Effectiveness of comprehensive postural and pulmonary rehabilitation in a child with cerebral palsy and comorbid pulmonary pathology: a case report

The presented clinical case highlights the need for effective rehabilitation strategies for children with combined motor and pulmonary impairments. Cerebral palsy and bronchial asthma often coexist, exacerbating each other’s course, reducing motor activity, and impairing quality of life. Although these conditions are well-studied individually, rehabilitation strategies addressing both within a single program remain poorly described. This case illustrates the integration of postural and pulmonary therapy and their synergistic effects.

The patient was a child with cerebral palsy (Gross Motor Function Classification System [GMFCS] level III; Manual Ability Classification System [MACS] level II), moderate spasticity of the lower extremities according to the Modified Ashworth Scale, and impaired static trunk control assessed by the Segmental Assessment of Trunk Control (SATCo) system (instability in thoracic and lumbar segments). Comorbid bronchial asthma manifested as recurrent dyspnea, reduced forced vital capacity (62% of predicted), and peak expiratory flow less than 120 L/min. The rehabilitation program included static postural correction with orthoses, diaphragmatic breathing and forced exhalation exercises, gentle manual therapy, massage, and physical exercises. After 6 weeks, improvements were observed in trunk control, forced vital capacity increased to 78% of predicted, peak expiratory flow improved to 180 L/min, frequency and severity of asthma attacks decreased, and overall motor activity improved.

This case demonstrates the effectiveness of a comprehensive interdisciplinary approach in rehabilitating children with multiple impairments. Simultaneous intervention targeting both pulmonary and motor functions may enhance adaptive reserves. Although data are limited to a single case, these findings support the potential effectiveness of integrative programs, warranting further investigation.

The case underscores the potential of personalized rehabilitation strategies to improve quality of life and functional independence in pediatric patients.