Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza 12613, Egypt.
Int J Environ Res Public Health. 2022 May 17;19(10):6101. doi: 10.3390/ijerph19106101.
Congenital diaphragmatic hernia (CDH) is a life-threatening condition with long-term complications including respiratory tract infections, respiratory muscle weakness, and abnormal lung functions. This study was designed to ascertain the effects of chest resistance and chest expansion exercises on respiratory muscle strength, lung function, and chest mobility in children with post-operative CDH.
This randomized controlled clinical study was conducted in the outpatient physiotherapy clinic at Prince Sattam bin Abdulaziz University. Thirty-two children with CDH aged 10-14 years between May 2020 and February 2021 were randomly allocated to the study group ( = 16) and the control group ( = 16). The control group underwent a usual chest physiotherapy program; however, the study group underwent a 12-week chest resistance exercise combined with chest expansion exercise in addition to usual chest physiotherapy, with three sessions per week. Respiratory muscle strength, lung function, and thoracic excursion were assessed pre- and post-treatment.
Using the 2 × 2 repeated ANOVA, significant time × group interactions were detected in favor of the study group, FVC (F = 4.82, 95% CI = -15.6 to -0.97, = 0.005, and η = 0.16), FEV1 (F = 4.54, 95% CI = -11.99 to -2.8, ˂ 0.001, and η = 0.14), PImax (F = 5.12, 95% CI = -15.71 to -5.3, ˂ 0.001, and η = 0.15), and thoracic excursion (F = 4.41, 95% CI = -2.04 to -0.16, = 0.036, and η = 0.17).
Concurrent chest resistance and expansion exercises may improve respiratory muscle strength, lung function, and thoracic excursion in children with post-operative CDH. The study findings suggest that concurrent chest and chest expansion exercises be part of an appropriate pulmonary rehabilitation program in children with a history of CDH.
先天性膈疝（CDH）是一种危及生命的疾病，其长期并发症包括呼吸道感染、呼吸肌无力和肺功能异常。本研究旨在确定胸阻抗和胸廓扩张运动对术后 CDH 患儿呼吸肌力量、肺功能和胸廓活动度的影响。
这是一项在 2020 年 5 月至 2021 年 2 月期间在沙特阿拉伯塔布克王子苏丹本阿卜杜勒阿齐兹大学门诊理疗诊所进行的随机对照临床研究。32 名年龄在 10-14 岁的 CDH 患儿被随机分配到研究组（n=16）和对照组（n=16）。对照组接受常规胸部物理治疗方案；然而，研究组在常规胸部物理治疗的基础上，还进行了 12 周的胸阻抗运动和胸廓扩张运动，每周 3 次。在治疗前后评估呼吸肌力量、肺功能和胸廓活动度。
使用 2×2 重复方差分析，发现时间×组间的显著交互作用有利于研究组，FVC（F=4.82，95%CI=-15.6 至-0.97，P=0.005，η=0.16），FEV1（F=4.54，95%CI=-11.99 至-2.8，P＜0.001，η=0.14），PImax（F=5.12，95%CI=-15.71 至-5.3，P＜0.001，η=0.15）和胸廓活动度（F=4.41，95%CI=-2.04 至-0.16，P=0.036，η=0.17）。
同时进行胸阻抗和胸廓扩张运动可能会提高术后 CDH 患儿的呼吸肌力量、肺功能和胸廓活动度。研究结果表明，在有 CDH 病史的儿童中，同时进行胸部和胸部扩张运动应成为适当的肺康复计划的一部分。
