Transcript Exercise and Pulmonary Rehabilitation in Children with

MET
CLD
(n=18)
Normal
(n=18)
P
7.9 + 1.7
(5.1 - 11.4)
7.7 + 1.7
(5.7 - 11.7)
> 0.05
Estimated MET levels for selected physical activities
Physical activity
Writing
Walking (2mph)
Golf (with cart)
Golf (without cart)
Badminton
Dancing aerobic
Karate or judo
Swimming (fast)
Hockey,field
Squash
MET
1.7
2.5
2.5
4.9
5.5
6.0
6.5
7.0
7.7
12.1
Conclusion
Despite having abnormal PFT, children with
CLD demonstrated the same levels of
optimal physical activity when compared to
normal children
CLD
Airway problems
• Hypersecretion
• Bronchospasm
• Collasped airway
• Ineffective cough
• Retained secretion
• Exercise limitation
Lung mechanic Chest wall mechanic
problems
problems
• Restrictive
• Hyperinflation
• Atelectasis
• Recurrent pneumonia
Pulmonary rehabilitation
& Exercise training
Question #2
How to perform pulmonary rehabilitation
and exercise training in children with
CLD?
Case illustration
A 7-yr-old boy
• Recurrent RUL/RML pneumonia
• Persistent RUL/RML atelectasis
since age
3 yrs
• Possible Rt. lung hypoplasia
• GER with mild delayed gastric emptying time
• Poor weight gain
RUL/RML lobectomy at the age of 5 yrs
Case illustration
PE (post surgery)
- BW 14 kgs
- Mild tachypnea & dyspnea
-  AP diameter of chest wall
-  Lung expansion Rt.> Lt.
-  Breath sound & medium crepitations RLL
- Lumbar kyphosis