cld (n=18) normal (n=18) p met 7.9 + 1.7 (5.1 - 11.4) 7.7 + 1.7 (5.7 - 11.7) > 0.05

CLD (n=18)

Normal(n=18)

P

MET 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 MET

WritingWalking (2mph)Golf (with cart)Golf (without cart)BadmintonDancing aerobicKarate or judoSwimming (fast)Hockey,fieldSquash

1.72.52.54.95.56.06.57.07.7

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

Lung mechanic problems

Chest wall mechanic problems

• Hypersecretion

• Bronchospasm

• Collasped airway

• Restrictive

• Hyperinflation

• Ineffective cough

• Retained secretion

• Exercise limitation

• 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

• 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

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