Exercise Capacity in Prepubertal Children with Cystic Fibrosis

Abstract

Background. Patients with cystic fibrosis (CF) are observed to have diminished lung function, nutritional status, and aerobic exercise capacity. All three parameters are related to prognosis and survival. However, there is little information regarding these parameters in prepubertal patients. Methods. Our study groups consisted of sixteen patients with CF (7 girls) and 99 healthy volunteers (52 girls). Subjects performed spirometry and a progressive exercise test to exhaustion on a cycle ergometer. Leg muscle strength was measured using an isokinetic dynamometer. Physical activity was examined using the modifiable activity questionnaire and accelerometer. Results. Nutritional status was similar between groups (BMI—boys control versus CF 18.5 versus 17.9, girls control versus CF 19.5 versus 17.4). Girls with CF were significantly smaller and lighter than controls. Lung function was significantly reduced in CF groups (FEV1—boys control versus CF 91% versus 84%, girls control versus CF 90% versus 82%). Patients with CF were as active and as fit as their healthy controls. Conclusion. In this group of prepubertal children with CF, nutritional status was comparable to healthy children of the same age. Their aerobic exercise tolerance and peripheral muscle strength were also relatively well preserved despite significantly lower lung function.

Levels of moderate–vigorous physical activity are low in Spanish children with cystic fibrosis: A comparison with healthy controls

“…The PA results of this study did not agree, at least apparently, with those of Kilbrige et al (2012) [20] and Selvadurai et al (2004) [6], where patients with CF were as active and fit as their healthy controls. With regard to this, there is evidence [31] that a minimum of 7-day monitoring is needed to provide a reliable estimate of usual PA behavior in children and adolescents and to assess differences in weekend vs. week day activity behavior, yet the study by Kilbrige et al [20] only used 3 days of monitoring PA. Moreover, the use of counts and a global measure of PA instead of the amount of minutes of light, moderate or vigorous PA could have altered the results of previous research [6], together with the use of different types of accelerometer among studies.…”

“…Moreover, the use of counts and a global measure of PA instead of the amount of minutes of light, moderate or vigorous PA could have altered the results of previous research [6], together with the use of different types of accelerometer among studies. RT3 accelerometers used in Kilbride et al [20] were compared to the Actigraph accelerometers and SenseWear Armband (SWA) in free-living energy expenditure (EE) within sedentary environments [32] and the RT3 model was found to be less valid for quantifying EE during light-intensity activities than Actigraph accelerometers and SWA. Recently, Rabinovich and colleagues [33] have recommended the use of GT3X Actigraph accelerometer as the most valid monitor to measure daily life PA in patients with chronic obstructive pulmonary disease.…”

“…To date, there are studies in which PA levels in children [6,20] or adults [21] with CF have been measured objectively by accelerometers. Yet the studies in CF children have some methodological limitations, i.e.…”

“…Yet the studies in CF children have some methodological limitations, i.e. use of activity counts rather than activity cut-point thresholds to quantify activity intensity [6] or insufficient number of accelerometer wearing days for appropriate PA analysis [20]. This situation makes it difficult to determine if children were performing light, MVPA or vigorous PA.…”

Physical Activity Levels and Performance in Italian Adolescents with Cystic Fibrosis: A Multicenter Cross-sectional Study

“…Most of the studies examined only leg muscle strength [23][24][25]. In our study a moderate correlation was find between upper limb strength and ISWT.…”