International Journal of Complementary & Alternative Medicine Review Article Open Access Some efficaciousAyurvedic panchakarma procedures in children with cerebral palsy Abstract Volume 11 Issue 1 - 2018 Cerebral palsy (CP) is defined as a non-progressive neuromotor disorder of cerebral Kshama Gupta, Prasad Mamidi origin. Motor disorders of CP are accompanied by disturbances of sensation, perception, Faculty of Ayurveda, Parul University, India cognition, communication and behavior. In Ayurveda, there is no single condition/disease which exactly show similarity with CP. Most of the authors considered CP as vata vyadhi. Correspondence: Kshama Gupta, Associate professor, Faculty Various Panchakarma procedures like Udwartana (medicated powder massage), Sarvaanga of Ayurveda, Parul University, Vadodara, Gujarat, 391760, India, abhyanga (full body massage with medicated oil), Baashpa sweda & Naadi sweda Tel 7567222309, Email [email protected] (steam bath) and Vasti (oil and decoction enemas) etc are found to be beneficial in the management of CP in children. Present study is focused on panchakarma procedures which Received: January 03, 2018 | Published: January 29, 2018 are commonly used and found effective in children with CP. Udwartana opens the minute channels and improves blood as well as lymphatic circulation. Udwartana is kapha, vata hara and removes aavarana or srotorodha. It provides a platform for further procedures like abhyanga, swedana and vasti. Sarvanga abhyanga, baashpa & naadi sweda reduce spasticity (especially scissoring phenomenon), improves flexibility of joints, improves circulation and reduces pain. Vasti is the major treatment for CP and it improves gross as well as fine motor functions, provides nourishment, improves overall general condition and quality of life in children with CP. Keywords: panchakarma, ayurveda, cerebral palsy, vasti, sweda, nasya Introduction decoction enemas) etc are found to be beneficial in the management of CP in children.5 Present study is focused on various panchakarma Cerebral palsy (CP) is defined as a non-progressive neuromotor procedures which are commonly used and found effective in the disorder of cerebral origin. Motor disorders of CP are often management of CP in children. accompanied by disturbances of sensation, perception, cognition, communication and behavior. CP is classified into four types, spastic, Review methodology ataxic, dyskinetic and mixed. Spastic CP accounts for a major portion of CP.1 In India, the prevalence of CP is estimated around 3 cases Electronic database, ‘Google scholar’ has been searched for per 1000 live births. There is no known cure for all four subtypes relevant studies and reviews published/appeared from 2007 to of CP.2 Stem cell transplantation procedures, Botulinum toxin December 2017. The key words used for search are, ‘Udwartana injections, intrathecal injection of baclofen, using various orthotic in cerebral palsy children’, ‘Sarvanga abhyanga in cerebral palsy devices, hyperbaric oxygen therapy, neuroplasticity etc are the new children’, ‘Naadi sweda in cerebral palsy children’, ‘Baashpa advancements evolved for managing CP.1 sweda in cerebral palsy children’, ‘Shashtika shali pinda sweda in cerebral palsy children’, ‘Vasti in cerebral palsy children’ and ‘Nasya In Ayurveda, there is no single condition/disease which exactly in cerebral palsy children’. Abstracts and full texts of open access show similarity with CP. Some conditions explained in Ayurveda, articles in English language were only considered. which have shown some similarity with CP are, phakka (a kind of nutritional disorder), pangulya (locomotor disorders), mukatva Panchakarma (dumbness), jadatva (mental disorders), ekanga roga (monoplegia), Panchakarma is a collective term which indicates five major sarvanga roga (quadriplegia), pakshaghata (hemiparesis) and therapeutic procedures of detoxification to cleanse the body channels, pakshavadha (hemiplegia) etc., vatavyadhi’s (neurological along with many other supportive procedures. Literally, Panchakarma disorders).1 Spastic CP can be considered as ‘Avarana janya vata is made up of ‘Pancha’ means ‘five’ and ‘karma’ means ‘procedure/ vyadhi/Kaphavrita vata’. Vata vyadhi is the most similar condition to action’ (procedures of purification). Ayurveda treats diseases by CP. 3 According to some authors, CP in Ayurveda can be considered as using two different methods, shodhana (purificatory) and shaman ‘Shiro-Marmabhigathaja Bala Vata Vyadhi’.4 (pacificatory). Shodhana means cleansing or detoxification of the Ayurvedic Panchakarma (five major ayurvedic procedures and body by expelling the deranged doshas (morbid materials inside the many allied procedures which are intended to cleanse the body) body causing various diseases). Shamana is pacification of symptoms therapy along with appropriate internal medication can provide good without eliminating the morbid doshas. Typically, all treatment improvement in quality of life of CP patients.1 It is well known fact protocols ought to begin with shodhana, followed by shamana for that internal medication along with Panchakarma procedures is better outcomes. When the body is saturated with toxins, the toxins more effective when compared with only oral medications.2 Various interfere with the absorption of herbal medicines. Furthermore, it panchakarma procedures like Udwartana (medicated powder is necessary to eliminate ama ( accumulated toxins in the channels) massage), Sarvaanga abhyanga (full body massage with medicated and to re-establish the homeostasis. The five main procedures within oil), Baashpa sweda & Naadi sweda (steam bath) and Vasti (oil and panchakarma are: vamana (emesis), virechana (purgation), nasya Submit Manuscript | http://medcraveonline.com Int J Complement Alt Med. 2018;11(1):37‒42. 37 © 2018 Gupta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Copyright: Some efficacious Ayurvedic panchakarma procedures in children with cerebral palsy ©2018 Gupta et al. 38 (nasal instillation of herbal oils/powders), basti or vasti (herbal temperament. For a person with vata temperament medicated oils enema), and raktamokshana (bloodletting). Primarily, these practices like ksheerabala, balaguduchyadi, karpasastyadi etc; for pitta are aimed at eliminating ama (toxins) from to body and cleanse temperament oils like bhringamlakadi, manjishtadi, kayyanyadi etc; the channels. Each procedure is performed in three phases: Poorva and for kapha temperament oils like eladi, asanavilwadi, marichadi karma (preparatory methods), Pradhana karma (main procedure) etc can be used.21Abhyanga provides nourishment due to its snigdha and Paschat karma (post-cleansing procedures which include dietary (unctous), mridu (soft) and picchila (sticky) qualities. Vayu resides in and behavioural regimen).6 sparsanendriya (skin) and massage is said to be as tvachya (good for the skin). Massage directly works on vata to bring it back to normalcy.1 Panchakarma is the ultimate mind body healing experience for Abhyanga along with swedana and vasti removes aavarana and detoxification of the body, for strengthening the immune system, srotorodha (obstruction of channels). Abhyanga and swedana together to restore the balance and wellbeing. It is one of the most effective divert the dosha’s from shakha to koshta, later from koshta dosha’s healing modality of ayurveda. Prior to panchakarma, poorva karma can be managed by vasti or other panchakarma procedures. When like deepana and paachana (appetizers and digestives), snehana vata comes to normalcy development of milestones will become (oleation) and swedana (sudation) are given to the patient. Ayurveda normal.2 Abhyanga reduces increased muscle tone, improves muscle considers that the purification of the body is important before the bulk and power in CP cases.3 commencement of any other therapy. Shodhana chikitsa (purificatory or cleansing procedures/panchakarma) is considered superior to Shamana chikitsa (treating with internal medicines) because the condition treated with shodhana therapy will never recur, whereas the condition treated with shamana therapy may recur in due course of time.7 Some effective panchakarma in CP Various panchakarma procedures like Udwartana (medicated powder massage), Sarvaanga abhyanga (full body massage with medicated oil), Baashpa sweda & Naadi sweda (steam bath), Shashtika shali pinda sweda – SSPS (sudation with a bolus prepared by boiled rice), Nasya, Shirodhara (oil drip over the forehead) and Vasti (oil and Figure 1 Udwartana. decoction enemas), are found to be beneficial in the management of CP. 1‒19 Present study is focused only on few panchakarma procedures which are commonly used and found effective in the management of CP like Udwartana, Sarvaanga abhyanga, Baashpa sweda & Naadi sweda, Shashtika shali pinda sweda, Nasya and Vasti. Udwartana Rookshana procedure (dryness inducing procedure) like ‘Udwartana’ seems to be beneficial in reducing the spasticity in CP patients and it is suitable in ‘Amavastha’ (accumulation of waste materials inside the body) or ‘Kapha aadhikya’(predominance of kapha dosha) (Figure 1).5 Considering the Bahya karma (external procedure), the Uudwarthana is the rookshana poorvakarma (preparatory procedure which induces dryness) used with powders of medicines it brings the Rukshana at the level of superficial Dhadhus (tissues) especially at the