Clinical Exercise Testing in Children and Adolescents with Cystic Fibrosis

Abstract

With advances in intensive supportive therapy and multi-disciplinary Cystic fibrosis (CF) care, life expectancy in CF has markedly increased over the last decade. Exercise testing has evolved as an integral part in CF patient management. Indeed, exercise testing includes the assessment of functional capacity and morbidity; however, it is also essential in demonstrating the effects of therapy and training programs. Moreover, regular exercise training can improve aerobic and anaerobic capacity, increase inspiratory muscle strength and enhance airway mucus clearance. Nevertheless, in spite of the beneficial effects of regular physical activity, standardized exercise testing followed by structured training is rather uncommon among CF clinicians. Reviewed in the present study are the most common field and laboratory exercise tests available in the healthcare of children and adolescents with CF. Thomas Radtke MSc

Exercise improves lung function and habitual activity in children with cystic fibrosis

“…Both formal and field tests of exercise are primarily limited by costs, equipment, space, and time [21]. Exercise training and habitual physical activity have been shown to be effective in children with CF and to slow the rate of decline of FEV 1 , particularly in girls [10,16].…”

A comparison of respiratory and peripheral muscle strength, functional exercise capacity, activities of daily living and physical fitness in patients with cystic fibrosis and healthy subjects

“…HR and SpO 2 values with the portable pulse oximeter, respiratory rate (RR), leg fatigue, general fatigue and dyspnea perception scores with the modified Borg scale were recorded before and after the test. The time to complete the test also recorded (Dechman & Scherer, 2008;Radtke, Stevens, Benden, & Williams, 2009;Skumlien, Hagelund, Bjortuft, & Ryg, 2006).…”

Cystic fibrosis and physiological responses to exercise

“…However, at a time when the ECFS has recognized CPET as the exercise testing method of choice when assessing aerobic fitness in mild-to-moderate CF patients, only an S max verification protocol, as outlined by Saynor et al [27], can confirm a 'true' VO 2max measurement obtained during a progressive exercise test in young CF patients. Furthermore, a key benefit of ramp incremental exercise compared with a shorter steep ramp test is that ramp testing spans the range of exercise intensities and, therefore, derives both important maximal and submaximal fitness parameters [36].…”