• Garnecki DA
• Canty A

• Cerebral Palsy / complications
• Cox Technique
• Diurnal Enuresis / therapy

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 technique 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 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” while he attributes to stress or laughing.

KEYWORDS: urinary incontinence, cerebral palsy, spastic quadriplegia, chiropractic, adjustments, flexion-distraction, vertebral subluxation, pediatric, scoliosis.

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