Children with bronchiectasis may benefit from a play-based therapeutic exercise regimen, which leads to improved fitness and basic movement skills (FMS), according to a recent pilot trial.
In the 11 children who received the 7-week therapeutic exercise program, mean motor outcomes significantly improved from 29.0 at baseline to 35.2 after the intervention (p = 0.01). By comparison, scores were mostly unchanged in 10 controls, increasing only slightly from 31.6 to 31.8. [Front Pediatr 2022;doi:10.3389/fped.2022.953429]
The same was true for the object control scores, which improved from a mean of 27.0 at baseline to 35.5 after 7 weeks in the exercise program group (p = 0.01) while remaining relatively constant in the controls (median, 31.0 to 32.3). . FMS parameters were measured using the gross motor development test.
The researchers also assessed the participants’ cardiorespiratory fitness by looking at the percentage change in heart rate during the submaximal treadmill test, and comparing this before and after the exercise program.
They found that in children assigned to the exercise program, the change in heart rate during the treadmill test decreased by six percentage points after the intervention. In controls, cardiorespiratory fitness remained largely unchanged, with the heart rate decreasing by only 0.9 percentage points.
“The program had a moderate positive effect on cardio-respiratory fitness,” the researchers said. “Although the small sample size precluded statistical significance, the observed effect size… was proportional to what has been reported for improvements in aerobic fitness in children with asthma.” Complete exercise training. [Clin Rehabil 2001;15:360-370]
These improvements in cardiorespiratory fitness were not accompanied by perceived athletic efficiency after the program (p = 0.63).
Similarly, quality of life was not affected by the play-based exercise regimen, resulting in no significant changes in physical, emotional, social, and school quality of life scores, as well as in the overall PedsQL 4.0 questionnaire score.
In this study, assigned patients underwent a therapeutic exercise program of a combination of supervised and unsupervised exercise. Each week, the children attended one 60-minute exercise session led by a clinical exercise physiologist, which was then supplemented with a home program that participants were expected to complete two days per week.
The supervised sessions consist of six activity stations that the children take turns; Each station included activities and games designed to target specific FMS parameters. Activities were also selected to be developmentally appropriate and tailored to the participants’ fitness level and skills. Home sessions consist of the last two games the child participated in during the supervised sessions.
“To our knowledge, this is the first study to evaluate the effects of a therapeutic exercise program on efficiency in FMS in children with chronic respiratory disease. The improvements in FMS resulting from the seven-session program were not only statistically significant, but clinically significant,” the researchers said.
They added, “The results are sufficiently positive to warrant a larger randomized controlled trial, testing the effectiveness of an exercise program in children with bronchiectasis and/or other chronic respiratory diseases.”
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