Background/Objectives: Childhood obesity appears to be an alarmingly growing global threat. Current evidence has shown that obesity can be successfully managed with interventions targeting movement skills, motor coordination and physical activity. However, data concerning physiotherapy practice are limited. We aimed to assess the impact of therapeutic exercise on the 6-minute walk test (6-MWT) in obese children and adolescents. Methods: A total of 31 obese children and adolescents (BMI > 30 kg/m²), 18 males and 13 females, aged from 8 to 18 years, were enrolled. Two study groups were formed: the control group (Group A), comprising ten children; and the intervention group (Group B), comprising 21 children. Daily exercise habits were obtained via interview; anthropometric data (weight, height and BMI) were recorded; and 6-MWT parameters, blood pressure and oxygen saturation (SaO₂) were assessed before and after a 4-month intervention program consisting of breathing and aerobic exercises. Results: There was a statistically significant increase in 6-minute walk distance (+43.34, p < 0.001) and an improvement in body weight (p < 0.01), blood pressure (p < 0.01) and oxygen saturation (p < 0.03) in Group B after the 4-month training program. Conclusions: All results highlight the potential of physical exercise in clinical practice to improve functional status and achieve weight loss. Future randomized controlled trials, including individualized therapeutic exercise programs in larger samples of obese children, are much anticipated.

Background/Objectives: Home spirometry allows people with cystic fibrosis (CF) to monitor their lung function from home. However, there are concerns about its feasibility and validity compared to traditional clinic spirometry. The aim of this study was to evaluate the feasibility and validity of telehealth spirometry for patients with CF living in a regional setting. Methods: This retrospective study included forty-eight people with cystic fibrosis (pwCF) aged 6–33 years. Participants performed home spirometry using a portable flow sensor spirometer over a one-year period, without supervision. Spirometry readings from portable spirometers were compared with the nearest in-clinic spirometry using the intra-correlation coefficient (ICC) and Bland–Altman plots. Data were collected over a period of one year, with regular intervals of measurements. Results: In 427 of the 877 (48.6%) attempted sessions, successful spirometry at home was recorded. Although we showed good reliability between at-home and in-clinic measurements using the Bland–Altman plots and intraclass correlation co-efficient (ICC) (values ranged from 0.76 to 0.88), analysis of the 117 pairs of at-home and in-clinic spirometries showed that mean differences of forced expiratory volume in the 1st sec (FEV1) and forced vital capacity (FVC) obtained at home (both in liter and z-score) had, on average, lower values than the corresponding values at the clinic. Conclusions: Home-based telehealth spirometry is feasible among pwCF and provides advantages, especially for those from remote or secluded areas. However, lower values in FVC and FEV1 obtained through home spirometry should not be used interchangeably with clinic values.

Background: Chronic respiratory conditions are a prominent public health issue and thus, building a patient registry might facilitate both policy decision making and improvement of clinical management processes. Hellenic Registry of patients with Home Mechanical Ventilation (HR-HMV) was initiated in 2017 and a web-based platform is used to support patient data collection. Eighteen hospital departments (including sleep labs) across Greece participate in this initiative, focusing on recording data for both children and adult patients supported by mechanical ventilation at home, including patients with Sleep Apnea–Hypopnea Syndrome (SAHS) under Positive Airway Pressure (PAP) therapy. Methods: The HR-HMV initiative ultimately aims to provide a database for evidence-based care and policy making in this specific domain. To this end, a web information system was developed and data were manually collected by clinics and hospital departments. Legal and privacy issues (such as General Data Protection Rule compliance and technical information security measures) have been considered while designing the web application. Based on the collected data, an exploratory statistical report of SAHS patients in Greece is presented. Results: Eleven out of the eighteen participating clinics and hospital departments have contributed with data by the time of the current study. More than 5000 adult and children patient records have been collected so far, the vast majority of which (i.e., 4900 patients) diagnosed with SAHS. Conclusion: The development and maintenance of patient registries is a valuable tool for policy decision making, observational/epidemiological research and beyond (e.g., health technology assessment procedures). However, as all data collection and processing approaches, registries are also related with potential biases. Along these lines, strengths and limitations must be considered when interpreting the collected data, and continuous validation of the collected clinical data per se should be emphasized. Especially for Greece, where the lack of national registries is eminent, we argue that HR-HMV could be a useful tool for the development and the update of related policies regarding the healthcare services for patients with home mechanical ventilation support and SAHS patients, which could be useful for related initiatives at a European level as well.

Background: Technology Depended Children (TDC) are frequently admitted to the hospital with significant cost for the Health Care System. Home care programs have been reported to reduce admissions and consequently the health care cost. Aim: The aim of this study was to evaluate the cost of care of TDC who entered a Hospital based Home Care Program. Patients and Methods: Children with chronic respiratory problems who are technology dependent entered prospectively in a hospital based home care program. The program was covered by two nurses and two physiotherapists who visited homes on a regular weekly basis and are referred to a tertiary Paediatric Department. We calculate the cost, the days of planned admissions and planned visits, the days of unplanned admissions in the Paediatric Department and PICU, one year ago and one year after their entry in the program. Results: 40 children entered the study. Mean age was 6, 07 years. (20/40 with gastrostomy, 18/40 with tracheostomy and 14/40 on mechanical ventilation). The mean number of scheduled visits were 2. 67 before and 3.15 after (p= 0,153). Mean number of unplanned admissions were 1. 67 before and 0.97 after (p= 0, 011). Mean days of hospitalization were 42.25 one year before and 11.35 one year after (p<0, 001). Mean days of admissions in the PICU were 19.7 before and 2.10 after (p <0,001). The mean cost for healthcare system was 14,344 Euros before and 7,938 Euros one year later (p< 0, 001). Conclusion: Implementation of the Hospital based Home Care program for TDC significantly reduced admissions and almost halved the cost of care for these children.

Background: Home care has been proved to reduce hospitalizations among technology dependent children (TDC). In remote regions, frequent telephone contacts might substitute home visits. Aim: To compare the effectiveness of home visits vs. telephone communication among TDC. Patients and Method: 40 TDC patients were divided in two groups: 1) Group A: 24 patients living in a 60km area around the tertiary center, monitored by home visits and 2) Group B: 16 patients living in a longer distance, monitored by telephone communication. The scheduled visits, the unplanned admissions and admissions to PICU were evaluated one year before and one year after the implementation of home care program. Results: Mean age of the patients was 6.07 years. 20/40 TDC had gastrostomy, 18/40 tracheostomy and 14/40 were on mechanical ventilation. Group A: mean number of scheduled visits were 2.64 before and 3.16 after (p= 0.158), mean number of unplanned admissions were 1.8 before and 1.04 after (p= 0.034) and 52.5 % of the patients had no admissions to PICU before, while 92.5% had no admissions after (p< 0.001). Group B: mean number of scheduled visits were 2.7 before and 3.13 after (p= 0.35), mean number of unplanned admissions were 1.46 before and 0.86 after (p= 0.09) and 53.3% of the patients had no admissions to PICU before, while 86.7% had no admissions after (p< 0.125). Conclusion: Telephone monitoring can reduce unplanned hospital admissions as effectively as home visit monitoring, but not PICU admissions.