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

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.

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