1. CLD (n=18) Normal (n=18) P MET 7.9 + 1.7 (5.1 - 11.4) 7.7 + 1.7 (5.7 - 11.7) > 0.05

2. Estimated MET levels for selected physical activities Physical activityMET Writing Walking (2mph) Golf (with cart) Golf (without cart) Badminton Dancing aerobic Karate or judo Swimming (fast) Hockey,field Squash 1.7 2.5 4.9 5.5 6.0 6.5 7.0 7.7 12.1

3. Conclusion Despite having abnormal PFT, children with CLD demonstrated the same levels of optimal physical activity when compared to normal children

4. CLD Airway problemsLung mechanic problems Chest wall mechanic problems Hypersecretion Bronchospasm Collasped airway Restrictive Hyperinflation Ineffective cough Retained secretion Exercise limitation Atelectasis Recurrent pneumonia Pulmonary rehabilitation & Exercise training

5. Question #2 How to perform pulmonary rehabilitation and exercise training in children with CLD?

6. Case illustration A 7-yr-old boy Recurrent RUL/RML pneumonia Persistent RUL/RML atelectasis Possible Rt. lung hypoplasia GER with mild delayed gastric emptying time Poor weight gain since age 3 yrs RUL/RML lobectomy at the age of 5 yrs

7. Case illustration PE (post surgery) - BW 14 kgs - Mild tachypnea & dyspnea -  AP diameter of chest wall -  Lung expansion Rt.> Lt. -  Breath sound & medium crepitations RLL - Lumbar kyphosis