Maestría en Física Médica UAEMéx Purpose: To examine the association between diaphragmatic thickness, assessed by ultrasonography, and upper arm muscle area (AMA), indicating nutritional status, in children and adolescents with cerebral palsy (CP), stratified by gross motor function severity. Materials and Methods: In this cross-sectional study, 50 children aged 2–12 years with a confirmed diagnosis of CP were evaluated. Participants were stratified into ambulatory (Gross Motor Function Classification System [GMFCS] I–III) and non-ambulatory (GMFCS IV–V) groups. Anthropometric parameters were collected to estimate AMA, and diaphragmatic thickness was measured using B-mode ultrasonography. Results: In the non-ambulatory group (GMFCS IV–V), diaphragmatic thickness showed a significant positive correlation with AMA during both inspiration ( r = 0.50; p = 0.002) and expiration ( r = 0.67; p < 0.001). No significant correlations were observed in ambulatory participants (GMFCS I–III). Moderate muscle mass deficits were common among non-ambulatory children, and approximately 60% of the total sample showed risk of adipose tissue deficit. Conclusion: In children with severe CP, a significant association between muscle reserve and diaphragmatic thickness suggests a functional link between nutritional status and respiratory muscle morphology. Diaphragmatic ultrasonography may serve as a non-invasive tool for integrated nutritional and respiratory monitoring in pediatric neurorehabilitation.

Background: Several childhood illnesses are at risk of developing significant respiratory problems associated with insufficient respiratory muscle strength. Predictive equations for respiratory muscle strength have been proposed in healthy children and adolescents. There are no studies summarizing prediction equations for respiratory muscle strength (RMS) in pediatric population. Objectice: To provide and discuss the contemporary literature regarding predictive equations for respiratory maximal mouth presssures in children and adolescents. Methods: Online databases were used in this integrative review to identify papers published up to 2023, from which we selected those used equations to predict RMS by maximum inspiratory and expiratory pressures in subjects under 18 years of age. Results: The publications reported nine studies from 2,534 healthy individuals ranging from 4 to 18 years old and 38 equations. The variables used for constructing the predictive model diverge, but the most used were lung function (spirometry) and independent variables (age, gender, weight, height and adequate geographic population). Conclusion: This review gathered different predictive equations that determine the normal value of maximum respiratory pressures in the pediatric population. Although most equations were generated from unstandardized procedure, it should compose the functional assessment of the respiratory muscles, as it is a quick, non-invasive and effective measure to detect respiratory muscle weakness. The proposed equations must be judiciously used by the health professional, taking into account demographic and individual characteristics.