Cohort study: cross-sectional design~A) Subjects:~Sample size estimation will be carried out to determine the recruited number of children selected randomly. Each participant's caregiver will sign a consent form authorizing the participation of their children in this study.~They will be selected based on the following:~Inclusion criteria:~age range from 6 to 12 years~children with β-thalassemia major and intermediate of both sex and control healthy children of both sex~They can follow instruction~Exclusive criteria:~Children will be excluded from the study if they have:~Defined Cardiovascular or respiratory disorders.~Renal failure~Visual or hearing impairment, Mentally retarded children~Myocardial infarction within the last month~Unstable angina, Recent thoraco-abdominal surgery~Thoracic or abdominal aneurysm or Current pneumothorax~II) Materials~For evaluation of pulmonary functions The measurements that are made include forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and the ratio of the two volumes (FEV1/FVC).~For evaluation of physical fitness Aerobic capacity and endurance By 6-Minute Walk Test , 3 minutes step test and Energy expenditure BMI Balance Pediatric balance scale
The aims of this study are:~To determine the correlation between pulmonary functions and physical fitness in children with β-thalassemia.~To differentiate between different types of B-thalassemia in both pulmonary functions and physical fitness