The Effect of Breathing Exercise on Pain Level, Balance, Gait, and Quality of Lıfe in Adolescents with Cerebral Palsy: A Single-Blind, Randomized Controlled Trial
Abstract views: 520
/ 
PDF downloads: 275
DOI:
https://doi.org/10.5281/zenodo.10048978Keywords:
Adolescent, Breathing Exercise, Cerebral Palsy, Quality of Life, PainAbstract
Objective: The aim of this study was to examine the effect of diaphragmatic breathing exercise with conventional physiotherapy program on pain level, functional capacity and quality of life in adolescents with cerebral palsy.
Methods: A total of twenty-seven adolescents with cerebral palsy (12-17 years of age) who were level 1-2 according to Gross Motor Functional Classification System participated in this randomized controlled study. Participants were randomly divided into two groups as the control group (n:13, mean age: 13.8±1.7 years, and the study group (n:14, mean age: 13.5±1.8 years). Both groups participated neurodevelopmental physiotherapy (NDT) program for 8 weeks. In addition to NDT program study group also recieved diaphragmatic breathing exercises for 8 weeks, everyday of the week, for 15 minutes. Both groups pain level assessed with Visual Analog Scale (VAS), balance assessed with Time Up and Go Test (TUG) and Pediatric Berg Balance Scale (PBBS), gait evaluated with Gillette Functional Gait Assessment Questionnaire (GFAQ, GFAQ-22), and quality of life was evaluated with the Pediatric Quality of Life Questionniare (PedsQL) before and after physiotherapy program.
Results: In both groups, after physiotherapy program balance, walking performance, and quality of life parameters increased (p<0.05). After breathing exercise pain level was changed from 6.8±0.7 to 5.1±0.5 (p=0.0001) in the study group, and from 6.5±0.1 to 6.3±1.2 (p=0.083) in the control group. After the physiotherapy program, there was a statistically significant improvement in pain level in the study group than the control group (p=0.005), but no significant difference was revealed between the two groups in other parameters (p>0.05).
Conclusion: We think that adding breathing exercise to the physiotherapy program can ocur improvement on pain level in adolescent with cerebral palsy.
References
Anand, B., Karthikbabu, S. (2021). Effects of additional inspiratory muscle training on mobility capacity and respiratory strength for school-children and adolescents with cerebral palsy: a randomized controlled trial. Brazilian Journal of Physical Therapy, 25(6), 891-899.
Anderson, B. E., Bliven, K. C. H. (2017). The use of breathing exercises in the treatment of chronic, nonspecific low back pain. Journal of sport rehabilitation, 26(5), 452-458.
Anderson, K. O., Cohen, M. Z., Mendoza, T. R., Guo, H., Harle, M. T., Cleeland, C. S. (2006). Brief cognitive‐behavioral audiotape interventions for cancer‐related pain: immediate but not long‐term effectiveness. Cancer: Interdisciplinary International Journal of the American Cancer Society, 107(1), 207-214.
Aslan, G. K., Gurses, H. N., Issever, H., Kiyan, E. (2014). Effects of respiratory muscle training on pulmonary functions in patients with slowly progressive neuromuscular disease: a randomized controlled trial. Clinical rehabilitation, 28(6), 573-581.
Aydoğan Arslan, S., Uğurlu, K., Sakizli Erdal, E., Keskin, E. D., Demirgüç, A. (2022). Effects of inspiratory muscle training on respiratory muscle strength, trunk control, balance and functional capacity in stroke patients: a single-blinded randomized controlled study. Topics in Stroke Rehabilitation, 29(1), 40-48.
Busch, V., Magerl, W., Kern, U., Haas, J., Hajak, G., Eichhammer, P. (2012). The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing—an experimental study. Pain Medicine, 13(2), 215-228.
Cans, C. (2000). Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Developmental Medicine & Child Neurology, 42(12), 816-824.
Carey, H., Martin, K., Combs-Miller, S., Heathcock, J. C. (2016). Reliability and responsiveness of the timed up and go test in children with cerebral palsy. Pediatric Physical Therapy, 28(4), 401-408.
Chalaye, P., Goffaux, P., Lafrenaye, S., Marchand, S. (2009). Respiratory effects on experimental heat pain and cardiac activity. Pain medicine, 10(8), 1334-1340.
Cvejic, E., Sandler, C. X., Keech, A., Barry, B. K., Lloyd, A. R., Vollmer-Conna, U. (2017). Autonomic nervous system function, activity patterns, and sleep after physical or cognitive challenge in people with chronic fatigue syndrome. Journal of Psychosomatic Research, 103, 91-94.
De Lima Crispim, T. R., Neto, M. G., Crispim, T. R. L., Dias, R. B., De Albuquerque, M. D. M., Saquetto, M. B., Magalhães, P. A. F. (2023). Addition of respiratory exercises to conventional rehabilitation for children and adolescents with cerebral palsy: a systematic review and meta-analysis. World Journal of Pediatrics, 19(4), 340-355.
El-Refaey, B. H., Abd-El Maksoud, G. M., Ali, O. I. (2017). Efficacy of feedback respiratory training on respiratory muscle strength and quality of life in children with spastic cerebral palsy: Randomized controlled trial. Bulletin of Faculty of Physical Therapy, 22, 46-52.
Engel, J. M., Petrina, T. J., Dudgeon, B. J., McKearnan, K. A. (2006). Cerebral palsy and chronic pain: a descriptive study of children and adolescents. Physical & occupational therapy in pediatrics, 25(4), 73-84.
Eriksson, E., Hägglund, G., Alriksson-Schmidt, A. I. (2020). Pain in children and adolescents with cerebral palsy–a cross-sectional register study of 3545 individuals. BMC neurology, 20, 1-9.
Findlay, B., Switzer, L., Narayanan, U., Chen, S., Fehlings, D. (2016). Investigating the impact of pain, age, Gross Motor Function Classification System, and sex on health‐related quality of life in children with cerebral palsy. Developmental Medicine & Child Neurology, 58(3), 292-297.
Jantakat, C., Ramrit, S., Emasithi, A., Siritaratiwat, W. (2015). Capacity of adolescents with cerebral palsy on paediatric balance scale and Berg balance scale. Research in Developmental Disabilities, 36, 72-77..
Jensen, M. P., Engel, J. M., McKearnan, K. A., Hoffman, A. J. (2003). Validity of pain intensity assessment in persons with cerebral palsy: a comparison of six scales. The Journal of Pain, 4(2), 56-63.
Keles, M. N., Elbasan, B., Apaydin, U., Aribas, Z., Bakirtas, A., Kokturk, N. (2018). Effects of inspiratory muscle training in children with cerebral palsy: a randomized controlled trial. Brazilian Journal of Physical Therapy, 22(6), 493-501.
Kepenek-Varol, B., Gürses, H. N., İçağasıoğlu, D. F. (2022). Effects of inspiratory muscle and balance training in children with hemiplegic cerebral palsy: a randomized controlled trial. Developmental neurorehabilitation, 25(1), 1-9.
Kozier, B. (2008). Fundamentals of nursing: concepts, process and practice. pearson education.
Kubsch, S. M., Neveau, T., & Vandertie, K. (2001). Effect of cutaneous stimulation on pain reduction in emergency department patients. Accident and emergency nursing, 9(3), 143-151.
Kwon, Y. H., Lee, H. Y. (2015). Differences in respiratory pressure and pulmonary function among children with spastic diplegic and hemiplegic cerebral palsy in comparison with normal controls. Journal of physical therapy science, 27(2), 401-403.
Lee, H. Y., Kim, K. (2014). Can walking ability enhance the effectiveness of breathing exercise in children with spastic cerebral palsy?. Journal of physical therapy science, 26(4), 539-542.
Mckinnon, C. T., Meehan, E. M., Harvey, A. R., Antolovich, G. C., Morgan, P. E. (2019). Prevalence and characteristics of pain in children and young adults with cerebral palsy: a systematic review. Developmental Medicine & Child Neurology, 61(3), 305-314.
Ostojic, K., Paget, S. P., & Morrow, A. M. (2019). Management of pain in children and adolescents with cerebral palsy: a systematic review. Developmental Medicine & Child Neurology, 61(3), 315-321.
Özveren, Y. D. D. H. (2011). Ağrı kontrolünde farmakolojik olmayan yöntemler. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 18(1), 83-92.
Parkinson, K. N., Dickinson, H. O., Arnaud, C., Lyons, A., & Colver, A. (2013). Pain in young people aged 13 to 17 years with cerebral palsy: cross-sectional, multicentre European study. Archives of disease in childhood, 98(6), 434-440.
Pfalzer, L., Fry, D. (2011). Effects of a 10-week inspiratory muscle training program on lower-extremity mobility in people with multiple sclerosis: a randomized controlled trial. International journal of MS care, 13(1), 32-42.
Pozuelo-Carrascosa, D. P., Carmona-Torres, J. M., Laredo-Aguilera, J. A., Latorre-Román, P. Á., Párraga-Montilla, J. A., Cobo-Cuenca, A. I. (2020). Effectiveness of respiratory muscle training for pulmonary function and walking ability in patients with stroke: a systematic review with meta-analysis. International journal of environmental research and public health, 17(15), 5356.
Ramstad, K., Jahnsen, R., Skjeldal, O. H., Diseth, T. H. (2012). Parent‐reported participation in children with cerebral palsy: the contribution of recurrent musculoskeletal pain and child mental health problems. Developmental Medicine & Child Neurology, 54(9), 829-835.
Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., Bax, M., Damiano, D., ... & Jacobsson, B. (2007). A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl, 109(suppl 109), 8-14.
Saunders, S. W., Rath, D., Hodges, P. W. (2004). Postural and respiratory activation of the trunk muscles changes with mode and speed of locomotion. Gait & posture, 20(3), 280-290.
Seyhan, K., Çankaya, Ö., Şimşek, T. T., Günel, M. K. (2018). Serebral palsili çocuklarda gillette fonksiyonel yürüme değerlendirme anketinin gözlemci içi güvenirlik ve geçerliğinin araştırılması. Fizyoterapi Rehabilitasyon, 29(3), 73-78.
Simard-Tremblay E, Constantin E, Gruber R, Brouillette RT, Shevell, M. (2011).Sleep in children with cerebral palsy: A review (pp. 1303–1310). Los Angeles, CA: SAGE Publications.
Vargus‐Adams, J. N., Martin, L. K. (2011). Domains of importance for parents, medical professionals and youth with cerebral palsy considering treatment outcomes. Child: care, health and development, 37(2), 276-281.
Varni, J. W., Burwinkle, T. M., Berrin, S. J., Sherman, S. A., Artavia, K., Malcarne, V. L., Chambers, H. G. (2006). The PedsQL in pediatric cerebral palsy: reliability, validity, and sensitivity of the Generic Core Scales and Cerebral Palsy Module. Developmental medicine and child neurology, 48(6), 442-449.
Wang, H., Wang, T., Tan, J. Y. B., Bressington, D., Zheng, S. L., Liu, X. L., Huang, H. Q. (2023). Development and validation of an evidence-based breathing exercise intervention protocol for chronic pain management in breast cancer survivors. Pain Management Nursing, 24(3), 357-364.
Wren, A. A., Wright, M. A., Carson, J. W., Keefe, F. J. (2011). Yoga for persistent pain: new findings and directions for an ancient practice. Paın, 152(3), 477-480.
Zou, L., Sasaki, J. E., Wei, G. X., Huang, T., Yeung, A. S., Neto, O. B., ... Hui, S. S. C. (2018). Effects of mind–body exercises (Tai Chi/Yoga) on heart rate variability parameters and perceived stress: A systematic review with meta-analysis of randomized controlled trials. Journal of Clinical Medicine, 7(11), 404.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 GEVHER NESIBE JOURNAL OF MEDICAL AND HEALTH SCIENCES
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The journal is licensed under a 