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 .
Cardiovascular disease risk factors and blood pressure response during exercise in healthy children and adolescents: the European Youth Heart Study.
Raised blood pressure ( BP ) response during exercise independently predicts future hypertension . Subjects with higher BP in childhood also have elevated BP later in life . Therefore , the factors related to the regulation of exercise BP in children needs to be well understood . We hypothesized that physiological cardiovascular disease ( CVD ) risk factors would influence BP response during exercise in children and adolescents . This is a cross-sectional study of 439 Danish third- grade children and 364 ninth- grade adolescents .  Systolic blood pressure ( SBP ) was measured with sphygmomanometer during a maximal aerobic fitness test . Examined CVD risk factors were high-density lipoprotein (HDL)- and low-density lipoprotein (LDL)-cholesterol , triglyceride , homeostasis model of assessment of insulin resistance ( HOMA-IR ) score , body mass index ( BMI ) , waist circumference , and aerobic fitness . A r and om effect model was used to test the hypotheses . In boys  , HOMA-IR score and BMI were positively related to SBP response during exercise ( β = 1.03 , P = 0.001 , and β = 0.58 , P = 0.017 , respectively ) . The effects sizes of HOMA-IR score and BMI and the significance levels only changed slightly ( β = 0.91 , P = 0.004 , and β = 0.43 , P = 0.08 , respectively ) when the two variables were added in the same model . A significant positive association was observed between aerobic fitness and SBP response in girls ( β = 3.13 and P = 0.002 ) . HOMA-IR score and BMI were found to be positively related to the SBP response in male children and youth . At least partly , adiposity and insulin sensitivity seem to influence exercise SBP through different mechanisms . The positive relationship observed between aerobic fitness and SBP response in girls remains unexplainable for us , although post hoc analyses revealed that it was the case in the ninth grade rs only
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 .