Results Overall , exercise intolerance is prevalent in pediatric chronic disease .
Background Physical activity ( PA ) is associated with a diverse range of health benefits .
International guidelines suggest that children should be participating in a minimum of 60 min of moderate to vigorous intensity PA per day to achieve these benefits .
However , current guidelines are intended for healthy children , and thus may not be applicable to children with a chronic disease .
Specifically , the dose of PA and disease specific exercise considerations are not included in these guidelines , leaving such children with few , if any , evidence -based informed suggestions pertaining to PA .
Thus , the purpose of this narrative review was to consider current literature in the area of exercise as medicine and provide practical applications for exercise in five prevalent pediatric chronic diseases : respiratory , congenital heart , metabolic , systemic inflammatory/autoimmune , and cancer .
Voluntary dehydration and heat intolerance in cystic fibrosis
Although exercise may be beneficial in cystic fibrosis ( CF ) , patients ' low tolerance to climatic heat stress means that physical exertion can increase morbidity and mortality . We postulated that the high salt content of CF patients ' sweat and the consequent absence of body-fluid hyperosmolality during a long episode of sweating might deprive such patients of a thirst stimulus . Eight children with CF ( four boys , four girls ; aged 9.5 - 14.1 years ) and eight controls , matched for age and sex , attended two r and omly ordered sessions of exercise ( cycling ) in a chamber at 31 - 33 degrees C , relative humidity 43 - 47 % . 20 min bouts of exercise ( at 45 % of predetermined maximum oxygen uptake ) were interspersed with 25 min rest periods . At one session , chilled water was given every 15 - 20 min to replace fluid lost ; at the other , drinking was guided by the child 's thirst . At the thirst-guided session , CF patients drank much less than the controls did ( 0.80 % vs 1.73 % initial body weight ) and lost twice as much fluid ( 1.57 % vs 0.78 % initial body weight ) . The recovery of heart rate after exercise was slower in CF patients , but there were no other signs of heat strain . The groups did not differ in any variable during the forced drinking session . We conclude that children with CF underestimate their fluid needs and undergo excessive dehydration during extended exposure to hot conditions
Results Overall , exercise intolerance is prevalent in pediatric chronic disease .
Background Physical activity ( PA ) is associated with a diverse range of health benefits .
International guidelines suggest that children should be participating in a minimum of 60 min of moderate to vigorous intensity PA per day to achieve these benefits .
However , current guidelines are intended for healthy children , and thus may not be applicable to children with a chronic disease .
Specifically , the dose of PA and disease specific exercise considerations are not included in these guidelines , leaving such children with few , if any , evidence -based informed suggestions pertaining to PA .
Thus , the purpose of this narrative review was to consider current literature in the area of exercise as medicine and provide practical applications for exercise in five prevalent pediatric chronic diseases : respiratory , congenital heart , metabolic , systemic inflammatory/autoimmune , and cancer .