREATMENT REGIMEN Matravasti will be given for 21 days with BALAASHWAGANDHALAKSHDI TAIL (Sahasrayogam) and ASHWAGANDHADI GHRITAM ( Bhaishajya Ratnavali) alternatively. Dose: 20 – 50 ml based on the age
CRITERIA OF ASSESSMENT s/no. 1. Aspect of development Physical Weight, Height, Assessment Head circumference, Chest
circumference 2. Sensory Difficulty with speech, hearing, vision, perception or sensation; Impaired sense of touch or pain 3. Motor Poor head control; Abnormal crawling or walking; Ataxia (Loss of coordination and balance);
Athetosis ( Involuntary slow writhing movements); Spasticity ( Abnormal stiffness, contraction of muscle) Limited range of motion 4. Adaptive functioning Self care (Activities of Daily Living – dressing, eating, bathing, toileting) Communication skills – understanding & expression of language Socialization – relating to other people 5. Behavioural Control of bed wetting Control on passing stools 6. Other aspects Difficulty in breathing, Difficulty in swallowing, Drooling of saliva, Joint contractures
INVESTIGATIONS Routine blood, urine and stool examination Specific tests like CT scan. EEG, etc., if possible FOLLOW UP STUDY Patients will be asked to review every month for consecutive 6 months. PRESENTATION FORM OF THESIS
The present research work will be presented in the form of a thesis, which will include following headings
1. INTRODUCTION 2. REVIEW OF LITERATURE DISEASE REVIEW – MODERN & AYURVEDA DRUG REVIW REVIEW OF MATRA VASTI REVIEW OF TRANSDISCIPLINARY APPROACHES REVIEW OF PREVIOUS / LATEST RESEARCHES
4. MATERIALS and METHODS 5. OBSEVATIONS and RESULTS 6. DISCUSSION 7. CONCLUSION and SUMMARY 8. BIBLIOGRAPHY
Supervisor Dr.CHANDAN MAL JAIN M.D(Balroga).,M.D(K.C).,Ph.D(Ayu).,M.A(San) Associate Professor & Head Department of Prasutitantra- Streeroga National Institute of Ayurveda, Jaipur
Scholar Dr.J.SNEHALATHA M.D(Balroga)
BIBLIOGRAPHY 1. Kasyapa samhita with English translation and commentary edited by P.V .Tiwari, Chaukhambha vishwabharati oriental publication 2. Sharma. P.V. Dravyaguna Vignan, chaukhambha bharti academy, varanasi, 16th edition, 1995. 3. Nelsons textbook of pediatrics (2006) 4. Kate tebbett, MANAGEMENT OF CEREBRAL PALSY – a transdisciplinary approach (2006), sage publications India Pvt. Ltd. New Delhi 5. Govindadas, Bhaisajya Ratnavali, edited by shri ambikadatta sastri, chaukamba sanskrit sanstan, varanasi, 1990. 6. Sahasrayogam 7. Susruta samhita 8. www.cerebralpalsy.org 9. www.ninds.nih.gov/disorders/cerebral_palsy 10. www.ucp.org 11. www.cerebral-palsy-help.com