Effectiveness of simple and basic home-based exercise programs including pediatric massage executed by caregivers at their homes in the management of children with spastic cerebral palsy: A randomized controlled trial.

Caregivers carried out all the treatment at home, so the researchers could not check how much, how often or how well it was actually done, or whether the two groups did it equally. Both groups did the home exercise programme and there was no untreated comparison group, so the improvement seen in both groups cannot be attributed to the programme alone; children of this age may change over 12 weeks anyway. Only 63 children at a single centre, recruited by purposive sampling rather than randomly from a defined population. Children were 4 to 12 years old, so the results do not apply outside that age range. The spasticity advantage for massage was borderline at six weeks (p = 0.049) and rests on an average across four limbs, so it is a small difference on a coarse scale. The paper describes blinding of the outcome assessors only; the families knew which treatment they were giving. Sixty-eight children were recruited to detect a moderate effect, which is a small number for detecting anything smaller.

The paper does not say who funded the study, and it reports no competing interests. It states that the trial was registered on ClinicalTrials.gov (NCT05111236).

Do not take this trial as proof that pediatric massage improves movement in children with spastic cerebral palsy. Every child did the home exercise programme, and the massage group's gross motor scores were no better than the exercise-only group's at six or twelve weeks. The only between-group difference was in spasticity, and at six weeks that was borderline (p = 0.049).