Garnecki DA, Canty AP |  J Clin Chiropr Pediatr2008 Mar; 9(1): 563-6

Objective: To discuss the case of a patient with spastic quadriplegia cerebral palsy (CP) and urinary incontinence wherein the symptoms were reduced significantly following chiropractic care utilizing flexion-distraction technique.

Clinical Features: A 13-year-old boy with a history of urinary incontinence associated with spastic quadriplegia CP presented to the clinic. The medical history revealed that the patient was diagnosed with CP at birth. Clinical examination revealed cervical, thoracic, and lumbo-sacral spinal dysfunction as well as right thoracic and left lumbar scoliosis. The patient had bilateral hamstring and achilles tenotomies at age 4 due to chronic muscle flexion contracture.

Intervention and Outcome: Patient care included Diversified, SOT blocking, Activator, and Toggle techniques twice a month for four months. Ten months after beginning chiropractic care, the treatment plan was reassessed and flexion distraction tech- nique was added to the patient’s protocol. The patient received two adjustments utilizing flexion-distraction technique for the lumbo-sacral spine, and the frequency of urinary incontinence accidents decreased from five times per day to less than two times per week over the course of 52 weeks.

Conclusion: The implementation of flexion distraction in this patient’s treatment plan appears to have resulted in significant improvement in urinary incontinence. This result may indicate that vertebral subluxations in conjunction with CP were in part responsible for the urinary incontinence and that the specificity of the applied technique resulted in a positive outcome. The incontinence has almost completely resolved in this patient. The patient continues to experience bouts of increased muscle spasticity and an occasional urinary “accident” which he attributes to stress or laughing.


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