Research: [Safety and efficacy of a therapeutic exercise program in young adults with repaired congenital diaphragmatic hernia]

Rehabilitacion (Madr)

. 2024 Jun 20;58(4):100859.

 doi: 10.1016/j.rh.2024.100859. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/38905956/

[Safety and efficacy of a therapeutic exercise program in young adults with repaired congenital diaphragmatic hernia]

[Article in Spanish]

A B Castillo Velásquez 1M Supervia 2D Pelaez Mata 3J C de Agustín Asensio 3M O Arroyo Riaño 1

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Abstract

Introduction and 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.

Material and 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.

Keywords: Bioimpedance; Bioimpedancia; Congenital diaphragmatic hernia; Efficacy; Eficacia; Ejercicio físico domiciliario; Hernia diafragmática congénita; Home physical exercise; Safety; Sarcopenia; Seguridad.

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