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Even though positive implications of inspiratory muscle training (In-MT) have been established in children and adolescents with bronchial asthma (C/AwBA), the role of combined inspiratory and expiratory muscle training (Ex-MT) within the same respiratory cycle (In/Ex-SC) is still unknown. This study was, therefore, set out to explore the effect of In/Ex-SC on respiratory muscle strength, pulmonary functions, and control of asthma symptoms in C/AwBA. This was a placebo-controlled randomized clinical investigation that included 51 C/AwBA (12-18 years). Participants were assigned randomly into three groups: Placebo, In-MT only, or combined In/Ex-SC training (n = 17, each group). The training was conducted for ∼35 min, thrice/week over 12 weeks. The maximal inspiratory (IPmax) and expiratory (EPmax) pressure (indicating the strength of the inspiratory and expiratory muscles, respectively), pulmonary functions [forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC index], and asthma control test (ACT) were assessed before and after the intervention. The In/Ex-SC yielded larger increases in IPmax and EPmax than either the Placebo training (P=.031 and P=.009 respectively) or the In-MT (P=.029 and P=.032 respectively). Further, In/Ex-SC produced favorable improvement in FEV1, FVC, and FEV1/FVC compared to the Placebo training (P=.001, P=.004, and P=.0005 respectively) or In-MT (P=.038, P=.037, and P=.025 respectively) training. Furthermore, In/Ex-SC led to better control of asthma symptoms than the Placebo (P<.001) or In-MT (P=.002) training. This study provides evidence that combined In/Ex-SC can considerably improve respiratory muscle strength, enhance pulmonary function, and promote control over asthma symptoms in C/AwBA. [ABSTRACT FROM AUTHOR]

Background: The integration of therapeutic approaches is increasingly recommended for children with cerebral palsy, to enhance outcomes. Nevertheless, clinicians still opt for separate or combined therapies based on little credible knowledge. Objective: This study endeavored to evaluate the effect of botulinum neurotoxin-A (BoNT-A) injection and reciprocal neuromuscular electrical stimulation (rNMES) and their combination on the upper extremity function in children with spastic hemiplegia. Methods: Sixty-four children with spastic hemiplegia (aged 6– 10 years) were randomly assigned to four treatment-based groups [group I (BoNT-A), group II (rNMES), group III (combined BoNT-A and rNMES), and group IV (Control)]. All children received a physical rehabilitation program, thrice/week over three months. Unilateral upper-limb function, bimanual hand function, and real-time arm-hand function were assessed using Melbourne Assessment (MA), Assisting Hand Assessment (AHA), and Pediatric Motor Activity Log (PMAL) scales respectively pre-treatment, post-treatment, and at 6 months follow-up. Results: Post-treatment, group III achieved greater improvement in MA, AHA, and PMAL compared to other groups (all P < 0.05), and the difference remained in favor of group III at the follow-up (all P < 0.05). Conclusions: This study suggests that BoNT-A and rNMES combined are more effective than either of them alone to enhance upper-extremity function in children with spastic hemiplegia. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the subsequent effects of plyometric training on weight-bearing symmetry, muscle strength, and gait performance in children with unilateral cerebral palsy., Methods: Thirty-nine children with spastic hemiplegia (age 8-12 years) were randomly divided into either the PLYO group ( n =19, received a 30-minute plyometric exercise program plus the traditional physical rehabilitation, twice/week for eight consecutive weeks) or Non-PLYO group ( n =20, received the traditional physical rehabilitation only). The weight-bearing symmetry index (WB-SI), maximum isometric muscle strength (MIMS) of quadriceps and hamstring muscles, and spatial-temporal gait parameters were assessed pre and post-intervention., Results: From pre- to post-intervention, changes of WB-SI among PLYO and Non-PLYO groups did not differ significantly ( P =.81; hindfoot and P =.23; forefoot). MIMS of quadriceps and hamstring muscles at 90° knee flexion ( P =.008 and .013 respectively) increased significantly in PLYO compared to Non-PLYO group. Walking speed ( P =.033), stride length ( P =.002), and step time ( P <.001) improved markedly in PLYO group more than in Non-PLYO group. The proportion of single leg support ( P =.14) among PLYO and Non-PLYO groups did not differ significantly., Conclusion: Addition of plyometric exercises to the physical rehabilitation programs of children with unilateral CP could achieve greater improvement in muscles strength and walking performance, but not in WB-SI.