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 .
Effects of exercise training and montelukast in children with mild asthma.
PURPOSE Data from the general population suggest that habitual exercise decreases bronchial responsiveness , but the possible role of exercise in asthmatics is undefined . The leukotriene receptor antagonist montelukast decreases bronchial responsiveness and exercise-induced symptoms in asthmatic children . This r and omized study in children with mild asthma evaluated the combined effects of aerobic training for 12 wk and montelukast or placebo on bronchial responsiveness ( BHR ) to methacholine , exercise-induced bronchoconstriction ( EIB ) , inflammatory markers in exhaled breath condensate ( EBC ) , and asthma exacerbations . METHODS Fifty children ( mean age + /- SD : 10.2 + /- 2.4 yr ) with mild stable asthma were r and omly assigned to placebo ( N = 25 ) or montelukast ( N = 25 ) . Before and after training , we assessed BHR and EIB and markers of airway inflammation-that is , exhaled nitric oxide ( eNO ) , pH , and cysteinyl-leukotriene concentration-in EBC . RESULTS Training increased maximal workload and peak minute ventilation . After training , the methacholine dose causing a 20 % fall in FEV1 ( PD20 ) increased in both groups . A decreased slope of FEV1 decline at increasing methacholine dose was found only in montelukast-treated children . EIB prevalence halved after training in both groups ( EIB + children , placebo group : 10 pretraining , 4 posttraining ; EIB + children , montelukast group : 8 pretraining , 5 posttraining ; P < 0.05 by chi on all children ) . Resting eNO was unaffected , whereas the pH of EBC decreased after training in both groups . Cysteinyl-leukotriene concentrations were low in most children at both times . During training , montelukast-treated children showed fewer asthma exacerbations compared with the same period of the previous year . CONCLUSIONS In children with mild stable asthma , exercise training decreased bronchial responsiveness to methacholine . Montelukast also decreased bronchial reactivity ( FEV1 slope ) and protected against exacerbations , suggesting a beneficial synergistic action of these two interventions in mild asthma
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 .