{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T16:26:02Z","timestamp":1758039962450,"version":"3.44.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to evaluate the application and rehabilitation outcomes of an integrated stepwise rehabilitation training model in pediatric patients undergoing minimally invasive repair of pectus excavatum (Nuss procedure).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort of 97 children who underwent the Nuss procedure between July 2019 and August 2021 were included in the study. Participants were divided into an observation group (<jats:italic>n<\/jats:italic>\u2009=\u200952) and a control group (<jats:italic>n<\/jats:italic>\u2009=\u200945). The observation group received a stepwise rehabilitation training model in addition to standard perioperative care, while the control group received only routine care. Rehabilitation outcomes, including physical development, pulmonary function, self-care ability, and treatment satisfaction, were assessed over a 12-month period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no statistically significant differences in baseline characteristics or postoperative complications between the two groups. In the observation group, all pulmonary function parameters demonstrated significant improvements at both 6- and 12-months post-surgery (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001). The control group did not indicate significant changes at 6 months, with improvements noted only at 12 months (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001). Postoperative satisfaction and self-care ability in the control group improved significantly at the 12-month follow-up. In contrast, the observation group exhibited significant improvements in these parameters as early as 6 months postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early implementation of an integrated stepwise rehabilitation training model enhances the recovery process in pediatric patients following the Nuss procedure. This approach is both effective and economically feasible, providing a practical framework for post-surgical rehabilitation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1591331","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T05:26:01Z","timestamp":1757568361000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of an integrated stepwise rehabilitation model following Nuss procedure in pediatric patients"],"prefix":"10.3389","volume":"13","author":[{"given":"Wen-Jing","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Li","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing-Jing","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Tong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.anplas.2012.07.005","article-title":"Management of breast asymmetry associated with primary funnel chest","volume":"58","author":"Ho Quoc","year":"2013","journal-title":"Ann Chir Plast Esthet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2876","DOI":"10.3760\/cma.j.issn.0366-6999.20123485","article-title":"Psychological trauma of funnel chest in adolescents and the appropriate age for minimally invasive surgery repair","volume":"126","author":"Zhao","year":"2013","journal-title":"Chin Med J (Engl)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"156","DOI":"10.17219\/acem\/194483","article-title":"Quality of life assessment after minimally invasive operative treatment in children with pectus excavatum: a single-center study and literature review","volume":"16","author":"Kroczek","year":"2025","journal-title":"Adv Clin Exp Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1016\/j.xjtc.2024.09.015","article-title":"Surgical treatment and outcomes of pectus arcuatum","volume":"28","author":"Zeineddine","year":"2024","journal-title":"JTCVS Tech"},{"key":"B5","doi-asserted-by":"publisher","first-page":"238","DOI":"10.5090\/jcs.23.034","article-title":"Commentary: technical advancement of pectus bar stabilization in chest wall deformity surgery: a 10-year trend and appraisal with 1,500 patients","volume":"56","author":"Nuss","year":"2023","journal-title":"J Chest Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1016\/j.jamcollsurg.2013.06.019","article-title":"Multicenter study of pectus excavatum, final report: complications, static\/exercise pulmonary function, and anatomic outcomes","volume":"217","author":"Kelly","year":"2013","journal-title":"J Am Coll Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1007\/s00383-024-05838-2","article-title":"Effect of cryoablation in Nuss bar placement on opioid utilization and length of stay","volume":"40","author":"Clinker","year":"2024","journal-title":"Pediatr Surg Int"},{"key":"B8","doi-asserted-by":"publisher","first-page":"161590","DOI":"10.1016\/j.jpedsurg.2024.05.020","article-title":"Short bars crossed\u2019 to remodel the entire chest wall in children and adolescents with pectus excavatum","volume":"59","author":"Weinhandl","year":"2024","journal-title":"J Pediatr Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1055\/s-2003-44807","article-title":"Life-threatening complication of the Nuss-procedure for funnel chest. 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