Expiratory Muscle Training in Children With Cerebral Palsy

Официальное название

Effects of Expiratory Muscle Training on Posture, Balance, Trunk Control, and Respiratory Function in Children With Cerebral Palsy

Обзор

This study aims to examine the effects of expiratory muscle training on posture, trunk control, balance, selective motor control, and respiratory function in children with spastic-type cerebral palsy (CP). The research focuses on evaluating an innovative rehabilitation approach that addresses common challenges observed in children with CP, such as trunk instability, reduced respiratory capacity, and postural abnormalities. In individuals with CP, the ineffective use of respiratory muscles affects not only the respiratory system but also trunk control and overall motor performance. While most existing studies emphasize inspiratory muscle training, research on expiratory muscle training remains limited. Therefore, this study seeks to fill this gap by investigating the neuromotor effects of expiratory muscle training-an emerging component of respiratory rehabilitation-in children with CP.

Вмешательства

• Поведенческое Expiratory Muscle Training
  In the expiratory muscle training group, participants will receive a respiratory exercise program consisting of breathing control, diaphragmatic breathing, and thoracic expansion exercises. In addition, expiratory muscle training (EMT) will be performed using the POWERbreathe EX1 device at 50% of each participant's measured maximal expiratory pressure (MEP). Participants will be instructed to perform 25 repetitions per session, structured as 5 cycles of 5 breaths with 1-minute rest intervals be
• Поведенческое Sham Expiratory Muscle Training
  In the sham expiratory muscle training group, participants will perform a respiratory exercise program including breathing control, diaphragmatic breathing, and thoracic expansion exercises. In addition, sham expiratory muscle training will be administered using the POWERbreathe EX1 device set at 10% of the participant's measured maximal expiratory pressure (MEP), providing minimal resistance. Participants will be instructed to perform the exercises daily at home for a period of 8 weeks. Compli

Первичные конечные точки

• Respiratory Muscle Strength Assessment (MIP/MEP) [Срок оценки: Before treatment, week 8]
• Peak Cough Flow [Срок оценки: before treatment, week 8]
• Assessment of Posture (PostureScreen App) [Срок оценки: before treatment, week 8]
• Trunk Control Assessment (ProKin Star Excursion Balance Test, Trunk Control Measurement Scale (TCMS)) [Срок оценки: Before treatment, week 8]
• Balance Assessment (PROKIN®) [Срок оценки: before treatmant, week 8]
• Selective Motor Control Assessment (SCALE), (Noraxon MyoMotion) [Срок оценки: before treatment, week 8]

Вторичные конечные точки (6)

• Communication Function Classification System (CFCS) [Срок оценки: before treatment]
• Gross Motor Function Classification System (GMFCS) [Срок оценки: before treatment]
• Muscle Tone Evaluation (Modified Ashworth Scale (MAS)) [Срок оценки: before treatment]
• Gross Motor Function Measure (GMFM) [Срок оценки: before treatment, week 8]
• Modified Functional Reach Test (MFRT) [Срок оценки: before treatment, week 8]
• Prone Plank Test [Срок оценки: before treatment, week 8]

Критерии участия

Критерии включения

• Diagnosis of cerebral palsy
• Age between 12 and 18 years
• Gross Motor Function Classification System (GMFCS) Level I or II
• Communication Function Classification System (CFCS) Level I, II, or III
• Spasticity graded as 0, 1, 1+, or 2 on the Modified Ashworth Scale
• No history of Botulinum Toxin-A injection or orthopedic surgery within the past 6 months

Критерии исключения

• Spasticity graded as 3 or 4 on the Modified Ashworth Scale Uncontrolled seizures
• Presence of congenital cardiopulmonary disease, autism spectrum disorder, balance-impairing conditions, or significant visual/hearing impairments
• Acute respiratory tract infection

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Список центров уточняется — проверьте первичный протокол.

Публикации

• de Lima Crispim TR, Neto MG, Crispim TRL, Dias RB, de Albuquerque MDM, Saquetto MB, Magalhaes PAF. Addition of respiratory exercises to conventional rehabilitation for children and adolescents with cerebral palsy: a systematic review and meta-analysis. World J Pediatr. 2023 Apr;19(4):340-355. doi: 10.1007/s12519-022-00642-1. Epub 2022 Nov 15. PMID 36376558
• Menezes KKP, Avelino PR, Alvarenga MTM, Nascimento LR. Inspiratory Training for Improving Respiratory Strength, Pulmonary Function, and Walking in Cerebral Palsy: A Meta-Analysis. Pediatr Phys Ther. 2024 Apr 1;36(2):207-215. doi: 10.1097/PEP.0000000000001092. Epub 2024 Mar 29. PMID 38568267
• Ishida H, Suehiro T, Watanabe S. Comparison of abdominal muscle activity and peak expiratory flow between forced vital capacity and fast expiration exercise. J Phys Ther Sci. 2017 Apr;29(4):563-566. doi: 10.1589/jpts.29.563. Epub 2017 Apr 20. PMID 28533585

Идентификаторы

NCT: NCT07048223 · IstinyeUni-Z.KAVRIK.001

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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