Çocuk Göğüs Hastalıklarında Rehabilitasyon Teknolojileri
Özet
Bu bölüm, çocukluk çağı kronik solunum hastalıklarında rehabilitasyon teknolojilerinin rolünü kapsamlı şekilde ele almaktadır. Astım, kistik fibrozis, bronkopulmoner displazi ve bronşektazi gibi hastalıkların çocuklarda solunum fonksiyonlarını, büyüme-gelişmeyi ve yaşam kalitesini önemli ölçüde etkilediği vurgulanmaktadır. Pulmoner rehabilitasyonun ana hedefleri; semptom kontrolü, egzersiz kapasitesinin artırılması, sekresyon yönetimi, komplikasyonların önlenmesi ve aile katılımının güçlendirilmesidir. Bölümde inhaler teknolojileri, oksijen ve noninvaziv ventilasyon sistemleri, mekanik öksürük yardımcıları, PEP/OPEP cihazları, giyilebilir sensörler, oyunlaştırılmış egzersiz sistemleri ve sanal gerçeklik gibi modern çözümler ayrıntılı biçimde açıklanmıştır. Ayrıca tele-rehabilitasyon ve mobil sağlık uygulamalarının çocuklarda tedaviye erişimi kolaylaştırdığı ve motivasyonu artırdığı belirtilmektedir. Teknolojik yeniliklerin, çocukların bireyselleştirilmiş ve sürdürülebilir rehabilitasyon programlarına katılımını önemli ölçüde güçlendirdiği ifade edilmektedir.
Referanslar
Smyth AR, Bell SC, Bojcin S, et al. European cystic fibrosis society standards of care: Best practice guidelines. J Cyst Fibros. 2014;13 Suppl 1:S23-S42. doi:10.1016/j.jcf.2014.03.010
World Health Organization. Asthma. Fact sheet. Geneva: WHO; 2023. https://www.who.int/news-room/fact-sheets/detail/asthma
Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life. N Engl J Med. 1995;332(3):133-138. doi:10.1056/NEJM199501193320301
Nici L, Donner C, Wouters E, et al. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med. 2006;173(12):1390-1413. doi:10.1164/rccm.200508-1211ST
Hebestreit H, Kieser S, Rudiger S, et al. Physical training improves fitness and quality of life in cystic fibrosis. Eur Respir J. 2010;35(3):578-583. doi:10.1183/09031936.00072909
Stickland MK, Jourdain T, Wong EY, Rodgers WM, Jendzjowsky NG, Macdonald GF. Using telehealth technology to deliver pulmonary rehabilitation. Can Respir J. 2011;18(4):216-220. doi:10.1155/2011/640865
Huckvale K, Morrison C, Ouyang J, Ghafur S, Car J. The evolution of mobile apps for asthma: An updated systematic assessment of content and tools. BMC Med. 2015;13:58. doi:10.1186/s12916-015-0288-8
Stocks J, Sonnappa S. Early life influences on the development of chronic obstructive pulmonary disease. Ther Adv Respir Dis. 2013;7(3):161-173. doi:10.1177/1753465813479428
García-Pérez-de-Sevilla G, Yvert T, Blanco Á, Sosa Pedreschi AI, Thuissard IJ, Pérez-Ruiz M. Effectiveness of physical exercise interventions on pulmonary function and physical fitness in children and adults with cystic fibrosis: a systematic review with meta-analysis. Healthcare (Basel). 2022;10(11):2205. doi:10.3390/healthcare10112205
Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188(8):e13-e64. doi:10.1164/rccm.201309-1634ST
Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention. 2023 Update. Available from: https://ginasthma.org
Chan AHY, Stewart AW, Harrison J, Camargo CA, Black PN, Mitchell EA. The effect of an electronic monitoring device with audiovisual reminder function on adherence to inhaled corticosteroids and school attendance in children with asthma: a randomized controlled trial. Lancet Respir Med. 2015;3(3):210–219. doi:10.1016/S2213-2600(15)00008-9
Abman SH, Collaco JM, Shepherd EG, et al. Interdisciplinary care of children with severe bronchopulmonary dysplasia. J Pediatr. 2017;181:12–28.e1. doi:10.1016/j.jpeds.2016.10.002
Fauroux B, Amaddeo A, Quera-Salva MA, Khirani S. Long-term non-invasive ventilation in children: Current use, indications and perspectives. Eur Respir J. 2017;50(1):1700014. doi:10.1183/13993003.00014-2017
Fouzas S, Priftis KN, Anthracopoulos MB. Pulse oximetry in pediatric practice. Pediatrics. 2011;128(4):740-752. doi:10.1542/peds.2011-0271
Alrajhi W, Gari M, Alhassan A, et al. Smart wearable sensors for remote monitoring of respiratory diseases: A systematic review. Sensors. 2021;21(11):3830. doi:10.3390/s21113830
Chatwin M, Toussaint M, Gonçalves MR, Sheers N, Mellies U, Gonzales-Bermejo J. Airway clearance techniques in neuromuscular disorders: A state of the art review. Respir Med. 2018;136:98-110. doi:10.1016/j.rmed.2018.01.012
McCool FD, Rosen MJ. Nonpharmacologic airway clearance therapies: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1 Suppl):250S-259S. doi:10.1378/chest.129.1_suppl.250S
Fauroux B, Hart N, Lofaso F. Airway clearance in children with neuromuscular disease. Paediatr Respir Rev. 2008;9(1):39-45. doi:10.1016/j.prrv.2007.11.006
McIlwaine M, Button B, Dwan K. Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis. Cochrane Database Syst Rev. 2015;(6):CD003147. doi:10.1002/14651858.CD003147.pub4
Pryor JA, Prasad SA. Physiotherapy techniques. In: Hodson ME, Geddes DM, Bush A, eds. Cystic Fibrosis. 4th ed. Boca Raton: CRC Press; 2007. p. 379-406.
Ringholz FC, Schneider L, Stanojevic S, et al. Long-term effects of positive expiratory pressure therapy in children with cystic fibrosis: adherence, quality of life, and lung function. Pediatr Pulmonol. 2021;56(4):845–853. doi:10.1002/ppul.25257
Nicolini A, Cardini F, Landucci N, Lanata S, Ferrari-Bravo M. Airway clearance techniques in respiratory diseases: current perspectives and future directions. Clin Med Insights Circ Respir Pulm Med. 2020;14:1-9. doi:10.1177/1179548420952077
Rodríguez-Núñez I, Monsalve-Campos K, Bretti MJ, González-Martínez F, Zubieta-Navarro A. Pediatric pulmonary rehabilitation in the light of qualitative research: What statistic cannot show. Andes Pediatr. 2023;94(3):392-400. doi:10.32641/andespediatr.v94i3.4494
Fekete M, Fazekas-Pongor V, Balazs P, Tarantini S, Nemeth AN, Varga JT. Role of new digital technologies and telemedicine in pulmonary rehabilitation: smart devices in the treatment of chronic respiratory diseases. Wien Klin Wochenschr. 2021;133(21):1201-1207. doi:10.1007/s00508-021-01919-y
Gruber W, Orenstein DM, Braumann KM. Effects of an exercise program in children with cystic fibrosis. Chest. 2001;120(1):148–156. doi:10.1378/chest.120.1.148
Fanelli A, Cabral AL, Neder JA, Martins MA, Carvalho CR. Exercise training on disease control and quality of life in asthmatic children. Med Sci Sports Exerc. 2007;39(9):1474–1480. doi:10.1249/mss.0b013e3180d099ad
Fekete M, Dokić S, Ristić L, et al. Video game-based pulmonary rehabilitation: potential and perspectives. Games Health J. 2021;10(4):236–243. doi:10.1089/g4h.2020.0147
McNamara RJ, Epsley C, Corhan A, McKeough ZJ. Videogame-based rehabilitation for respiratory patients: a systematic review. Chron Respir Dis. 2019;16:1479973119856852. doi:10.1177/1479973119856852
Ucgun, H., Gurses, H. N., Kaya, M., & Cakır, E. Video game‐based exercise in children and adolescents with non‐cystic fibrosis bronchiectasis: A randomized comparative study of aerobic and breathing exercises. Pediatric Pulmonology, 2022; 57(9), 2207-2217. doi: 10.1002/ppul.26026
Silva-Lavigne C, Johnson C, Liu M, et al. Asthma Heroes: a gamified mobile application for pediatric asthma management. JMIR Serious Games. 2022;10(3):e36149. doi:10.2196/36149
van Delden R, Moreno A, Reidsma D, et al. SpiroPlay: a respiration-controlled game for children with asthma. Interact Comput. 2020;32(1):52–66. doi:10.1093/iwc/iwz033
Blum J, Rockstroh C, Göritz AS. Virtual reality in respiratory rehabilitation: immersion, presence, and therapeutic potential. Front Psychol. 2020;11:524. doi:10.3389/fpsyg.2020.00524
Colombo V, Aliverti A, Sacco V. Virtual reality–based pulmonary rehabilitation: feasibility and clinical perspectives. J Clin Med. 2022;11(3):845. doi:10.3390/jcm11030845
Direito A, Carraça E, Rawstorn J, Whittaker R, Maddison R. mHealth technologies to influence physical activity and sedentary behaviors in children and adolescents: a systematic review. Int J Behav Nutr Phys Act. 2017;14:83. doi:10.1186/s12966-017-0538-3
Migueles JH, Aadland E, Andersen LB, et al. Association of wearable device–measured physical activity and sedentary time with health outcomes in children: a systematic review and meta-analysis. JAMA Pediatr. 2022;176(4):390–400. doi:10.1001/jamapediatrics.2021.6362
Chung C, Kim DK, Lee JK, et al. Smartphone app-guided pulmonary rehabilitation in chronic respiratory diseases: a randomized controlled trial. JMIR Mhealth Uhealth. 2025;13(8):e64884. doi:10.2196/64884
Cox NS, Dal Corso S, Hansen H, et al. Telerehabilitation for chronic respiratory disease. Cochrane Database Syst Rev. 2021;1(1):CD013040. doi:10.1002/14651858.CD013040.pub2
Clark H, Bassett S, Siegert R. Web-based pulmonary rehabilitation: an alternative to conventional delivery. Physiother Res Int. 2019;24(2):e1763. doi:10.1002/pri.1763
Jiménez-Reguera B, et al. Effectiveness of “HappyAir” web-based platform for COPD and asthma management. Int J Chron Obstruct Pulmon Dis. 2020;15:2475–2486. doi:10.2147/COPD.S267642
Chaplin E, Hewitt S, Apps L, et al. Interactive web-based pulmonary rehabilitation program: SPACE for COPD. BMJ Open Respir Res. 2015;2(1):e000031. doi:10.1136/bmjresp-2014-000031
Dai Y, Huang H, Zhang Y, He N, Shen M, Li H. The effects of telerehabilitation on physiological function and disease symptom for patients with chronic respiratory disease: a systematic review and meta-analysis. BMC Pulm Med. 2024;24(1):305. doi:10.1186/s12890-024-03104-8
Holland AE, Cox NS, Houchen-Wolloff L, Rochester CL, Garvey C, ZuWallack R, Singh SJ. Defining modern pulmonary rehabilitation: an official American Thoracic Society workshop report. Ann Am Thorac Soc. 2021;18(5):e12–e29. doi:10.1513/AnnalsATS.202102-146ST
McNamara RJ, Dale M, McKeough ZJ. Innovative strategies to improve the reach and engagement in pulmonary rehabilitation. J Thorac Dis. 2019;11(Suppl 17):S2192–S2199. doi:10.21037/jtd.2019.10.29