Respiratory function and motor performance in children with cerebral palsy

Abstract

Background: Children with severe cerebral palsy (CP) have a high incidence of respiratory complications which is a leading cause of death among them. Understanding the relationship between these respiratory complications and underlying disability becomes important in their rehabilitation. Objectives: This study was aimed at investigating the relationship between each of respiratory rate (RR), Chest excursion at the 4 th (CE4), 7 th (CE7) and 9 th (CE9) intercostals spaces, forced vital capacity (FVC), forced expiratory volume in one second (FEV 1 ) and peak expiratory flow (PEF) across the levels of Gross Motor Function Classification System (GMFCS) of children with CP. Methods: 52 children with CP with a mean age of 72months were recruited into this study. They were classified into group I (13), II (6), III (8), IV (11) and V (14) using the GMFCS. Their RR, CE4, CE7, CE9, FVC, FEV 1 and PEF were measured using standard procedures in supine lying. Only those children in GMFCS I to IV were able to take instructions for the performance of spirometry. Data was analysed using IBM SPSS 20. P value was set at 0.05. Results: The RR significantly increased across the levels of GMFCS (p=0.03) with post hoc analysis showing a significant difference in children in GMFCS I and V (p=0.01). PEF significantly reduced across the levels of GMFCS (p=0.02) with post hoc analysis showing a significant difference in children in GMFCS I and each of II (p=0.02), III (p=0.01) and IV (p=0.02). Conclusion: RR and PEF of children with CP worsen with the severity of the condition. Therefore, interventions aimed at improving pulmonary function should be integrated in the rehabilitation of these children.