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Effectiveness of the manual diaphragmatic stretching technique on respiratory function in cerebral palsy: A randomised controlled trial
Respiratory failure resulting from diaphragmatic muscle weakness is a major cause of long-term hospitalization in children with cerebral palsy (CP). Manual diaphragmatic stretching technique (MDST) can be directly applied to stretch diaphragmatic muscle and has been reported to improve respiratory f...
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| Published in: | Respiratory medicine 2021-08, Vol.184, p.106443-106443, Article 106443 |
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| creator | Bennett, Surussawadi Siritaratiwat, Wantana Tanrangka, Nittaya Bennett, Michael John Kanpittaya, Jaturat |
| description | Respiratory failure resulting from diaphragmatic muscle weakness is a major cause of long-term hospitalization in children with cerebral palsy (CP). Manual diaphragmatic stretching technique (MDST) can be directly applied to stretch diaphragmatic muscle and has been reported to improve respiratory function in patients with asthma and COPD. However, there have been no studies among CP. This study aimed to examine the effects of a six-week MDST course on respiratory function among CP.
Fifty-three children with spastic CP were randomly assigned to experimental (n = 27) and control (n = 26) groups. The experimental group received MDST on non-consecutive days, three days per week for six weeks alongside standard physiotherapy (SDPT), while the control group received only SDPT. The outcome variables were diaphragmatic mobility, pulmonary function and chest wall expansion.
MDST significantly improved diaphragmatic mobility on both sides of the body, with a between-group difference of 0.97 cm (95% CI 0.55–1.39 cm, p |
| doi_str_mv | 10.1016/j.rmed.2021.106443 |
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Fifty-three children with spastic CP were randomly assigned to experimental (n = 27) and control (n = 26) groups. The experimental group received MDST on non-consecutive days, three days per week for six weeks alongside standard physiotherapy (SDPT), while the control group received only SDPT. The outcome variables were diaphragmatic mobility, pulmonary function and chest wall expansion.
MDST significantly improved diaphragmatic mobility on both sides of the body, with a between-group difference of 0.97 cm (95% CI 0.55–1.39 cm, p < 0.001) for the right side and 0.82 cm (95% CI 0.35–1.29 cm, p = 0.001) for the left side. MDST significantly improved chest wall expansion at the xiphoid process and umbilical levels, with between-group differences of 0.57 cm (95% CI 0.12–1.20 cm, p = 0.013) and 0.87 cm (95% CI 0.31–1.43 cm, p = 0.003), respectively. There was no significant difference in pulmonary function testing between the groups.
MDST could significantly improve diaphragmatic mobility, and lower and abdominal chest wall expansion, among children with CP. Therefore, MDST could be considered as an additional technique for physiotherapy programmes, to improve diaphragmatic function in spastic CP.
•Six weeks of MDST can improve diaphragmatic mobility in children with spastic CP.•Abdominal and lower chest wall expansions are improved in spastic CP after MDST.•FVC% predicted is slightly increased after MDST when compared with pre-treatment.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2021.106443</identifier><identifier>PMID: 34029936</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adolescent ; Asthma ; Births ; Cerebral palsy ; Cerebral Palsy - complications ; Cerebral Palsy - physiopathology ; Cerebral Palsy - therapy ; Chest ; Child ; Children ; Chronic obstructive pulmonary disease ; Data collection ; Diaphragm ; Diaphragm (Anatomy) ; Diaphragm - physiopathology ; Expansion ; Female ; Humans ; Lung - physiopathology ; Male ; Manual diaphragmatic stretching technique ; Mobility ; Mortality ; Muscles ; Paralysis ; Physical therapy ; Physical Therapy Modalities ; Prospective Studies ; Pulmonary functions ; Respiratory failure ; Respiratory function ; Respiratory Function Tests - methods ; Respiratory Insufficiency - etiology ; Respiratory Insufficiency - prevention & control ; Single-Blind Method ; Stretching ; Thoracic Wall - physiopathology ; Treatment Outcome ; Ultrasonic imaging ; Ultrasonography</subject><ispartof>Respiratory medicine, 2021-08, Vol.184, p.106443-106443, Article 106443</ispartof><rights>2021 Elsevier Ltd</rights><rights>Copyright © 2021 Elsevier Ltd. All rights reserved.</rights><rights>2021. Elsevier Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-64e8840250e67276f006702bbe63061f742253e65cd00247ee4fed0a4ab3e0403</citedby><cites>FETCH-LOGICAL-c428t-64e8840250e67276f006702bbe63061f742253e65cd00247ee4fed0a4ab3e0403</cites><orcidid>0000-0002-6893-7313</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34029936$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bennett, Surussawadi</creatorcontrib><creatorcontrib>Siritaratiwat, Wantana</creatorcontrib><creatorcontrib>Tanrangka, Nittaya</creatorcontrib><creatorcontrib>Bennett, Michael John</creatorcontrib><creatorcontrib>Kanpittaya, Jaturat</creatorcontrib><title>Effectiveness of the manual diaphragmatic stretching technique on respiratory function in cerebral palsy: A randomised controlled trial</title><title>Respiratory medicine</title><addtitle>Respir Med</addtitle><description>Respiratory failure resulting from diaphragmatic muscle weakness is a major cause of long-term hospitalization in children with cerebral palsy (CP). Manual diaphragmatic stretching technique (MDST) can be directly applied to stretch diaphragmatic muscle and has been reported to improve respiratory function in patients with asthma and COPD. However, there have been no studies among CP. This study aimed to examine the effects of a six-week MDST course on respiratory function among CP.
Fifty-three children with spastic CP were randomly assigned to experimental (n = 27) and control (n = 26) groups. The experimental group received MDST on non-consecutive days, three days per week for six weeks alongside standard physiotherapy (SDPT), while the control group received only SDPT. The outcome variables were diaphragmatic mobility, pulmonary function and chest wall expansion.
MDST significantly improved diaphragmatic mobility on both sides of the body, with a between-group difference of 0.97 cm (95% CI 0.55–1.39 cm, p < 0.001) for the right side and 0.82 cm (95% CI 0.35–1.29 cm, p = 0.001) for the left side. MDST significantly improved chest wall expansion at the xiphoid process and umbilical levels, with between-group differences of 0.57 cm (95% CI 0.12–1.20 cm, p = 0.013) and 0.87 cm (95% CI 0.31–1.43 cm, p = 0.003), respectively. There was no significant difference in pulmonary function testing between the groups.
MDST could significantly improve diaphragmatic mobility, and lower and abdominal chest wall expansion, among children with CP. Therefore, MDST could be considered as an additional technique for physiotherapy programmes, to improve diaphragmatic function in spastic CP.
•Six weeks of MDST can improve diaphragmatic mobility in children with spastic CP.•Abdominal and lower chest wall expansions are improved in spastic CP after MDST.•FVC% predicted is slightly increased after MDST when compared with pre-treatment.</description><subject>Adolescent</subject><subject>Asthma</subject><subject>Births</subject><subject>Cerebral palsy</subject><subject>Cerebral Palsy - complications</subject><subject>Cerebral Palsy - physiopathology</subject><subject>Cerebral Palsy - therapy</subject><subject>Chest</subject><subject>Child</subject><subject>Children</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Data collection</subject><subject>Diaphragm</subject><subject>Diaphragm (Anatomy)</subject><subject>Diaphragm - physiopathology</subject><subject>Expansion</subject><subject>Female</subject><subject>Humans</subject><subject>Lung - physiopathology</subject><subject>Male</subject><subject>Manual diaphragmatic stretching technique</subject><subject>Mobility</subject><subject>Mortality</subject><subject>Muscles</subject><subject>Paralysis</subject><subject>Physical therapy</subject><subject>Physical Therapy Modalities</subject><subject>Prospective Studies</subject><subject>Pulmonary functions</subject><subject>Respiratory failure</subject><subject>Respiratory function</subject><subject>Respiratory Function Tests - methods</subject><subject>Respiratory Insufficiency - etiology</subject><subject>Respiratory Insufficiency - prevention & control</subject><subject>Single-Blind Method</subject><subject>Stretching</subject><subject>Thoracic Wall - physiopathology</subject><subject>Treatment Outcome</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography</subject><issn>0954-6111</issn><issn>1532-3064</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kUGP1SAUhYnROM_RP-DCkLhx0-eFUtoaN5PJOJpM4kbXhNLLPF5aqEAneb_Avy3Nm9m4mBVw-c7JgUPIewZ7Bkx-Pu7jjOOeA2dlIIWoX5Ada2pe1eX0kuygb0QlGWMX5E1KRwDohYDX5KIWwPu-ljvy98ZaNNk9oMeUaLA0H5DO2q96oqPTyyHq-1lnZ2jKEbM5OH9PM5qDd39WpMHTiGlxUecQT9SuvpiVofPUYMQhFptFT-n0hV7RqP0YZpdwpCb4HMM0lW2OTk9vyStbMHz3uF6S399ufl1_r-5-3v64vrqrjOBdrqTArivhG0DZ8lZaANkCHwaU5c3MtoLzpkbZmBGAixZRWBxBCz3UCALqS_Lp7LvEUPKnrEoeg9OkPYY1qaIuDtD2G_rxP_QY1uhLuo3qu5Z1DS8UP1MmhpQiWrVEN-t4UgzUVpM6qq0mtdWkzjUV0YdH63XY7p4kT70U4OsZwPIXDw6jSsahNzi6WOpSY3DP-f8DLfWkmg</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Bennett, Surussawadi</creator><creator>Siritaratiwat, Wantana</creator><creator>Tanrangka, Nittaya</creator><creator>Bennett, Michael John</creator><creator>Kanpittaya, Jaturat</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>ASE</scope><scope>FPQ</scope><scope>H94</scope><scope>K6X</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6893-7313</orcidid></search><sort><creationdate>20210801</creationdate><title>Effectiveness of the manual diaphragmatic stretching technique on respiratory function in cerebral palsy: A randomised controlled trial</title><author>Bennett, Surussawadi ; Siritaratiwat, Wantana ; Tanrangka, Nittaya ; Bennett, Michael John ; Kanpittaya, Jaturat</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-64e8840250e67276f006702bbe63061f742253e65cd00247ee4fed0a4ab3e0403</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Asthma</topic><topic>Births</topic><topic>Cerebral palsy</topic><topic>Cerebral Palsy - complications</topic><topic>Cerebral Palsy - physiopathology</topic><topic>Cerebral Palsy - therapy</topic><topic>Chest</topic><topic>Child</topic><topic>Children</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Data collection</topic><topic>Diaphragm</topic><topic>Diaphragm (Anatomy)</topic><topic>Diaphragm - physiopathology</topic><topic>Expansion</topic><topic>Female</topic><topic>Humans</topic><topic>Lung - physiopathology</topic><topic>Male</topic><topic>Manual diaphragmatic stretching technique</topic><topic>Mobility</topic><topic>Mortality</topic><topic>Muscles</topic><topic>Paralysis</topic><topic>Physical therapy</topic><topic>Physical Therapy Modalities</topic><topic>Prospective Studies</topic><topic>Pulmonary functions</topic><topic>Respiratory failure</topic><topic>Respiratory function</topic><topic>Respiratory Function Tests - methods</topic><topic>Respiratory Insufficiency - etiology</topic><topic>Respiratory Insufficiency - prevention & control</topic><topic>Single-Blind Method</topic><topic>Stretching</topic><topic>Thoracic Wall - physiopathology</topic><topic>Treatment Outcome</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bennett, Surussawadi</creatorcontrib><creatorcontrib>Siritaratiwat, Wantana</creatorcontrib><creatorcontrib>Tanrangka, Nittaya</creatorcontrib><creatorcontrib>Bennett, Michael John</creatorcontrib><creatorcontrib>Kanpittaya, Jaturat</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bennett, Surussawadi</au><au>Siritaratiwat, Wantana</au><au>Tanrangka, Nittaya</au><au>Bennett, Michael John</au><au>Kanpittaya, Jaturat</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of the manual diaphragmatic stretching technique on respiratory function in cerebral palsy: A randomised controlled trial</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>184</volume><spage>106443</spage><epage>106443</epage><pages>106443-106443</pages><artnum>106443</artnum><issn>0954-6111</issn><eissn>1532-3064</eissn><abstract>Respiratory failure resulting from diaphragmatic muscle weakness is a major cause of long-term hospitalization in children with cerebral palsy (CP). Manual diaphragmatic stretching technique (MDST) can be directly applied to stretch diaphragmatic muscle and has been reported to improve respiratory function in patients with asthma and COPD. However, there have been no studies among CP. This study aimed to examine the effects of a six-week MDST course on respiratory function among CP.
Fifty-three children with spastic CP were randomly assigned to experimental (n = 27) and control (n = 26) groups. The experimental group received MDST on non-consecutive days, three days per week for six weeks alongside standard physiotherapy (SDPT), while the control group received only SDPT. The outcome variables were diaphragmatic mobility, pulmonary function and chest wall expansion.
MDST significantly improved diaphragmatic mobility on both sides of the body, with a between-group difference of 0.97 cm (95% CI 0.55–1.39 cm, p < 0.001) for the right side and 0.82 cm (95% CI 0.35–1.29 cm, p = 0.001) for the left side. MDST significantly improved chest wall expansion at the xiphoid process and umbilical levels, with between-group differences of 0.57 cm (95% CI 0.12–1.20 cm, p = 0.013) and 0.87 cm (95% CI 0.31–1.43 cm, p = 0.003), respectively. There was no significant difference in pulmonary function testing between the groups.
MDST could significantly improve diaphragmatic mobility, and lower and abdominal chest wall expansion, among children with CP. Therefore, MDST could be considered as an additional technique for physiotherapy programmes, to improve diaphragmatic function in spastic CP.
•Six weeks of MDST can improve diaphragmatic mobility in children with spastic CP.•Abdominal and lower chest wall expansions are improved in spastic CP after MDST.•FVC% predicted is slightly increased after MDST when compared with pre-treatment.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>34029936</pmid><doi>10.1016/j.rmed.2021.106443</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-6893-7313</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Asthma Births Cerebral palsy Cerebral Palsy - complications Cerebral Palsy - physiopathology Cerebral Palsy - therapy Chest Child Children Chronic obstructive pulmonary disease Data collection Diaphragm Diaphragm (Anatomy) Diaphragm - physiopathology Expansion Female Humans Lung - physiopathology Male Manual diaphragmatic stretching technique Mobility Mortality Muscles Paralysis Physical therapy Physical Therapy Modalities Prospective Studies Pulmonary functions Respiratory failure Respiratory function Respiratory Function Tests - methods Respiratory Insufficiency - etiology Respiratory Insufficiency - prevention & control Single-Blind Method Stretching Thoracic Wall - physiopathology Treatment Outcome Ultrasonic imaging Ultrasonography |
| title | Effectiveness of the manual diaphragmatic stretching technique on respiratory function in cerebral palsy: A randomised controlled trial |
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