Comparative effect of different treatment approaches on lumbar hyperlordosis, respiratory muscle strength, and balance in diplegic children: A randomized controlled clinical trial

The aim of this study was to compare the effect of different treatment approaches (pressure biofeedback training of the abdominal drawing-in maneuver with and without prone hip extension, whole-body vibration, and core stability exercises) on lumbar hyperlordosis, respiratory muscle strength, and balance in children with diplegic cerebral palsy. Forty-five children, ranged in age from 8 to 12 years, were randomly allocated into three groups (A, B, C). All children underwent a specialized exercise program for one hour, three days/ week for three successive months. In addition, group A received pressure biofeedback training, group B underwent the whole-body vibration, and group C underwent the core stability exercises. The lumbar lordotic angle, active lumbar and hip range of motion, respiratory muscle strength, and balance were measured before and after three months of treatment. We found a significant decrease in lumbar lordotic angle along with a significant increase in active lumbar and hip range of motion of group A and group C post-treatment (p < 0.001) in favor of group A, while non-significant change was found in group B (p > 0.05). A significant improvement was recorded in the three groups' respiratory muscle strength and stability indices in favor of group B (p < 0.001). Pressure biofeedback training and core stability exercises are the best adjunctive to traditional physical therapy to improve lumbar hyperlordosis, respiratory muscle strength, and balance together in children with diplegic cerebral palsy. Moreover, whole-body vibration is the best adjunctive to improve respiratory muscle strength and balance.