Bewegungstherapie in der Kinder- und Jugendlichenrehabilitation

Although recommended in most treatment guidelines for child/adolescent rehabilitation, there is a lack of standards regarding the amount of exercise therapy that children and adolescents should receive during rehabilitation to ensure effective treatment. First, existing treatment guidelines were examined with regard to data on the frequency, duration, content, and modes of procedure of exercise therapy in the treatment of children and adolescents with asthma, obesity, and atopic dermatitis. Moreover, the actual implementation of exercise therapy in child/adolescent rehabilitative care was analyzed by using standardized data on the classification of therapeutic measures of the years 2007/2008 and comparing different rehabilitation centers. In the context of a nationwide survey, experts and clinicians were asked to describe and define how exercise therapy can be adopted in rehabilitative practice. On this basis, an expert workshop was conducted during which a pilot version of treatment guidelines for child/adolescent rehabilitation was developed and compared with actual medical care practice. Obese children/adolescents receive the highest amount of exercise therapy (4.7 h/week). However, children suffering from atopic dermatitis engage just as long in therapeutic exercises (1.9 h/week) as do children with asthma (1.9 h/week). Exercise therapy modules vary significantly between rehabilitation centers in terms of average frequency and duration. When comparing treatment guidelines and actual medical practice, it becomes apparent that only children up to the age of 7 with atopic dermatitis or asthma are provided to some degree adequately with exercise therapeutic treatment, whereas children aged 8 or older with asthma and/or obesity receive too little exercise therapy. Potential reasons for large variations between rehabilitation centers regarding the use of exercise therapy as well as possible factors that influence discrepancies between actual rehabilitative care practice and therapeutic guidelines are discussed.