Comparing the Effects of Incentive Spirometry Vs Mirror-Mediated Deep Breathing On Pulmonary Function, Sleep, and Quality Of Life in Children with Spastic Diplegic Cerebral Palsy (CP): A Single-Blind Randomized Controlled Trial

Abstract

Objective: This study aimed to examine the effect of incentive spirometer as visual feedback vs. deep breathing exercise via mirror-mediated therapy in children with cerebral palsy.

Study Design: Randomized clinical trial.

Place and Duration of Study: National Institute of Rehabilitation Medicine (NIRM), 1st September 2023 to 11th December 2023.

Materials and Methods: 54 children with spastic Cerebral Palsy were randomly assigned to an experimental group (n=29) and a control group (n=25). Both groups underwent breathing exercises in front of a mirror, with the experimental group using an additional Incentive Spirometer. Pre and post-values of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC were measured using pulmonary function tests. Quality of life and sleep problems were assessed using CPQOL and SDSC, respectively. Data were analyzed using SPSS version 23.

Results: Between-group analysis showed non-significant results for FVC, FEV1, and SDSC (p>0.05), FEV1/FVC, CPQOL, and SDSC. However significant results were obtained on comparing mean differences of FEV1/FVC, SDSC and CPQOL in the experimental group when compared to control group (p>0.05). Within-group analysis showed significant improvements (p<0.05) in FEV1/FVC, CPQOL, FEV1, and SDSC in both groups, except for FVC which was non-significant (p>0.05) for both groups.

Conclusion: There was no significant difference in use of Incentive Spirometer as visual feedback and deep breathing exercises via mirror-mediated therapy in improving lung function, sleep problems, and quality of life in children with spastic cerebral palsy when both groups were compared to each other. However significant improvements were observed in the experimental group in sleep problems and quality of life in children with spastic cerebral palsy when mean differences of CPQOL and SDSC were compared between groups.

Key Words: Cerebral Palsy, Deep breathing, Incentive spirometer, Mirror-mediated therapy, Visual feedback.