Can Walking Ability Enhance the Effectiveness of Breathing Exercise in Children with Spastic Cerebral Palsy?

Abstract

[Purpose] The purpose of this study was to compare differences in respiratory pressure and pulmonary function and the effectiveness of respiratory feedback training according to walking ability in children with cerebral palsy (CP). [Subjects and Methods] Twenty-three children with spastic CP were enrolled in the final analysis and were divided into an independent walking group (n=12) and non-independent walking group. All children received respiratory feedback training for four weeks. Before and after the training, respiratory muscle strength was measured and a pulmonary function test was performed. [Results] Comparison of respiratory pressure and pulmonary function test results between the two revealed that the independent walking group had significantly higher respiratory function than the other group in all variables except peak expiratory flow. In comparison of changes in respiratory function between the two groups, the independent walking group showed significantly higher improvement of respiratory function in terms of maximal inspiratory pressure, maximal expiratory pressure, and forced vital capacity. [Conclusion] These findings showed that children with independent walking ability had better respiratory muscle strength and pulmonary function compared with children without independent walking ability. Understanding respiratory function and the effectiveness of respiratory training according to walking ability will be valuable clinical information for respiratory assessment and therapy in children with CP.

Change in Pulmonary Function after Incentive Spirometer Exercise in Children with Spastic Cerebral Palsy: A Randomized Controlled Study

“…According to another previous study by Kwon and Lee, 9 the children at GMFCS level III had a higher gain in FVC after FRT than the children at GMFCS level I or II. 31 They suggested that children at GMFCS level I or II may have already reached the upper level of their respiratory function capacity, and thus, their improvement is not significant after FRT. The normal values of FVC and FEV 1 can vary depending on various factors such as height, weight, and sex, and thus, predicted values (%) for FVC or FEV 1 are preferred to compare the results across studies.…”

Changes in cardiopulmonary function in normal adults after the Rockport 1 mile walking test: a preliminary study

“…The MIP and MEP are the most commonly used variables in assessing respiratory muscle pressure because they are easy to evaluate and the measurements have fewer adverse effects 9 ) . Respiratory competence has been widely used to diagnose and monitor pulmonary function and respiratory pressure in many studies 10 , 11 ) .…”

Respiratory morbidity in children with cerebral palsy: an overview

“…Motor impairment results in limited physical activity, loss of muscle mass, weakening of respiratory muscles, and compromised pulmonary function. 3,50,51 Consequently, and not surprisingly, children with CP who are able to walk, have better respiratory muscle strength and respiratory training resulting in better respiratory function (maximal inspiratory pressure, maximal expiratory pressure, and forced vital capacity). 51 Ers€ oz et al 9 demonstrated decreased chest mobility in patients with spastic CP, independent of their cognitive status, and this was more prominent in older children.…”

“…3,50,51 Consequently, and not surprisingly, children with CP who are able to walk, have better respiratory muscle strength and respiratory training resulting in better respiratory function (maximal inspiratory pressure, maximal expiratory pressure, and forced vital capacity). 51 Ers€ oz et al 9 demonstrated decreased chest mobility in patients with spastic CP, independent of their cognitive status, and this was more prominent in older children. In the study by Lampe et al 8 , mean values of chest expansion and vital capacity were lower than normal in adults with CP (GMFCS levels I-IV) and lower in patients with more severe motor impairment (i.e.…”