Abstract：
OBJECTIVE: Patients with congenital diaphragmatic hernia (CDH) can have up to 40 times more frequency of muskuloskeletal deformities and decreased perception of physical activity tan their pairs. The objective of this study is to evaluate the safety and efficacy of an individualized exercise program in late adolescents and young adults with repaired CDH, as well as a description of their basal status.
METHODS: Non randomized prospective trial of 13 patients with repaired CDH between 1997-2005. An initial physical exploration and a pre-post assessment of bioimpedance (BIA), dynamometry, maximal inspiratory and expiratory pressure (MIP/MEP), 6-minute walk test (6MWT), physical activity level (IPAQ) and quality of life (QoL) was made. The training program last for 4 weeks. For the statistical analysis, the Student\'s t test for paired samples and Wilcoxon test were used.
RESULTS: 77% (n=10) were male with a mean age of 19.23±2.13 years. In baseline BIA, 62% (n=8) had truncal sarcopenia that improved in -0.43±0.58, and P=.016. MIP, MEP, 6MWT and QoL tests increased by -7.27±8.26 cmH2O, P=.008; -11.91±10.20 cmH2O, P=.002; -70.63±17.88 m, P=.001; -42,19±26.79, P=.00 respectively. The IPAQ did not change significantly (P=0.86), however the time dedicated to muscle strengthening increased. No adverse effects were reported.
CONCLUSIONS: A personalized rehabilitation program is safe and could improve the respiratory muscle strength and truncal sarcopenia as well as the submaximal effort capacity in late adolescents and young adults with repaired CDH.
METHODS: Non randomized prospective trial of 13 patients with repaired CDH between 1997-2005. An initial physical exploration and a pre-post assessment of bioimpedance (BIA), dynamometry, maximal inspiratory and expiratory pressure (MIP/MEP), 6-minute walk test (6MWT), physical activity level (IPAQ) and quality of life (QoL) was made. The training program last for 4 weeks. For the statistical analysis, the Student\'s t test for paired samples and Wilcoxon test were used.
RESULTS: 77% (n=10) were male with a mean age of 19.23±2.13 years. In baseline BIA, 62% (n=8) had truncal sarcopenia that improved in -0.43±0.58, and P=.016. MIP, MEP, 6MWT and QoL tests increased by -7.27±8.26 cmH2O, P=.008; -11.91±10.20 cmH2O, P=.002; -70.63±17.88 m, P=.001; -42,19±26.79, P=.00 respectively. The IPAQ did not change significantly (P=0.86), however the time dedicated to muscle strengthening increased. No adverse effects were reported.
CONCLUSIONS: A personalized rehabilitation program is safe and could improve the respiratory muscle strength and truncal sarcopenia as well as the submaximal effort capacity in late adolescents and young adults with repaired CDH.
摘要：
目的：先天性膈疝（CDH）患者的肌肉骨骼畸形频率高达40倍，对身体活动的感知下降。这项研究的目的是评估个性化运动计划在晚期青少年和CDH修复的年轻人中的安全性和有效性，以及对其基础状态的描述。
方法：1997-2005年间对13例CDH修复患者进行非随机前瞻性试验。最初的物理探索和生物阻抗（BIA）的事后评估，测力计,最大吸气和呼气压力（MIP/MEP），6分钟步行测试（6MWT），身体活动水平(IPAQ)和生活质量(QoL)。培训计划持续4周。对于统计分析，使用配对样品的学生t检验和Wilcoxon检验。
结果：77%（n=10）为男性，平均年龄为19.23±2.13岁。在基线BIA中，62%（n=8）的躯干肌少症改善幅度为-0.43±0.58，P=0.016。MIP,MEP,6MWT和QoL测试增加了-7.27±8.26cmH2O，P=.008;-11.91±10.20cmH2O,P=.002;-70.63±17.88m,P=.001；-42,19±26.79，P=.00。IPAQ没有显著变化(P=0.86),然而，致力于肌肉加强的时间增加。无不良反应报告。
结论：个性化康复计划是安全的，可以改善CDH修复的晚期青少年和年轻成年人的呼吸肌力量和躯干肌肉减少症以及亚最大努力能力。
方法：1997-2005年间对13例CDH修复患者进行非随机前瞻性试验。最初的物理探索和生物阻抗（BIA）的事后评估，测力计,最大吸气和呼气压力（MIP/MEP），6分钟步行测试（6MWT），身体活动水平(IPAQ)和生活质量(QoL)。培训计划持续4周。对于统计分析，使用配对样品的学生t检验和Wilcoxon检验。
结果：77%（n=10）为男性，平均年龄为19.23±2.13岁。在基线BIA中，62%（n=8）的躯干肌少症改善幅度为-0.43±0.58，P=0.016。MIP,MEP,6MWT和QoL测试增加了-7.27±8.26cmH2O，P=.008;-11.91±10.20cmH2O,P=.002;-70.63±17.88m,P=.001；-42,19±26.79，P=.00。IPAQ没有显著变化(P=0.86),然而，致力于肌肉加强的时间增加。无不良反应报告。
结论：个性化康复计划是安全的，可以改善CDH修复的晚期青少年和年轻成年人的呼吸肌力量和躯干肌肉减少症以及亚最大努力能力。
