The effectiveness of complex postural and respiratory rehabilitation in a child with cerebral palsy and comorbid pulmonary pathology (clinical case)

The clinical relevance of this case lies in the need to develop effective rehabilitation strategies for children with combined motor and respiratory impairments. Cerebral palsy (CP) and bronchial asthma often coexist, exacerbating each other's clinical course, reducing physical activity levels, and impairing quality of life. Although both conditions are well-studied individually, rehabilitation approaches that address them simultaneously remain poorly explored. This clinical observation illustrates the potential of integrating respiratory and postural therapy, demonstrating their synergistic effect. The patient is a child with cerebral palsy, classified as level III on the GMFCS scale and level II on the MACS scale, with moderate spasticity of the lower limbs (Ashworth scale) and impaired trunk control (SATCo assessment indicating instability in the thoracic and lumbar regions). Comorbid bronchial asthma manifested as frequent episodes of shortness of breath, reduced vital lung capacity (VC 62% of predicted), and low peak expiratory flow rate (PEF 120 L/min). The rehabilitation program included static postural correction using orthoses, breathing exercises emphasizing diaphragmatic breathing and forced exhalation, gentle manual techniques, massage, and physical training. After six weeks, improvements were noted in trunk control, VC increased to 78% of predicted, PEF rose to 180 L/min, asthma attacks became less frequent and less severe, and overall physical activity improved. This case demonstrates the effectiveness of a comprehensive, interdisciplinary approach to the rehabilitation of children with multiple impairments. It highlights the importance of simultaneous intervention on both respiratory and motor functions as a way to enhance the body's adaptive capacity. Although based on a single case, the findings support a hypothesis about the potential effectiveness of integrative programs, warranting further scientific investigation. Thus, the presented case emphasizes the potential of personalized rehabilitation strategies to improve quality of life and functional independence in patients.