Effects of diaphragmatic breathing and manual diaphragm relaxation on respiratory muscle strength, chest expansion, pulmonary function, and sitting ability in children with diplegic cerebral palsy: A randomized controlled trial

Objective: The aim of this study was to investigate the effects of manual diaphragmatic relaxation combined with diaphragmatic breathing on respiratory muscle strength, pulmonary function, chest expansion, and sitting ability in children with diplegic cerebral palsy (CP). Materials and Methods: This randomized controlled study was conducted with 15 children with diplegic CP aged 5–15 years. Participants were randomly divided into two groups (control and intervention); both groups received conventional physiotherapy two days a week (45 minutes) for eight weeks. The intervention group additionally received manual diaphragm relaxation and diaphragmatic breathing exercises. The primary outcome was respiratory muscle strength (maximum inspiratory pressure and maximum respiratory pressure. Secondary outcomes were pulmonary function test (PFT), chest expansion and sitting dimension of the Gross Motor Functional Measurement (GMFM-B). (NCT05559346) Results: After eight weeks of intervention, the intervention group showed improvement in respiratory muscle strength, chest mobility, and GMFM-B score (p < 0.05). Respiratory muscle strength was significantly higher in the intervention group than in the control group (p < 0.05), but PFT parameters and GMFM-B scores were not significantly different between the two groups (p > 0.05) Conclusion: Adding manual diaphragmatic relaxation and diaphragmatic breathing exercises to the physiotherapy program in children with CP may contribute to the rehabilitation program.