The Effect of Inspiratory Muscle Training on Respiratory Parameters, Trunk Control, Gait, and Functional Independence...

The aim of this study was to investigate the effects of inspiratory muscle training (IMT) on respiratory parameters, trunk control, gait, and functional independence in children with cerebral palsy (CP).

A total of 36 children with CP, (mean age 7.89 ± 2.17 years; 55.5% male) were included in this prospective, randomized controlled trial. Participants were randomly assigned to two groups; the experimental group received IMT in addition to a routine exercise program, while the control group received sham IMT in addition to the routine exercise program for 6 weeks. Respiratory muscle strength (maximum inspiratory pressure [MIP] and maximum expiratory pressure), pulmonary function (spirometry), trunk control (Trunk Control Measurement Scale), gait speed (10-Meter Walk Test), gait endurance (2-Minute Walk Test), and functional independence (Functional Independence Measure for Children) were assessed. All evaluations were conducted by physiotherapists at baseline, at the 6th week, and at the 12th week.

In the intergroup comparisons, significant differences were found in MIP, forced expiratory volume in the first second (FEV₁), and FEV₁/ forced vital capacity (P = 0.009, P = 0.023, P = 0.007, respectively). In the experimental group, the within-group effect sizes for MIP and FEV₁ were greater than those observed in the control group (P < 0.001, η² = 0.794; P < 0.001, η² = 0.521, respectively). No significant differences were observed between the groups in 10-Meter Walk Test, 2-Minute Walk Test, and Functional Independence Measure for Children scores (P > 0.05). For Trunk Control Measurement Scale, although a significant within-group improvement was observed in the experimental group (P < 0.001), additional analyses were performed because of the substantial baseline imbalance between groups. After adjustment for baseline differences, the overall group effect remained significant (F = 6.133, P = 0.019, partial η² = 0.157), whereas the group × time interaction was not significant (linear mixed model (LMM): F = 0.187, P = 0.830; analysis of covariance (ANCOVA): F = 0.879, P = 0.355).

IMT added to a routine exercise program in children with CP was superior to sham IMT in addition to the routine exercise program in improving inspiratory muscle strength and pulmonary function (FEV₁).