Bilateral Asymmetry of Respiratory Muscle Activity During Breathing in Children With Spastic Cerebral Palsy

N/ANot Yet RecruitingNCT07777809

Sahmyook University20 enrolled

Overview

This observational cross-sectional study investigates the bilateral asymmetry of respiratory muscle activity during breathing in children with spastic cerebral palsy (CP). Children with CP often exhibit structural deformities, which may lead to impaired chest mobility and asymmetric respiratory function. The primary objective is to objectively evaluate the imbalance in the activation of bilateral respiratory muscles (intercostal, external oblique, and sternocleidomastoid) using non-invasive surface electromyography (sEMG). Muscle activity will be measured during resting breathing and active breathing tasks. The findings aim to provide clinical evidence for developing selective respiratory muscle training programs for this population.

Children with spastic cerebral palsy frequently experience abnormal muscle tone and motor control issues, leading to structural deformities like scoliosis and pelvic asymmetry. These structural changes can restrict chest wall mobility and cause inefficient, asymmetrical breathing patterns. While ultrasound is often used to assess diaphragm function, it has limitations in evaluating functional respiratory pressure differences based on gross motor function levels and requires high cognitive cooperation. Therefore, this study utilizes surface electromyography (sEMG) to quantify the muscle activation (Root Mean Square, RMS) of respiratory and accessory muscles. The study involves children aged 4 to 12 years with spastic CP. Measurements are conducted in a seated position under two main conditions: 30 seconds of resting breathing and an active breathing task involving blowing a pinwheel or bubbles. An Asymmetry Index (AI) will be calculated to compare the degree of bilateral muscle activation imbalance across the different breathing conditions.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Spastic Cerebral Palsy (sCP)

Eligibility

Sex: ALLMin age: 4 YearsMax age: 12 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Children with Gross Motor Function Classification System (GMFCS) Level I or II * Children with sufficient cognitive ability to understand instructions and voluntarily perform tasks * Children with a Trunk Appearance Clinical Evaluation (TRACE) score of 4 or higher out of a total of 12 points Exclusion Criteria: * Children who have undergone orthopedic surgery of the spine or lower extremities, or received botulinum toxin injection treatment within the past 6 months * Children with acute or chronic respiratory diseases, such as asthma or acute pneumonia * Children with severe cardiac disorders, intellectual disabilities, or visual and auditory impairments that may interfere with the experiment

Outcomes

Primary Outcomes

Root Mean Square (RMS) of Respiratory Muscle Activity

Muscle activation amplitude of the intercostal, external oblique, and sternocleidomastoid muscles measured using surface electromyography (sEMG). The raw sEMG signals are full-wave rectified and smoothed using a 50ms moving window to calculate the RMS values during resting and active breathing tasks.

Time frame: Up to 30 minutes (measured once during the single-day assessment session)

Asymmetry Index (AI) of Respiratory Muscle Activation

The asymmetry index will be calculated using the Root Mean Square (RMS) values obtained from surface electromyography (sEMG) . The formula used is (Right RMS - Left RMS) / (Right RMS + Left RMS) X 100 . The index evaluates the percentage of imbalance between the right and left respiratory muscles (intercostal, external oblique, and sternocleidomastoid) during resting breathing and active breathing tasks.