Effect of SCS Technique on Oromotor Skills in Children With CP

Effect of Strain Counter Strain on Oromotor Functions in Children With Spastic Cerebral Palsy: A Randomized Controlled Trial

This study evaluates the clinical efficacy of the Strain Counter-Strain (SCS) technique on improving oromotor functions in children with spastic cerebral palsy. The intervention specifically targets the masseter, SCM, upper trapezius, scalenes, and suprahyoid muscles to release myofascial tension. The study aims to determine if modulating muscle tone through SCS can provide a stable postural foundation to enhance functional oral motor skills. Outcomes are measured after 4 weeks (one month) of intervention, focusing on mouth opening range, drooling frequency and severity, and overall oral motor functions

Study Overview

• Status: Active, not recruiting
• Conditions: Sialorrhea; Spastic Cerebral Palsy (sCP); Oral Motor Functions; Strain Counterstrain Technique; Mouth Opening
• Intervention / Treatment: Procedure: Strain Counter-Strain (SCS); Procedure: Designed Oral Motor Program

Detailed Description

This study follows a Randomized Controlled Trial (RCT) design. Children with spastic cerebral palsy are screened for inclusion based on impaired oromotor control and persistent neck muscle tension.

The Control Group receives a designed oral motor program aimed at improving oral motor functions, mouth opening, and drooling severity, conducted over 4 weeks (one month).

The Study Group receives the same designed oral motor program, preceded by the Strain Counter-Strain (SCS) technique applied to the masseter, sternocleidomastoid (SCM), scalenes, upper trapezius, and suprahyoid muscles. The SCS technique aims to normalize cervical alignment and release restrictive tension in the orofacial region.

Outcome Measures: Functional and physical changes are assessed at baseline and after the 4-week period. The primary outcomes include:

Mouth opening range (measured in centimeters). Drooling frequency and severity (using standardized scales). Oral motor functions (evaluated through standardized scales). The comparison seeks to demonstrate how stabilizing the proximal postural base through SCS facilitates refined distal oromotor performance

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Giza, Egypt
    • Faculty of physical therapy, Cairo University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Chronological age was 4 - 8 years from gender was selected
• Their degrees of spasticity were 1, 1+ according to modified Ashworth scale.
• They had moderate drooling according to modified drooling questionnaire.
• Mouth opening limitation was less than 3 cm.
• Their levels of motor function were II - III- IV according to gross motor function classification system.
• Their levels of feeding abilities were III on Eating and Drinking Ability Classification System.
• Children were able to follow instruction

Exclusion Criteria:

• Any history of jaw, head, and face trauma.
• Facial or dental developmental abnormalities.
• Any history of head and neck surgical intervention.
• Congenital abnormalities of head and neck

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Strain counter-strain plus oral motor program; This group receives the Strain Counter-Strain (SCS) technique followed by a designed oral motor program. The intervention targets the masseter, SCM, upper trapezius, scalenes, and suprahyoid muscles to release myofascial tension and normalize cervical alignment, conducted 3 sessions per week for 4 weeks	Procedure: Strain Counter-Strain (SCS); A manual therapy technique used to release myofascial tightness and muscle tension in the head and neck region to provide a stable postural foundation for oromotor skills; Procedure: Designed Oral Motor Program; A structured exercise program designed to enhance oral motor functions, including feeding efficiency, mouth opening range, and drooling
Active Comparator: Oral motor program only; This group receives only the designed oral motor program aimed at improving the strength, range of motion, and coordination of the masticatory and suprahyoid muscles. The program is conducted 3 sessions per week for 4 weeks	Procedure: Designed Oral Motor Program; A structured exercise program designed to enhance oral motor functions, including feeding efficiency, mouth opening range, and drooling

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Oral motor functions	Assessment of oral motor skills including feeding, swallowing, and coordination using the Oral Motor Assessment Scale (OMAS). The scale scores range from 0 to 2, where higher scores indicate better function	Baseline and after 4 weeks of intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mouth Opening Range	Measurement of the maximum inter-incisal distance using tape measurement (measured in centimeters)	Baseline and after 4 weeks of intervention
Drooling Frequency and Severity	Evaluation of drooling patterns using the Modified Drooling Questionnaire (MDQ). Higher scores indicate more frequent and severe drooling.	Baseline and after 4 weeks of intervention

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Study Director: Kamal Shoukry, PhD, Professor of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University

Study record dates

Study Major Dates

• Study Start (Actual): January 20, 2026
• Primary Completion (Estimated): April 15, 2026
• Study Completion (Estimated): May 30, 2026

Study Registration Dates

• First Submitted: April 1, 2026
• First Submitted That Met QC Criteria: April 1, 2026
• First Posted (Actual): April 8, 2026

Study Record Updates

• Last Update Posted (Actual): April 14, 2026
• Last Update Submitted That Met QC Criteria: April 9, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Mouth Opening; Masseter Muscle; Spastic cerebral palsy; Pediatric Physical Therapy; Strain Counter-Strain; SCS technique; Oromotor Functions; Drooling Severity
• Additional Relevant MeSH Terms: Mouth Diseases; Stomatognathic Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Salivary Gland Diseases; Brain Damage, Chronic; Cerebral Palsy; Sialorrhea
• Other Study ID Numbers: P.T.REC/012/006363

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be available to protect the privacy and confidentiality of the participants. The study results will be disseminated through the final thesis and potential peer-reviewed publications as aggregate data only

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No