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Not yet recruitingNCT07777809Updated Aug 20, 2026

Bilateral Asymmetry of Respiratory Muscle Activity During Breathing in Children With Spastic Cerebral Palsy

An observational study in Spastic Cerebral Palsy (sCP), sponsored by Sahmyook University. Not yet recruiting at 1 site in South Korea. Open to participants aged 4 Years to 12 Years. Per ClinicalTrials.gov, last updated 2026-08-20.

Sponsored by Sahmyook University · Observational

Study type
Observational
Model
Case-only
Time perspective
Cross-sectional
Enrollment
20
Ages
4 Years to 12 Years
Sex
All
01

Study summary

This observational cross-sectional study investigates the bilateral asymmetry of respiratory muscle activity during breathing in children with spastic cerebral palsy (CP). Children with CP often exhibit structural deformities, which may lead to impaired chest mobility and asymmetric respiratory function. The primary objective is to objectively evaluate the imbalance in the activation of bilateral respiratory muscles (intercostal, external oblique, and sternocleidomastoid) using non-invasive surface electromyography (sEMG). Muscle activity will be measured during resting breathing and active breathing tasks. The findings aim to provide clinical evidence for developing selective respiratory muscle training programs for this population.

Read the detailed description

Children with spastic cerebral palsy frequently experience abnormal muscle tone and motor control issues, leading to structural deformities like scoliosis and pelvic asymmetry. These structural changes can restrict chest wall mobility and cause inefficient, asymmetrical breathing patterns. While ultrasound is often used to assess diaphragm function, it has limitations in evaluating functional respiratory pressure differences based on gross motor function levels and requires high cognitive cooperation. Therefore, this study utilizes surface electromyography (sEMG) to quantify the muscle activation (Root Mean Square, RMS) of respiratory and accessory muscles. The study involves children aged 4 to 12 years with spastic CP. Measurements are conducted in a seated position under two main conditions: 30 seconds of resting breathing and an active breathing task involving blowing a pinwheel or bubbles. An Asymmetry Index (AI) will be calculated to compare the degree of bilateral muscle activation imbalance across the different breathing conditions.

02

Conditions studied

  • Spastic Cerebral Palsy (sCP)

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Keywords

  • Surface Electromyography
  • Respiratory Muscle
  • Asymmetry
03

Who can participate

Ages eligible
4 Years to 12 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Children aged 4 to 12 years diagnosed with spastic cerebral palsy who are receiving treatment at a local outpatient rehabilitation center (Easy Rehabilitation Medicine Clinic, Yongin-si, Gyeonggi-do, Republic of Korea).

Inclusion criteria

  • Children with Gross Motor Function Classification System (GMFCS) Level I or II
  • Children with sufficient cognitive ability to understand instructions and voluntarily perform tasks
  • Children with a Trunk Appearance Clinical Evaluation (TRACE) score of 4 or higher out of a total of 12 points

Exclusion criteria

Exclusion Criteria:

  • Children who have undergone orthopedic surgery of the spine or lower extremities, or received botulinum toxin injection treatment within the past 6 months
  • Children with acute or chronic respiratory diseases, such as asthma or acute pneumonia
  • Children with severe cardiac disorders, intellectual disabilities, or visual and auditory impairments that may interfere with the experiment
04

Study design

Observational model
Case-only
Time perspective
Cross-sectional
Enrollment
20 participants (estimated)
Patient registry
No

Groups and cohorts

  • Spastic Cerebral Palsy Group

    Children aged 4 to 12 years with spastic cerebral palsy, GMFCS level I-II, and TRACE score of 4 or higher.

    Diagnostic Test: Surface Electromyography (sEMG) assessment

Interventions

  • Diagnostic testSurface Electromyography (sEMG) assessment

    Measuring the bilateral activation of respiratory muscles (intercostal, external oblique, and sternocleidomastoid) using sEMG under two conditions: 30 seconds of resting breathing and active breathing tasks (blowing a pinwheel or bubbles).

05

What researchers measure

Primary outcomes

  1. Root Mean Square (RMS) of Respiratory Muscle Activity

    Muscle activation amplitude of the intercostal, external oblique, and sternocleidomastoid muscles measured using surface electromyography (sEMG). The raw sEMG signals are full-wave rectified and smoothed using a 50ms moving window to calculate the RMS values during resting and active breathing tasks.

    Time frame: Up to 30 minutes (measured once during the single-day assessment session)

  2. Asymmetry Index (AI) of Respiratory Muscle Activation

    The asymmetry index will be calculated using the Root Mean Square (RMS) values obtained from surface electromyography (sEMG) . The formula used is (Right RMS - Left RMS) / (Right RMS + Left RMS) X 100 . The index evaluates the percentage of imbalance between the right and left respiratory muscles (intercostal, external oblique, and sternocleidomastoid) during resting breathing and active breathing tasks.

    Time frame: Up to 30 minutes (measured once during the single-day assessment session)

06

Study locations

1 site
  • Easy Rehabilitation Medicine Clinic
    Yongin-si, Gyeonggi-do, South Korea
    • jemin Yoo, +82 9936-9957 · Contact · jemin9957@naver.com · +82 9936-9957
    • jemin Yoo · Principal investigator
07

References and documents

Individual participant data

Plan to share: Undecided — The decision to share individual participant data (IPD) has not yet been finalized. Future data sharing will depend on the specific requirements of the target journal where the study results will be submitted. If sharing becomes necessary, only fully de-identified data (e.g., sEMG measurements) will be provided upon reasonable request. Any data sharing will be strictly subject to additional review and approval by the Sahmyook University Institutional Review Board to protect the privacy and confidentiality of the pediatric participants with spastic cerebral palsy.

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07777809
Lead sponsor
Sahmyook University
Responsible party
Yoo jemin (Graduate Student, Sahmyook University) — Principal investigator
First posted
Aug 20, 2026
Start date
Aug 2026 (estimated)
Primary completion
Aug 2027 (estimated)
Completion
Aug 2027 (estimated)
Last update
Aug 20, 2026

Study contacts

jemin Yoo
Contact
jemin9957@naver.com
+82 9936-9957
jemin Yoo
principal investigator · Sahmyook University
Seungwon Lee
study director · Sahmyook University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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