Exercise Training in Children and Adolescents with Cystic Fibrosis: Theory into Practice

Abstract

Physical activity and exercise training play an important role in the clinical management of patients with cystic fibrosis (CF). Exercise training is more common and recognized as an essential part of rehabilitation programmes and overall CF care. Regular exercise training is associated with improved aerobic and anaerobic capacity, higher pulmonary function, and enhanced airway mucus clearance. Furthermore, patients with higher aerobic fitness have an improved survival. Aerobic and anaerobic training may have different effects, while the combination of both have been reported to be beneficial in CF. However, exercise training remains underutilised and not always incorporated into routine CF management. We provide an update on aerobic and anaerobic responses to exercise and general training recommendations in children and adolescents with CF. We propose that an active lifestyle and exercise training are an efficacious part of regular CF patient management.

Active Video Game Playing in Children and Adolescents With Cystic Fibrosis: Exercise or Just Fun?

“…The target was computed considering 80% of the maximum heart rate. 11 A mean value of 166 beats/min (range of 162.4 -169.6) was obtained. During the 20-min exercise session, there was no significant difference in the maximum heart rate reached over time between the Xbox Kinect (mean Ϯ SD beats/min of 165.0 Ϯ 23.6) and stationary cycle (170.8 Ϯ 13.2, P ϭ .2) groups, but the heart rate target was reached more often with the stationary cycle (20 of 30 subjects) compared with Xbox Kinect (12 of 30 subjects, P ϭ .02).…”

“…The control intervention consisted of high-intensity, constant, aerobic stationary cycle exercise to reach the heart rate target for this population: 80% of the maximum heart rate for age. 11 Specific indications were provided to subjects for both activities.…”

“…9 General exercise and training recommendations in children and adolescents with CF have already been defined in terms of method, frequency, duration, and intensity. 11 Exercise programs should be tailored to individual needs, as there is considerable variability between subjects in terms of fitness, enthusiasm, and preference for particular types of activities. 12 A recent review of physical activity levels in subjects with CF assessed the effect of an exercise program on participation in physical activity, but underscored the lack of evidence regarding strategies for promoting the commencement of and adherence to regular physical activity.…”

"CF chatters": the development of a theoretically informed physical activity intervention for youth with cystic fibrosis

“…There may be a positive effect from exercise on pulmonary function by increasing aerobic and anaerobic capacity [8] and strengthening ventilatory muscles, with chronic exercise programs being associated with a slower rate of pulmonary function decline [9]. Furthermore, exercise stimulates mucus clearance [10]; by blocking the sodium channels of the respiratory epithelium, exercise also contributes to lower mucus viscosity and the easing of mucus clearance [11,12].…”

Exercise Performance and Breathing Patterns in Cystic Fibrosis

“…In another review, Williams et al present general exercise and training recommendations for children and adolescents with CF including cycling, walking, gymnastics and day to day activities for about 30 min, 3-5 times per week intermittently (Williams et al, 2010). For patients with mild to moderate disease they add activities like swimming, tennis and climbing.…”