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 .
Symptoms, lactate and exercise limitation at peak cycle ergometry in adults with cystic fibrosis
The purpose of this study was to investigate symptoms , lactate accumulation and limiting factors at peak exercise in cystic fibrosis ( CF ) patients . In total , 104 CF adults attending an adult CF centre and 27 controls performed progressive cycle ergometry to a symptom-limited maximum . Measurements taken at peak exercise included : heart rate , ventilation , oxygen uptake , carbon dioxide output , oxygen saturation and blood lactate . Symptom scores of perceived breathlessness and muscle effort were recorded using Borg scales . The CF subjects had a lower mean body mass index , forced expiratory volume in one second ( FEV1 ) and peak oxygen uptake than controls . Peak lactate concentrations were very similar to controls ( mean±sd 6.8±2.0 mmol·L−1 versus 7.4±1.0 mmol·L−1 ) . Symptom scores were no different to controls for either breathlessness ( 4.5±2.0 versus 4.3±1.0 ) or perceived muscle effort ( 6.1±2.0 versus 6.5±1.0 ) , with higher scores for muscle effort than breathlessness in both groups . In addition , peak ventilation was lower than the predicted maximum , and high peak heart rates were recorded supporting nonpulmonary factors as important in limiting peak exercise . Peak oxygen uptake was correlated with FEV1 . Comparison of CF subjects with mild or moderate pulmonary disease and controls revealed similar exercise responses . In contrast , those CF patients with severe lung disease ( FEV1 < 40 % predicted ) had significantly higher breathlessness , lower muscle effort scores , lower peak lactate , lower peak heart rate and a mean ventilation exceeding predicted , thus confirming that ventilation was the major factor limiting exercise . In conclusion , cystic fibrosis subjects have a reduced peak exercise capacity , but their exercise response is similar to controls in generating high blood-lactate concentrations and symptoms of muscle effort in excess of dyspnoea . Nonpulmonary factors influence peak performance more in those without severe disease
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 .