About this trial

This study will investigate whether adding motor imagery to thoracic expansion exercises can improve respiratory function in children with spina bifida. Motor imagery involves mentally imagining a movement or bodily action without physically performing an additional movement.

Children with spina bifida will participate in two exercise sessions separated by a 14-day washout period. In one session, participants will perform thoracic expansion exercises alone. In the other session, the same thoracic expansion exercises will be combined with guided motor imagery. The order of the two sessions will be randomized.

Respiratory function will be assessed before and immediately after each session. The primary outcome will be the change in forced vital capacity (FVC). Additional outcomes will include forced expiratory volume in one second (FEV1), forced expiratory flow at 25-75% of forced vital capacity (FEF25-75), peak expiratory flow (PEF), chest expansion, and peripheral oxygen saturation (SpO2).

The study aims to determine whether combining motor imagery with thoracic expansion exercises produces greater immediate improvements in respiratory function than thoracic expansion exercises alone.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Diagnosis of spina bifida.

Age between 7 and 18 years.

Clinically stable, with no acute respiratory infection or respiratory distress.

Ability to maintain a seated position.

Disqualifiers

Acute respiratory tract infection or pneumonia.

Chronic pulmonary disease.

Severe scoliosis or severe thoracic deformity.

Serious cardiac or metabolic disease.

Trial design

Design model

Crossover

Treatments tested in this trial

Thoracic Expansion Exercises
Behavioral
Participants will perform approximately 15 minutes of thoracic expansion exercises targeting the upper, middle, and lower thoracic regions. The physiotherapist will facilitate expansion of the targeted chest wall region during inspiration using standardized verbal and manual guidance. When appropriate, mild manual resistance may be applied during inspiration and individually adjusted according to the participant's ability.
Motor Imagery-Supported Thoracic Expansion Exercises
Behavioral
Participants will perform the same approximately 15-minute thoracic expansion exercise protocol while receiving standardized guided motor imagery instructions. During inspiration, participants will be instructed to imagine the expansion of the chest as a rising wave, and during expiration to imagine the wave gradually receding. The imagery will be synchronized with thoracic expansion and the level of manual resistance applied by the physiotherapist.

Treatment groups

30 Participants

are divided into 2 treatment groups

Group A: Sequence ABExperimental treatment 2 interventions

Group B: Sequence BAExperimental treatment 2 interventions

Trial outcomes

Primary outcomes

1

Change in Forced Vital Capacity (FVC)

Forced vital capacity (FVC) will be measured by spirometry with the participant in a seated position using a nose clip. At least three technically acceptable maneuvers will be performed, and the best acceptable value will be recorded in liters (L). The change from pre-intervention to immediately post-intervention will be calculated for each intervention condition. The primary analysis will compare the change in FVC between motor imagery-supported thoracic expansion exercises and thoracic expansion exercises alone.

Time frame