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 .
Wingate test performance in children with asthma: aerobic or anaerobic limitation?
To investigate the anaerobic capacity in children with bronchial asthma , eight male children with atopic asthma ( age : 12 + /- 1.7 yr ) and seven healthy control subjects ( age : 12 + /- 1 yr ) performed a 30-s all-out exercise test : the Wingate anaerobic test ( WanT ) .  Post-exercise plasma epinephrine ( E ) , norepinephrine ( NE ) , venous blood lactate ( La ) , and blood pH levels were determined . Peak power ( Ppeak ) , mean power ( Pm ) , and total energy expenditure ( Wtot ) during the WanT were assessed . The relative importance of aerobic ( WO2 ) and anaerobic ( Wana ) energy release during the WanT was also evaluated . In comparison with control subjects , the children with asthma exhibited lower Ppeak ( W.kg-1 ) : 6 + /- 1.14 vs 7.3 + /- 0.5 , P < 0.05 ; lower Pm ( W.kg-1 ) : 4.7 + /- 0.8 vs 5.9 + /- 0.5 , P < 0.05 ; and lower Wtot ( Jg-1 ) : 140.3 + /- 25 vs 176.9 + /- 19 , P < 0.05 . The relative contribution of WO2 ( 26 % ) and Wana ( 74 % ) to the Wtot was identical in both groups . Blood lactate and pH kinetics revealed significantly lower La values and less acidosis in the asthmatic group ( P < 0.001 ) . Lastly , E ( pg.ml-1 ) concentrations were lower in the asthmatic group : 274.96 + /- 84.58 vs 901.28 + /- 604.76 , P < 0.05 . These results suggest a reduced anaerobic capacity in children with asthma . A diminished adrenergic response to exhausting exercise , leading to a decreased anaerobic glycolysis , could partly account for this phenomenon
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 .