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

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.

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