The Effectiveness of Respiratory Muscle Training and Exercise in Obese Adolescents

This study aims to investigate the effects of respiratory muscle training and exercise on respiratory muscle strength, pulmonary function, and exercise tolerance in obese adolescents diagnosed with specific learning disabilities. A total of 44 participants will be included and assigned to two different intervention groups, with 22 participants in each group. Participants will undergo baseline assessment, followed by assessments after routine treatment and after the intervention period. The study will compare changes in respiratory and functional outcomes between the two intervention groups.

Inclusion Criteria: * Age between 10 and 16 years. * Body mass index (BMI) ≥ 95th percentile (or \> +2 standard deviations/Z-score) according to World Health Organization (WHO) criteria. * Diagnosis of specific learning disorder according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), documented with a Child with Special Needs Report. * Total intelligence quotient (IQ) score of ≥90 according to the Wechsler Intelligence Scale for Children (WISC-R). * Written informed consent signed by the participants' legal guardians. Exclusion Criteria: \- Presence of additional neurodevelopmental diagnoses such as cerebral palsy, epilepsy, pervasive developmental disorders, or intellectual disability. Uncontrolled cardiovascular diseases. * Musculoskeletal disorders such as scoliosis, kyphosis, or chest wall deformities. * Regular use of medications such as bronchodilators, steroids, or beta-blockers. * History of an acute respiratory tract infection or surgical intervention within the previous 4 weeks. * Presence of contraindications to spirometry according to the current guidelines of the American Thoracic Society (ATS) and European Respiratory Society (ERS).