The effect of breathing exercises on pain level, functionalcapacity and quali̇ty of life i̇n adolescents with cerebral palsy

Ecem Yıldız ÇANGUR, The Effect of Breathing Exercises on Pain Level, Functional Capacity and Quality of Life in Adolescents with Cerebral Palsy. Hasan Kalyoncu University, Graduate Educatıon Instıtute. Department of Physiotherapy and Rehabilitation, Master Of Science Thesis, Gaziantep 2023. Aim of this study was to investigate the effects of breathing exercises implemented to neurodevelopmental physiotherapy on pain level, functional capacity and quality of life in adolescents with cerebral palsy. 27 adolescents, aged between 12-17 years were diagnosed with hemiparetic or diparetic cerebral palsy, level 1-2 according to GMFCS participated in the study. Participants were allocated to treatment (n=14) and control groups (n=13) using a simple random method. The both groups recieved the NDT program for eight weeks (40 minutes, two days a week). The control group recieved diaphragmatic breathing exercises training (two days a week, 15 minutes) in addition to the NDT program. Demographic information such as age, weight, height and body mass index of all participants were recorded. All participants were evaluated before and after the training. The evaluations were performed by a physiotherapist who was different from the physiotherapist conducting the treatment. Visual Analog Scale (VAS) was used to assess the pain level, 1 Minute Walking Test (1MWT) to assess functional capacity, Timed Up and Go (TUG), Pediatric Berg Balance Scale (PBBS) to assess balance, Gillette Functional Walking Assessment Questionnaire (FDA) to assess walking performance, Pediatric Quality of Life. Questionniare'in (PedsQL) to assess quality of life and Pittsburgh Sleep Quality Index (PUKI) to assess sleep quality. After training the pain level decreased in favor of the treatment group (p=0,005), there was no difference in the control group (p=0,083). After the training there was an increment in the 1MWT scores in both groups ( respectively p<0,001, p=0,003) but there was no significant difference between the groups after the training (p=0,229). TUG and PBBS values were increased in the treatment group ( respectively p<0,001, p=0,001) and control group ( respectively p<0,001, p=0,003) after the training. There was no difference observed between the groups ( respectively p=0,182, p=0,108). FDA and FDA-22 values increased in the treatment group (respectively, p=0.008, p=0.002). There was no change in the FDA value in the control group (p=0.157), an increase in the FDA-22 score was found (p=0.041). There was no difference between the groups when the groups were compared ( respectively, p=0.336, p=0.559). In intra-group comparisons of the quality of life parameter after the training, an increment was found in both groups ( respectively, p=0.001, p=0.003), no difference was found between the groups when the groups were compared (p=0.396). Sleep quality values increased in both groups ( respectively, p=0.001, p=0.030). There was no difference between the groups (p=0.249). As a result, it was seen that breathing exercises implemented to neurodevelopmental physiotherapy reduced the pain level, had no effect on functional capacity, balance, walking performance, quality of life and sleep quallity. We think that, studies examining the effects of breathing exercises performed at different intensity and duration on pain, functional capacity and balance are needed. Keywords: cerebral palsy, adolescent, breathing exercise, pain