Exercise and Pulmonary Rehabilitation in Children with Chronic Lung Diseases

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CLD (n18) Normal (n18) P
MET 7.9 1.7 (5.1 - 11.4) 7.7 1.7 (5.7 - 11.7) gt 0.05
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Estimated MET levels for selected physical
activities
Physical activity MET
Writing Walking (2mph) Golf (with cart) Golf (without cart) Badminton Dancing aerobic Karate or judo Swimming (fast) Hockey,field Squash 1.7 2.5 2.5 4.9 5.5 6.0 6.5 7.0 7.7 12.1
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Conclusion

• Despite having abnormal PFT, children with
  CLD demonstrated the same levels of optimal
  physical activity when compared to normal children

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CLD
Chest wall mechanic problems
Airway problems
Lung mechanic problems

• Hypersecretion
• Bronchospasm
• Collasped airway

• Restrictive
• Hyperinflation

• Atelectasis
• Recurrent pneumonia

• Ineffective cough
• Retained secretion
• Exercise limitation

Pulmonary rehabilitation Exercise training
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Question 2

How to perform pulmonary rehabilitation and
exercise training in children with CLD?
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Case illustration

• A 7-yr-old boy
• Recurrent RUL/RML pneumonia
• Persistent RUL/RML atelectasis
• Possible Rt. lung hypoplasia
• GER with mild delayed gastric emptying time
• Poor weight gain

since age 3 yrs
RUL/RML lobectomy at the age of 5 yrs
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Case illustration

PE (post surgery) - BW 14 kgs - Mild
tachypnea dyspnea - ? AP diameter of chest
wall - ? Lung expansion Rt.gt Lt. - ?
Breath sound medium crepitations RLL -
Lumbar kyphosis