[Systematic literature review on interventions in rehabilitation for children and adolescents with asthma bronchiale].
Relevant data bases were used to collect and evaluate guidelines, meta-analyses, and reviews as well as primary studies dealing with asthma therapy for children and adolescents. Treatment approaches whose effectiveness with regard to bronchial asthma was empirically verified (i. e., evidence-based) were identified (medical and diagnostic procedures as well as drug trials were excluded from the analysis). 152 methodically sound studies referring to asthma treatment of children and adolescents were selected. Strong evidence was found for patient education, parent education, exercise therapy, inhalation, and tobacco withdrawal. Nutritional counseling and avoidance of allergens showed limited evidence. Psychotherapy, relaxation techniques, breathing exercises, climate therapy, clinical social work (social and legal counseling services, vocational reintegration counseling, aftercare) and integration counseling showed inconsistent evidence. No evidence was found for alternative medicine. Challenges regarding the development of treatment standards for children and adolescent rehabilitation are highlighted; these refer to limitations in report quality in some of the studies, the validity of treatments for comorbid conditions, a lack of differentiation for different age groups, and transferability of outpatient or international study results to inpatient rehabilitation.
Institut für Psychotherapie und Medizinische Psychologie, Arbeitsbereich Rehabilitationswissenschaften, Universität Würzburg, Würzburg. j.ahnert@uni-wuerzburg.de
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J
Ahnert
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Löffler
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J
Müller
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H
Vogel
D000293:Adolescent; D001249:Asthma / Q000534:rehabilitation*; D001945:Breathing Exercises; D002648:Child; D003299:Cooperative Behavior; D019317:Evidence-Based Medicine; D015444:Exercise; D005247:Feeding Behavior; D006801:Humans; D033183:Interdisciplinary Communication; D010290:Parents / Q000193:education; D010348:Patient Care Team; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D012050:Rehabilitation, Vocational; D012130:Respiratory Hypersensitivity / Q000517:prevention & control / Q000534:rehabilitation; D012947:Social Work; D014028:Tobacco Smoke Pollution / Q000517:prevention & control
D014028:Tobacco Smoke Pollution