Physical activity and its correlates in people with cystic fibrosis: a systematic review

Abstract

Cystic fibrosis (CF) is a life-shortening genetic disease, affecting multiple life domains including physical activity (PA). Although higher PA levels are associated with multiple health benefits, little insight exists on the PA level of people with CF (PwCF) compared to healthy peers. Evidence on the influencing factors (i.e. correlates) of PA in this clinical population is scarce, but essential to fully understand their PA behaviour. Therefore, the present review aims to provide an overview of the PA level of PwCF compared to healthy peers, and the correlates of PA in PwCF. A systematic search of three databases resulted in 46 included studies. Analysis of 16 studies showed that the CF population is equally active compared to healthy peers, but there is a trend towards less high-intensity PA in youths with CF. Furthermore, PA is positively associated with quality of life, lung function, (maximal) exercise capacity, bone mineral density and quadriceps force. Also, PA was lower on weekdays compared to weekend days and lower when experiencing pulmonary exacerbations. More high-quality research is required in PwCF, particularly longitudinal studies that further explore the correlates of PA, with PA investigated as a primary outcome and measured objectively.

Impact of habitual physical activity and exercise capacity on quality of life in adolescents and adults with cystic fibrosis

“…Physical activity, including exercise, sport, and recreational activities, is widely accepted to have physical and psychosocial benefits in pwCF and is recommended for CF care, regardless of age and disease severity 4,5 . Side effects are rare and do not constitute an impediment to participation in physical activity 6 .…”

“…There is also a lack of studies evaluating the influence of physical activity on HRQoL in pwCF. In a recent review by Kinaupenne et al, only three studies were identified that used accelerometry to assess the relationship between physical activity and QoL were identified 4 …”

“…2,3 Physical activity, including exercise, sport, and recreational activities, is widely accepted to have physical and psychosocial benefits in pwCF and is recommended for CF care, regardless of age and disease severity. 4,5 Side effects are rare and do not constitute an impediment to participation in physical activity. 6 The positive influence of regular physical activity on exercise capacity appears undisputed and therefore has a major impact on prognosis and mortality of pwCF.…”

“…In a recent review by Kinaupenne et al, only three studies were identified that used accelerometry to assess the relationship between physical activity and QoL were identified. 4 The aims of the current study were to objectively assess physical activity in a large number of adolescent and adult pwCF with varying disease severity in a home-based setting, and to examine the impact of exercise capacity, and total and different intensities of physical activity, on HRQoL. We hypothesize that there is a direct relationship between the amount and intensity of physical activity and HRQoL in pwCF.…”

“…Data comparing healthy individuals and pwCF in terms of total activity and time spent at different activity intensities are inconsistent. 4 One reason for this is the methodological quality of the studies, which used both subjective and objective methods to measure physical activity. 13 The advantage of subjective, self-reported methods such as questionnaires or activity logs is that they are nonburdensome for the individual, versatile, and cost-effective.…”