BACKGROUND AND OBJECTIVE

Pediatric post-operative congenital diaphragmatic hernia (CDH) patients have been shown to encounter reduced pulmonary function tests (PFT) potentially leading to respiratory symptoms. Strategies involving exercise have been used to improve PFT. This meta-analysis aims to determine the effectiveness of exercise in improving lung function in pediatric post-operative CDH patients.

METHODS

An electronic search was done on May 2023 in MEDLINE via Pubmed, Cochrane Library, Embase, ClinicalKey, Scopus, Google Scholar, and Herdin Plus, using the search terms "exercise" and "congenital diaphragmatic hernia" and "children" or "pediatric" and "pulmonary function" or "lung function". The study included pediatric patients in whom CDH has been surgically corrected, and excluded patients who were unable to perform the test maneuvers, have cardiopulmonary instability, and have serious associated anomalies. Randomized controlled trials (RCT) were identified and independently assessed by two review authors. Each RCT was independently assessed for bias by two review authors using the Cochrane Handbook for Systematic Reviews of Interventions. The RevMan 5.4 software was used for statistical analysis.

RESULTS

A total of 124 participants from three studies were included in the meta-analysis. The pooled mean difference showed a significantly higher mean functional vital capacity (FVC) (MD=6.12, 95%CI=3.91 to 8.33, p-value < 0.00001) and forced expiratory volume in 1 second (FEV1 ) (MD=6.25, 95%CI=3.39 to 9.10, p-value < 0.0001) in the study group compared to the control group.

CONCLUSION

Exercise may be effective in improving lung function in children with pediatric post-operative CDH. However, the study is limited by its small sample size, the lack of assessment of long-term outcomes, and the difference in exercise regimens used in each RCT. Further studies are recommended to determine the most optimal exercise regimen and to measure its effect on the other outcomes for this population.

Human ; Exercise ; Hernias, Diaphragmatic, Congenital ; Child ; Children

Introduction : The increasing aging population of the Philippines impacts on the socioeconomic development of the country, prompting a deeper look into their quality of life. This study sought to determine the effect of the Elderly Development Program on the quality of life of the elderly population of Los Baños. Methods : A 4-month prospective cohort study of the elderly population in Los Baños, Laguna compared the quality of life scores of a group enrolled in the Elderly Development Program and an unexposed control, using the World Health Organization Quality of Life Abbreviated Version for Filipino Older Persons questionnaire. Results : Quality of life scores where higher for the EDP group during the four months of observation. In Month 2, significant differences were found in all domains except for the psychological domain. Only the physical health domain score was significant in the EDP group for Month 3 (p = 0.003) and Month 4 (p = 0.029). Both the EDP and control groups had higher overall and domain scores in Month 4 compared with baseline. Conclusion The Elderly Development Program may improve the overall quality of life of elderly persons, specifically in the physical health domain. These improvements are likely due to the focus of the program on the physical aspect of the elderly.
Aged ; Quality of Life