Riddhi Shah, Dr. Sweety Shah


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.


Cerebral palsy,Ergonomics,Respiration,Seat inclination

Full Text:



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