Efektivitas Myofascial Release terhadap Penurunan Spastisitas dan Peningkatan Lingkup Gerak Sendi Ankle pada Spastik Cerebral Palsy

Latar Belakang: Cerebral palsy spastik merupakan gangguan neurologis nonprogresif yang ditandai dengan peningkatan tonus otot (spastisitas) dan keterbatasan lingkup gerak sendi (LGS), sehingga dapat menghambat kemampuan gerak dan aktivitas fungsional anak. Salah satu intervensi fisioterapi yang dapat diberikan untuk mengatasi kondisi tersebut adalah myofascial release yang bertujuan meningkatkan fleksibilitas jaringan lunak dan mobilitas sendi. Tujuan: Penelitian ini bertujuan untuk mengetahui efektivitas myofascial release terhadap penurunan spastisitas dan peningkatan lingkup gerak sendi ankle pada anak dengan spastik cerebral palsy. Metode: Penelitian ini menggunakan desain pre-experimental dengan pendekatan one group pretest-posttest. Sampel penelitian berjumlah 12 anak dengan spastik cerebral palsy. Intervensi myofascial release diberikan sebanyak 3 kali seminggu selama 3 minggu dengan total 9 sesi terapi berdurasi 10 menit. Pengukuran spastisitas dilakukan menggunakan Modified Ashworth Scale (MAS), sedangkan lingkup gerak sendi ankle diukur menggunakan goniometer. Data LGS dianalisis menggunakan uji Wilcoxon, sedangkan data spastisitas dianalisis secara deskriptif. Hasil: Hasil penelitian menunjukkan adanya peningkatan rerata lingkup gerak sendi ankle dari 110,8° menjadi 112,5° setelah pemberian intervensi myofascial release. Sebanyak 4 dari 12 anak mengalami peningkatan LGS dengan rerata peningkatan sebesar 2°. Hasil uji Wilcoxon menunjukkan terdapat perbedaan yang signifikan antara nilai pretest dan posttest LGS dengan nilai p=0,046 (p<0,05). Sementara itu, hasil pengukuran spastisitas menggunakan MAS menunjukkan tidak adanya penurunan spastisitas yang bermakna setelah intervensi, sehingga tingkat spastisitas cenderung tetap atau stagnan selama periode penelitian. Kesimpulan: Myofascial release efektif dalam meningkatkan lingkup gerak sendi ankle pada anak dengan spastik cerebral palsy, namun belum menunjukkan efektivitas dalam menurunkan tingkat spastisitas.

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The Effectiveness of Myofascial Release in Reducing Spasticity and Improving Range of Motion in The Ankle Joint of Patients with Spastic Cerebral Palsy
Rizqy Nasrullah Zulkarnain, Khabib Abdullah SST., M.Kes, Atik Swandari S.ST, M.Kes
ABSTRACT
Background: Spastic cerebral palsy is a non-progressive neurological disorder characterized by increased muscle tone (spasticity) and limited range of motion (ROM), which can hinder a child’s motor skills and functional activities. One physical therapy intervention that can be used to address this condition is myofascial release, which aims to improve soft tissue flexibility and joint mobility. Objective: This study aimed to determine the effectiveness of myofascial release in reducing spasticity and increasing ankle range of motion in children with spastic cerebral palsy. Methods: This study employed a pre-experimental design with a one-group pretest-posttest approach. The study sample consisted of 12 children with spastic cerebral palsy. Myofascial release was administered three times a week for three weeks, totaling nine therapy sessions, each lasting 10 minutes. Spasticity was measured using the Modified Ashworth Scale (MAS), while ankle joint range of motion was measured using a goniometer. Range of motion data were analyzed using the Wilcoxon test, while spasticity data were analyzed descriptively. Results: The results showed an increase in the mean ankle joint range of motion from 110.8° to 112.5° after the myofascial release intervention. Four of the 12 children experienced an increase in LGS, with an average increase of 2°. The results of the Wilcoxon test showed a significant difference between the pre-test and post-test LGS values, with a p-value of 0.046 (p < 0.05). Meanwhile, spasticity measurements using the MAS showed no significant reduction in spasticity following the intervention, indicating that spasticity levels remained stable or stagnant during the study period. Conclusion: Myofascial release is effective in improving ankle joint range of motion in children with spastic cerebral palsy, but has not yet demonstrated effectiveness in reducing spasticity levels.