Low-Cost Joystick for Pediatric Respiratory Exercises

Addition of respiratory exercises to conventional rehabilitation for children and adolescents with cerebral palsy: a systematic review and meta-analysis

BACKGROUND

Respiratory dysfunctions are an important cause of morbidity and death in cerebral palsy (CP) populations. Respiratory exercises in addition to conventional rehabilitation have been suggested to improve respiratory status in CP patients. The objective of this systematic review and meta-analysis was to verify the effects of the addition of respiratory exercises to conventional rehabilitation on pulmonary function, functional capacity, respiratory muscle strength, gross motor function and quality of life in children and adolescents with CP.

METHODS

We searched for randomized controlled clinical trials in PubMed/Medline, Lilacs, SciELO, EMBASE and Physiotheraphy Evidence (PEDro) from their inception until July 2022 without language restrictions. Studies that included respiratory exercises (breathing exercise program; feedback respiratory training; incentive spirometer exercise; inspiratory muscle training; and combination of respiratory exercises + incentive spirometer exercise) in combination with conventional rehabilitation for children and adolescents with CP were evaluated by two independent reviewers. The mean difference (MD) and 95% confidence interval (CI) were estimated by random effect models.

RESULTS

Ten studies met the eligibility criteria, including 324 children aged from 6 to 16 years. The meta-analysis showed an improvement in inspiratory muscle strength of 22.96 cmH2O (18.63-27.27, n = 55) and pulmonary function of 0.60 (0.38-0.82, n = 98) for forced vital capacity (L); 0.22 (0.06-0.39, n = 98) for forced expiratory volume at 1 second (L); and 0.50 (0.05-0.04, n = 98) for peak expiratory flow (L/min). Functional skills in daily living activities improved in the intervention group. Caregivers' assistance of daily living activities, functional capacity, gross motor function and expiratory muscle strength showed a nonsignificant improvement. Social well-being and acceptance and functioning domains improved in only one study.

CONCLUSIONS

Emerging data show significant enhancements in inspiratory muscle strength and pulmonary function in CP patients after respiratory training in addition to conventional rehabilitation. There is no consensus on the frequency, type or intensity of respiratory exercises for children with and adolescents with CP.

The effect of three-dimensional nursing management on the respiratory exercise compliance and nursing efficiency in post-thoracotomy patients with acute pulmonary embolisms

OBJECTIVE

To study the effect of the three-dimensional nursing management mode on compliance with respiratory function exercises and on the nursing efficiency in post-thoracotomy, acute pulmonary embolism (PE) patients.

METHODS

A cohort of 20 post-thoracotomy patients with acute PE were equally and randomly divided into two groups. The patients in the experimental group underwent the three-dimensional nursing management mode, and the patients in the control group underwent ordinary nursing. The compliance with respiratory function exercises during the hospital stay and within 3 months after discharge was observed, and the efficiency of the three-dimensional nursing management mode was determined according to the patient recovery.

RESULTS

The overall recovery effect in the experimental group was good, the respiratory function exercise effect was significant, and just one patient still had dyspnea after one week of nursing. There were 5 patients with chest tightness and chest pain and 7 patients with dyspnea in the control group. One patient died after a recurrence of the disease (P < 0.05). The total nursing efficiency was 90% in the experimental group and 30% in the control group (P < 0.05). Three months after discharge, the patients in the two groups were followed up, and a survey was conducted. In the experimental group, 14 patients and their families were very satisfied with the nursing. In the control group, 2 patients and their families were dissatisfied with the nursing, and the difference was statistically significant (P < 0.05).

CONCLUSIONS

Three-dimensional nursing management with post-thoracotomy, acute pulmonary embolism patients contributes to improving the patients' compliance with respiratory function exercises and to the nursing efficiency. It can greatly improve the nursing efficiency, relieve patients' post-surgical pain, and can promote the formation of a good doctor-patient relationship to a certain extent.