BACKGROUND

Respiratory problems are commonly observed in children with cerebral palsy.They frequently show abnormal muscle tone,impaired muscle contraction,and altered postural control.These abnormal muscle tones and movements not only adversely affect development of trunk muscles that are the foundation of respiration,but also cause thoracic deformity,which leads to respiratory problems.Ergonomic approach can be recognized as a simple intervention to improve respiratory function in children with CP.The modification of sitting posture changes the structure of respiratory muscles in resting position.A sitting device such as a wheelchair can be modified accordingly.

METHODOLOGY

Spastic cerebral palsy patients aging 6–15 years,ability to maintain sitting position independently and follow commands,(GMFCS level I–IV)were selected.Subjects were

asked to sit on chair with its seat surface inclined anterior 15°,horizontal 0°,and posterior 15°.Inclination was given by wedge.Instructions and demonstrations were provided prior to the manoeuvre. Using pulmonary function testing device,Forced Vital Capacity(FVC),Forced Expiratory Volume in 1 second(FEV1),Peak Expiratory flow rate(PEFR) and Maximum voluntary ventilation(MVV)were measured.

RESULT

Friedman test indicated that FVC at anterior 15° inclination of seat surface (1.50 ± 0.80 L)was significantly greater than at posterior 15°inclination of seat surface (1.38 ± 0.73 L)and horizontal inclination(1.44 ± 0.74 L)(P < 0.05).FEV1 at anterior 15° inclination of seat surface(1.47 ± 0.77 L)was significantly greater than at posterior 15° inclination of seat surface(1.35 ± 0.68 L)and horizontal inclination(1.39 ± 0.74 L)(P < 0.05).PEFR at anterior 15° inclination of seat surface(3.07 ± 1.71 L),at posterior 15° inclination of seat surface(2.90 ± 1.69 L)and horizontal inclination(3.08±1.72 L),(P = 0.05) shows no significant difference.MVV at anterior 15° inclination of seat surface(34.82 ± 13.21),at posterior 15° inclination of seat surface (34.00 ± 13.09)and horizontal inclination(34.82 ± 10.82)(P > 0.05)shows no significant difference.

CONCLUSION

The present study concludes that significant difference is observed in FVC and FEV1,while there is no significant difference in PEFR and MVV across three seat inclinations.It shows that adjustment of seat inclination can be an effective intervention to improve the respiratory function of children with spastic cerebral palsy.