The impact of a respiratory physiotherapy program on functionality in adolescents and young adults with cerebral palsy.

A program of inspiratory muscle training with a threshold device was implimented. The participants were trained to use a device which placed resistance during inspiration and expiration. The training period lasted 1 week, without resistance. The threshold device was used by the participants. They hold the device and placed the mouthpiece between their lips and over their tongue. Before the beginning of the measurements, the guardians of the participants and those participants who are over 14 years old signed the consent form. Initially, measurements were performed on all research variables. The experimental group followed a 20-minute respiratory muscle exercise program using a threshold respiratory muscle device, which applied resistance during inspiration and expiration, 4 times per week. The sessions were organised in groups of 2 to 3 participants and were supervised by a physiotherapist in the premices of the collaborative schools and bodies. The resistance started at 30% of the initial Maximum Inspiratory Pressure (MIP) and Maximum Expiratory Pressure (MEP), in low intensity. The resistance was adjusted every 2 weeks according to the score of perceived exertion in Borg RPE scale. When the participants indicated a perceived exertion of 2 or less in Borg RPE scale the resistance increased per 5%-10%. In each session there is an attendance checklist and an exercise diary where details concerning the performance are noted, such as intensity in the threshold devise, duration of the session, Borg RPE at the end of the session. In one month, all survey variables were re-measured. In each session the participants are instructed to perform 10-15 breaths in the threshold device. Afterwards, there is a break of 20-30 seconds with diaphragmatic breathing and the cycle begins again. The participants also followed the physiotherapy program of each school or body, which includes stretching, strengthening exercises, aerobic exrcise for 3-4 times per week, delivered by another physiotherapist. The duration of the respiratory muscle training program lasts 8 weeks, and the program isimplemented 4 times each week. In total, three measurements of the variables will be performed (0, 4 and 8 weeks).