title: Assessing the effectiveness of massage therapy for bilateral cleft lip reconstruction scars.
abstract: OBJECTIVE
  Bilateral cleft lips occur when the bones that form the upper lip fail to fuse at birth. Surgical reconstruction creates scars, which may lead to the following impairments: adhesions, decreased oral range of motion, decreased strength of orbicularis oris muscle, and asymmetry of oral region leading to poor self-esteem. The purpose of this case study is to determine the effectiveness of massage therapy in its ability to improve these impairments.
  
  
  METHODS
  A five-week treatment plan consisting of fascial release, kneading, and intraoral techniques. Subjective information was assessed on two scales: restriction of scar and clients attitudes and acceptance of scar. Objective information was cataloged through photographs, a palpatory chart, and a self-created "Pen Test".
  
  
  RESULTS
  Results included increase range of motion and strength, decrease restrictions (palpable and subjective), and increase of symmetry. Client's perceived confidence of scar and its appearance increased.
  
  
  CONCLUSIONS
  The evidence suggests that massage therapy helped with the impairments associated with scars formed by bilateral cleft lip reconstruction.
authors.affiliation: Ottawa, ON, Canada.
authors.forename: Emilie
authors.initials: E
authors.lastname: McKay
keywords: adhesions; cleft lip; massage therapy; scars