The effects of myofascial release of the diaphragm and chest on the functional parameters of the lungs and characteristics of the abdominal muscles and diaphragm in children with cerebral palsy: Randomized clinical trials

Brief name: Myofascial release of the diaphragm and chest What: Two techniques will be proposed in the project. Arm 1. The patient is lying down on their back, with limbs relaxed; in the case of individuals with contractures, the position will be secured by a roller or wedge. The therapist will be standing behind the patient’s head and will place their hands on the rib arch. The manual contact of both hands with the patient will occur from the pisiform, hypothenar region and the last three fingers bilaterally to the underside of the seventh to tenth rib costal cartilages, with the therapist’s forearms aligned toward the participant’s shoulders. During inhalation, the therapist will press gently with both hands in an upward and slightly lateral direction, which will be accompanied by elevation of the ribs. During exhalation, the therapist will deepen the pressure towards the inside of the body cavity, maintaining constant pressure and resistance. In subsequent cycles, the therapist will gradually increase the depth of contact on the edge of the ribs. This manoeuvre will be performed in two cycles of ten deep inhalations and exhalations. There must be a 1-minute break between cycles. In the control group, sham therapy will be used, in which there is no traction or resistance components. Arm 2. The patient will still be lying down on their back. The therapist will try to hold the costal arches of the patient with their hands. A gentle pressure in the dorsal direction will activate the sternum area of the diaphragm. The pressure of the hand will be adjusted according tothe rhythm of the respiratory system, deepening at each exhalation. The technique will be repeated in two cycles of ten deep inhalations and exhalations. There must be a 1-minute break between cycles. Who provided: The therapist performing the therapeutic techniques for the study will be an individual with long-term experience of working with myofascial techniques. This person will not be directly involved in the project and will not be familiar with the details of the study or the procedures. How: The therapeutic intervention will be performed face to face, the therapist will use his or her hand while performing the therapeutic techniques. The specificity of the method of mysofascial release assumes individual work with the participant. The approximate duration of each session, 30 minutes. In addition, an attendance list will be signed at each therapy session and examination to accurately monitor attendance at each scheduled therapy session. Where: The research will be carried out in rehabilitation centres and at the Jerzy Kukuczka Academy of Physical Education in Katowice. Special Primary School No. 23 in Jastrzebie-Zdroj, the Complex of Special Schools for Mother Teresa of Calcutta in Zory, Rehabilitation Centres in Zory, Jastrzebie-Zdroj, Rybnik. When: Children with CP will be randomly assigned to experimental and control groups. The experimental group will receive six sessions of therapy (myofascial release of the diaphragm and chest) whereas the control group will receive six sessions of placebo therapy. The measurements will be taken before treatment, after the first treatment and after the sixth treatment, as well as one month after the end of the experiment. The myofascial release therapy will be performed at intervals of 3-4 days. The intervention will be applied twice a week for 3 weeks, total 6 sessions.