T Rehabili. J. Volume 05, Issue 01 2021 203 C Co op py yr ri i g gh ht t: Authors retain copyright and grant the TRJ right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work’s authorship and initial publication in this journal. R RE ES S E EA AR RC CH H A AR RT T I I C CL L E E E EF F F F E EC CT T S S O OF F S ST T R RE ET TC CH HI I N NG G E EX X E ER RC CI I S S E ES S W WI I T T H H O OR R W WI I T T H HO OU UT T B BA AC CL L O OF FE EN N O ON N S S P PA AS S T T I I C CI I T T Y Y , , F F L LU UI I D D I I N NT TA AK KE E A AN ND D C CA AL L O OR RI I E ES S I I N NT T A AK KE E I I N N C CE ER RE EB BR RA AL L P PA AL L S S Y Y C CH HI I L LD DR RE EN N Muhammad Ahmed 1 : Conception, data collection, writing; Revised and accountable for all aspects Aleem Liaqat 2 : Conception, Revised and accountable for all aspects Nabeela Kanwal 3 : Analysis & interpretation of data, Revised and accountable for all aspects ABSTRACT Objectives: to find out the effectiveness of stretching exercises and baclofen alone and combined in spastic cerebral palsy children on spasticity, fluid and calorie intake. Material & Methods: A single-blinded, randomized control trial was conducted at Allama Iqbal Hospital, and Idrees Teaching Hospital. The n=60 participants between 5-12 years, having spasticity score of 2 or more on Modified Ashworth Scale (MAS). The participants were randomly divided into three treatment groups receiving Baclofen, sustained stretching exercises and combination baclofen and sustained stretching exercises. Data were collected at baseline and after six weeks as fluid and calorie intake, and spasticity on Modified Ashworth Scale (MAS). Results: The result showed significant difference (p<0.05) among group with large effect size while comparing mean differences of Fluid intake {F(df)=2,57(988.603), η 2 =0.972, p<0.001} and Calories intake {F(df)= 2,57(166.877), η 2 =0.854, p<0.001}. While there was no significant difference in mean difference of spasticity {F(df)= 2,57(2.119), p=0.130}. Conclusion: baclofen along with stretching exercises significantly improved fluid, calorie intake and spasticity Keywords: Calories, cerebral palsy, spasticity, stretching exercises INTRODUCTION Cerebral Palsy is a group of permanent disorders of development of movement and posture, causing activity limitation, that are attributed to non- progressive disturbances that occurred in the developing fetal and infant. The motor impairments of CP is often followed by disturbances of perception, cognition, behaviour, communication, epilepsy, sensation, and musculoskeletal problems. 1 The worldwide prevalence of CP is 2.5 per 1000, but it may differ from 1-6 per 1000 births. As every 2 to 3 children out of 1000 have CP, which makes it the most common neurodevelopmental motor disability in children. 2 The most common type of CP is spastic which comprises 80% of total cases reported. 3 The upper motor neuron lesion causes spasticity, hyperreflexia, and extensor plantar response. Also, spastic cerebral palsy patients have mass, slow and effortful movements instead of fine movements. 4 Spastic CP patient usually presents with muscle imbalance, stand with bent knees and legs tightly closed together i.e. scissors-type gait. The patient usually has typical pattern of muscle weakness, sensory and motor control impairment, 1 which affects the activities of daily living of children. 5 In spastic CP patient malnutrition and growth failure is common condition and mainly occurs due to reduced fluid and calorie intake, excessive loss of nutrients and abnormal energy metabolism. 6 The management of CP requires multidisciplinary team approach to address medical, psychological, social, intellectual, and educational issues to gain functional independence and improves performance in activities of daily living. In many previous studies different treatment approaches such as pharmacological, non-pharmacological and surgical were being used for the management of CP patient. 4 Physical therapy, occupational therapy and electrical stimulation is an integral part of CP management, 7 however oral anti-spasticity drugs such as benzodiazepines, baclofen, and tizanidine are also used to reduce general spasticity. 8,9 A previous literature showed significant improvement in spasticity after stretching exercises in spastic cerebral palsy children. 10 Also, intrathecal baclofen is also effective in reducing spasticity by acting on receptors in brain and spinal cord to reduce abnormal tone. 11,12 However studies have been conducted previously but as far as authors’ knowledge based on literature review, no published data was found on effectiveness of baclofen along with stretching exercise on fluid, calorie intake and spasticity. The aim of the study was to find out the effectiveness of stretching exercises and baclofen alone and combined in spastic cerebral palsy children on spasticity, fluid and calorie intake. 1. HOD Physical Therapy. Department of Physical Therapy. Idrees Teaching Hospital Sialkot Pakistan. 2. Consultant Rehabilitation Specialist/CEO. Islamabad Physical Therapy & Rehabilitation Centre Islamabad. Pakistan 3. Lecturer. Faculty of rehabilitation & Allied Health Sciences, Riphah International University. Islamabad Pakistan. Correspondence Muhammad Ahmed HOD Physical Therapy. Department of Physical Therapy. Idrees Teaching Hospital Sialkot Pakistan. E-mail: physiopkahmad@gmail.com Received on: 21-08-2001 Revision on: 03-04-2021 Published on: 30-06-2021 Citation; Ahmed M, Liaqat A, Kanwal N. Effects of stretching exercises with or without baclofen on spasticity, fluid intake and calories intake in cerebral palsy children. T Rehabili. J. 2021:05(01);203-207 soi: 21-2017/re-trjvol05iss01p203 doi: https://doi.org/10.52567/trj.v5i01.59