Functional and structural respiratory impairment in cerebral palsy- GMFCS IV and V: Insights from ultrasound and inspiratory muscle testing - 17/04/26
Abstract |
Background |
Children with cerebral palsy (CP) classified at Gross Motor Function Classification System (GMFCS) levels IV and V present severe motor and respiratory impairment, which limits the feasibility of conventional pulmonary function testing. Non-invasive alternatives, such as diaphragmatic ultrasound and dynamic inspiratory muscle assessment, may provide clinically meaningful insights into respiratory function in this population.
Objective |
To evaluate respiratory muscle strength and diaphragmatic function in children and adolescents with CP (GMFCS IV–V) and to explore correlations among inspiratory strength, flow, and ultrasound-derived parameters.
Methods |
This cross-sectional study included 32 participants aged 6–17 years. Respiratory muscle strength was assessed using maximal inspiratory (PImax) and expiratory pressures (PEmax) measured with a digital manometer. Dynamic inspiratory performance was evaluated through the S-index and peak inspiratory flow (PIF) using the PowerBreathe® K5 device. Diaphragmatic thickness, excursion, contraction speed, and echogenicity were assessed by ultrasound.
Results |
Measured PImax and PEmax were significantly lower than predicted values (p < 0.001), indicating reduced respiratory muscle strength in children and adolescents with CP classified as GMFCS IV–V. Diaphragmatic excursion was lower than reference values, particularly in those with more severe motor impairment. PImax showed moderate positive correlations with mean S-index, best S-index, and peak inspiratory flow. In the regression model, mean inspiratory volume was the main determinant of PImax, and the model demonstrated moderate explanatory power.
Conclusions |
Children and adolescents with severe CP (GMFCS IV–V) exhibit marked impairment in respiratory muscle strength and reduced diaphragmatic mobility. The combined use of dynamic inspiratory assessment and diaphragmatic ultrasound represents a feasible and non-invasive approach to characterize respiratory dysfunction in this population.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Children with severe cerebral palsy (GMFCS IV–V) exhibit marked respiratory muscle weakness. |
• | PImax and PEmax correspond to approximately 60% and 27% of predicted values. |
• | Diaphragmatic excursion is significantly reduced in children with higher motor impairment. |
• | Dynamic inspiratory measures (S-index and PIF) correlate with inspiratory muscle strength. |
• | Combined diaphragmatic ultrasound and inspiratory assessment is feasible in non-cooperative patients. |
Keywords : Cerebral palsy, Respiratory muscle strength, Diaphragm ultrasound, Inspiratory function, Pediatric rehabilitation
Plan
Vol 256
Article 108819- mai 2026 Retour au numéro
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