Inspiratory muscle training and trunk control exercises on respiratory strength and motor function in spinal muscular atrophy: randomized controlled trial

Görkem Ata ^1,2, Ayşe Nur Tunalı Van Den Berg ³, Emre Dansuk ³

⁰Graduate School of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul Medipol University, Istanbul, Turkey. gata@medipol.edu.tr.

Scientific Reports +

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December 19, 2025

View abstract on PubMed

Summary

This study found that combining inspiratory muscle training (IMT) with trunk control exercises improved respiratory and motor functions in children with spinal muscular atrophy (SMA). The combined approach showed clinically relevant benefits for children with SMA.

Area Of Science

Neurology
Pediatrics
Rehabilitation Medicine

Background

Spinal muscular atrophy (SMA) is a progressive neuromuscular disease causing respiratory muscle weakness and functional decline.
Effective rehabilitation strategies are crucial for managing SMA symptoms and improving quality of life in affected children.

Purpose Of The Study

To evaluate the impact of respiratory exercises, inspiratory muscle training (IMT), and trunk control training on children with SMA.
To compare the efficacy of a pulmonary rehabilitation program with and without additional trunk control exercises.

Main Methods

Thirty-eight children with SMA were randomized into two groups: a pulmonary rehabilitation group (PRG) and a trunk control group (TCG).
PRG performed breathing exercises and IMT, while TCG received the same plus trunk exercises over 8 weeks.
Outcomes included respiratory muscle strength, pulmonary function, peak cough flow, trunk control, upper limb function, and motor performance.

Main Results

Both groups showed significant improvements in respiratory strength and motor outcomes.
Inspiratory muscle strength (MIP) increased substantially in both groups, with larger effect sizes in the TCG.
The TCG demonstrated additional significant gains in sitting balance, selective movement control, and upper limb function.

Conclusions

Combining IMT with trunk control training is safe, feasible, and offers clinically relevant advantages for children with SMA.
This combined approach may enhance respiratory and motor function more effectively than IMT alone.

Keywords:

Breathing exercises Maximal respiratory pressures Neuromuscular diseases Respiratory function tests Spinal muscular atrophy