Table of Contents Author Guidelines Submit a Manuscript
International Journal of Pediatrics
Volume 2010, Article ID 670640, 7 pages
http://dx.doi.org/10.1155/2010/670640
Review Article

Exercise Training in Children and Adolescents with Cystic Fibrosis: Theory into Practice

1Children's Health and Exercise Research Centre, School of Sport and Health Sciences, University of Exeter, Exeter EX1 2LU, UK
2Division of Pulmonary Medicine, University Hospital Zurich, 8091 Zurich, Switzerland

Received 19 January 2010; Revised 31 May 2010; Accepted 23 August 2010

Academic Editor: Patricia A. Nixon

Copyright © 2010 Craig A. Williams et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. R. M. Malina, C. Bouchard, and O. Bar-Or, Growth, Maturation, and Physical Activity, Human Kinetics, Champaign, Ill, USA, 2nd edition, 2004.
  2. R. J. Shepard, Aerobic Fitness and Health, Human Kinetics, Leeds, UK, 1994.
  3. S. R. Boas, “Exercise recommendations for individuals with cystic fibrosis,” Sports Medicine, vol. 24, no. 1, pp. 17–37, 1997. View at Google Scholar · View at Scopus
  4. T. Radtke, D. Stevens, C. Benden, and C. A. Williams, “Clinical exercise testing in children and adolescents with cystic fibrosis,” Pediatric Physical Therapy, vol. 21, no. 3, pp. 275–281, 2009. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  5. M. Barker, A. Hebestreit, W. Gruber, and H. Hebestreit, “Exercise testing and training in German CF centers,” Pediatric Pulmonology, vol. 37, no. 4, pp. 351–355, 2004. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  6. D. Stevens, P. J. Oades, N. Armstrong, and C. A. Williams, “A survey of exercise testing and training in UK cystic fibrosis clinics,” Journal of Cystic Fibrosis. In press. View at Publisher · View at Google Scholar · View at PubMed
  7. W. Gruber, D. M. Orenstein, K. M. Braumann, and G. Hüls, “Health-related fitness and trainability in children with cystic fibrosis,” Pediatric Pulmonology, vol. 43, no. 10, pp. 953–964, 2008. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  8. H. Hebestreit, S. Kieser, S. Junge et al., “Long-term effects of a partially supervised conditioning programme in cystic fibrosis,” European Respiratory Journal, vol. 35, no. 3, pp. 578–583, 2010. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  9. P. H. Klijn, S. W. Terheggen-Lagro, C. K. Van der Ent, J. Van der Net, J. L. Kimpen, and P. J. Helders, “Anaerobic exercise in pediatric cystic fibrosis,” Pediatric Pulmonology, vol. 36, no. 3, pp. 223–229, 2003. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  10. A. J. Moorcroft, M. E. Dodd, J. Morris, and A. K. Webb, “Individualised unsupervised exercise training in adults with cystic fibrosis: a 1 year randomised controlled trial,” Thorax, vol. 59, no. 12, pp. 1074–1080, 2004. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  11. A. Turchetta, T. Salerno, V. Lucidi, F. Libera, R. Cutrera, and A. Bush, “Usefulness of a program of hospital-supervised physical training in patients with cystic fibrosis,” Pediatric Pulmonology, vol. 38, no. 2, pp. 115–118, 2004. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  12. K. Wassermann, J. E. Hansen, D. Y. Sue, R. Casaburi, and B. J. Whipp, Principles of Exercise Testing and Interpretation, Lippincott Williams & Wilkins, Philadelphia, Pa, USA, 3rd edition, 1999.
  13. J. Bradley and F. Moran, “Physical training for cystic fibrosis,” Cochrane Database of Systematic Reviews, no. 1, Article ID CD002768, 2008. View at Publisher · View at Google Scholar · View at PubMed
  14. D. L. Wilkes, J. E. Schneiderman, T. Nguyen et al., “Exercise and physical activity in children with cystic fibrosis,” Paediatric Respiratory Reviews, vol. 10, no. 3, pp. 105–109, 2009. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  15. M. I. Asher, R. L. Pardy, A. L. Coates, E. Thomas, and P. T. Macklem, “The effects of inspiratory muscle training in patients with cystic fibrosis,” American Review of Respiratory Disease, vol. 126, no. 5, pp. 855–859, 1982. View at Google Scholar · View at Scopus
  16. P. H. C. Klijn, A. Oudshoorn, C. K. Van Der Ent, J. Van Der Net, J. L. Kimpen, and P. J. M. Helders, “Effects of anaerobic training in children with cystic fibrosis: a randomized controlled study,” Chest, vol. 125, no. 4, pp. 1299–1305, 2004. View at Publisher · View at Google Scholar · View at Scopus
  17. L. Lannefors and P. Wollmer, “Mucus clearance with three chest physiotherapy regimes in cystic fibrosis: a comparison between postural drainage, PEP and physical exercise,” European Respiratory Journal, vol. 5, no. 6, pp. 748–753, 1992. View at Google Scholar · View at Scopus
  18. J. Schneiderman-Walker, S. L. Pollock, M. Corey et al., “A randomized controlled trial of a 3-year home exercise program in cystic fibrosis,” Journal of Pediatrics, vol. 136, no. 3, pp. 304–310, 2000. View at Google Scholar · View at Scopus
  19. H. C. Selvadurai, C. J. Blimkie, N. Meyers, C. M. Mellis, P. J. Cooper, and P. P. Van Asperen, “Randomized controlled study of in-hospital exercise training programs in children with cystic fibrosis,” Pediatric Pulmonology, vol. 33, no. 3, pp. 194–200, 2002. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  20. A. Hebestreit, U. Kersting, B. Basler, R. Jeschke, and H. Hebestreit, “Exercise inhibits epithelial sodium channels in patients with cystic fibrosis,” American Journal of Respiratory and Critical Care Medicine, vol. 164, no. 3, pp. 443–446, 2001. View at Google Scholar · View at Scopus
  21. A. J. Moorcroft, M. E. Dodd, and A. K. Webb, “Exercise testing and prognosis in adult cystic fibrosis,” Thorax, vol. 52, no. 3, pp. 291–293, 1997. View at Google Scholar · View at Scopus
  22. P. A. Nixon, D. M. Orenstein, S. F. Kelsey, and C. F. Doershuk, “The prognostic value of exercise testing in patients with cystic fibrosis,” New England Journal of Medicine, vol. 327, no. 25, pp. 1785–1788, 1992. View at Google Scholar · View at Scopus
  23. P. Pianosi, J. LeBlanc, and A. Almudevar, “Peak oxygen uptake and mortality in children with cystic fibrosis,” Thorax, vol. 60, no. 1, pp. 50–54, 2005. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  24. D. M. Orenstein, B. A. Franklin, C. F. Doershuk et al., “Exercise conditioning and cardiopulmonary fitness in cystic fibrosis. The effects of a three-month supervised running program,” Chest, vol. 80, no. 4, pp. 392–398, 1981. View at Google Scholar · View at Scopus
  25. D. M. Orenstein, M. F. Hovell, M. Mulvihill et al., “Strength vs aerobic training in children with cystic fibrosis: a randomized controlled trial,” Chest, vol. 126, no. 4, pp. 1204–1214, 2004. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  26. K. De Meer, V. A. M. Gulmans, and J. Van der Laag, “Peripheral muscle weakness and exercise capacity in children with cystic fibrosis,” American Journal of Respiratory and Critical Care Medicine, vol. 159, no. 3, pp. 748–754, 1999. View at Google Scholar · View at Scopus
  27. P. H. C. Klijn, J. Van Der Net, J. L. Kimpen, P. J. M. Helders, and C. K. Van Der Ent, “Longitudinal determinants of peak aerobic performance in children with cystic fibrosis,” Chest, vol. 124, no. 6, pp. 2215–2219, 2003. View at Publisher · View at Google Scholar · View at Scopus
  28. E. Pouliou, S. Nanas, A. Papamichalopoulos et al., “Prolonged oxygen kinetics during early recovery from maximal exercise in adult patients with cystic fibrosis,” Chest, vol. 119, no. 4, pp. 1073–1078, 2001. View at Publisher · View at Google Scholar · View at Scopus
  29. A. R. Shah, D. Gozal, and T. G. Keens, “Determinants of aerobic and anaerobic exercise performance in cystic fibrosis,” American Journal of Respiratory and Critical Care Medicine, vol. 157, no. 4, part 1, pp. 1145–1150, 1998. View at Google Scholar · View at Scopus
  30. K. De Meer, J. A. L. Jeneson, V. A. M. Gulmans, J. Van Der Laag, and R. Berger, “Efficiency of oxidative work performance of skeletal muscle in patients with cystic fibrosis,” Thorax, vol. 50, no. 9, pp. 980–983, 1995. View at Google Scholar · View at Scopus
  31. D. Stevens, P. J. Oades, N. Armstrong, and C. A. Williams, “Early oxygen uptake recovery following exercise testing in children with chronic chest diseases,” Pediatric Pulmonology, vol. 44, no. 5, pp. 480–488, 2009. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  32. H. Hebestreit, A. Hebestreit, A. Trusen, and R. L. Hughson, “Oxygen uptake kinetics are slowed in cystic fibrosis,” Medicine and Science in Sports and Exercise, vol. 37, no. 1, pp. 10–17, 2005. View at Publisher · View at Google Scholar · View at Scopus
  33. P. A. Nixon, D. M. Orenstein, and S. F. Kelsey, “Habitual physical activity in children and adolescents with cystic fibrosis,” Medicine and Science in Sports and Exercise, vol. 33, no. 1, pp. 30–35, 2001. View at Google Scholar · View at Scopus
  34. H. C. Selvadurai, C. J. Blimkie, P. J. Cooper, C. M. Mellis, and P. P. Van Asperen, “Gender differences in habitual activity in children with cystic fibrosis,” Archives of Disease in Childhood, vol. 89, no. 10, pp. 928–933, 2004. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  35. T. Hinkley, D. Crawford, J. Salmon, A. D. Okely, and K. Hesketh, “Preschool children and physical activity. A review of correlates,” American Journal of Preventive Medicine, vol. 34, no. 5, pp. 435–441, 2008. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  36. V. P. Lopes, C. M. S. Vasques, J. A. R. Maia, and J. C. V. Ferreira, “Habitual physical activity levels in childhood and adolescence assessed with accelerometry,” Journal of Sports Medicine and Physical Fitness, vol. 47, no. 2, pp. 217–222, 2007. View at Google Scholar · View at Scopus
  37. M. S. Zach, B. Purrer, and B. Oberwaldner, “Effect of swimming on forced expiration and sputum clearance in cystic fibrosis,” Lancet, vol. 2, no. 8257, pp. 1201–1203, 1981. View at Google Scholar · View at Scopus
  38. V. A. M. Gulmans, K. De Meer, H. J. L. Brackel, J. A. J. Faber, R. Berger, and P. J. M. Helders, “Outpatient exercise training in children with cystic fibrosis: physiological effects, perceived competence, and acceptability,” Pediatric Pulmonology, vol. 28, no. 1, pp. 39–46, 1999. View at Publisher · View at Google Scholar · View at Scopus
  39. S. R. Boas, M. J. Danduran, and S. A. McColley, “Energy metabolism during anaerobic exercise in children with cystic fibrosis and asthma,” Medicine and Science in Sports and Exercise, vol. 31, no. 9, pp. 1242–1249, 1999. View at Publisher · View at Google Scholar · View at Scopus
  40. M. E. Cabrera, M. D. Lough, C. F. Doershuk, and G. A. DeRivera, “Anaerobic performance assessed by the Wingate Test in patients with cystic fibrosis,” Pediatric Exercise Science, vol. 5, pp. 78–87, 1993. View at Google Scholar
  41. L. C. Lands, G. J. F. Heigenhauser, and N. L. Jones, “Analysis of factors limiting maximal exercise performance in cystic fibrosis,” Clinical Science, vol. 83, no. 4, pp. 391–397, 1992. View at Google Scholar · View at Scopus
  42. S. R. Boas, M. L. Joswiak, P. A. Nixon, J. A. Fulton, and D. M. Orenstein, “Factors limiting anaerobic performance in adolescent males with cystic fibrosis,” Medicine and Science in Sports and Exercise, vol. 28, no. 3, pp. 291–298, 1996. View at Publisher · View at Google Scholar · View at Scopus
  43. H. C. Selvadurai, K. O. Mckay, C. J. Blimkie, P. J. Cooper, C. M. Mellis, and P. P. Van Asperen, “The relationship between genotype and exercise tolerance in children with cystic fibrosis,” American Journal of Respiratory and Critical Care Medicine, vol. 165, no. 6, pp. 762–765, 2002. View at Google Scholar · View at Scopus
  44. C. Braggion, M. Cornacchia, A. Miano, F. Schena, G. Verlato, and G. Mastella, “Exercise tolerance and effects of training in young patients with cystic fibrosis and mild airway obstruction,” Pediatric Pulmonology, vol. 7, no. 3, pp. 145–152, 1989. View at Google Scholar · View at Scopus
  45. A. Barak, I. D. Wexler, O. Efrati et al., “Trampoline use as physiotherapy for cystic fibrosis patients,” Pediatric Pulmonology, vol. 39, no. 1, pp. 70–73, 2005. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  46. J. Curran and M. Mahony, “Trampolining as an adjunct to regular physiotherapy in children with cystic fibrosis,” Irish Medical Journal, vol. 101, no. 6, article 188, 2008. View at Google Scholar
  47. C. Hurson, K. Browne, O. Callender et al., “Pediatric trampoline injuries,” Journal of Pediatric Orthopaedics, vol. 27, no. 7, pp. 729–732, 2007. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  48. J. K. Stanghelle, N. Hjeltnes, H. J. Bangstad, and H. Michalsen, “Effect of daily short bouts of trampoline exercise during 8 weeks on the pulmonary function and the maximal oxygen uptake of children with cystic fibrosis,” International Journal of Sports Medicine, vol. 9, supplement 1, pp. 32–36, 1988. View at Google Scholar · View at Scopus
  49. O. Bar-Or and T. W. Rowland, Pediatric Exercise Medicine: From Physiological Principles to Health Care Application, Human Kinetics, Champaign, Ill, USA, 1st edition, 2004.
  50. O. Bar-Or, C. J. R. Blimkie, J. A. Hay, J. D. MacDougall, D. S. Ward, and W. M. Wilson, “Voluntary dehydration and heat intolerance in cystic fibrosis,” Lancet, vol. 339, no. 8795, pp. 696–699, 1992. View at Google Scholar · View at Scopus
  51. M. E. Speechly-Dick, S. J. Rimmer, and M. E. Hodson, “Exacerbations of cystic fibrosis after holidays at high altitude—a cautionary tale,” Respiratory Medicine, vol. 86, no. 1, pp. 55–56, 1992. View at Google Scholar · View at Scopus
  52. A. K. Webb and M. E. Dodd, “Exercise and sport in cystic fibrosis: benefits and risks,” British Journal of Sports Medicine, vol. 33, no. 2, pp. 77–78, 1999. View at Google Scholar · View at Scopus
  53. D. M. Orenstein, “Cystic fibrosis,” in Sports and Exercise for Children with Chronic Health Conditions, B. Goldberg, Ed., pp. 167–186, Human Kinetics, Champaign, Ill, USA, 1995. View at Google Scholar
  54. A. M. Ferrazza, D. Martolini, G. Valli, and P. Palange, “Cardiopulmonary exercise testing in the functional and prognostic evaluation of patients with pulmonary diseases,” Respiration, vol. 77, no. 1, pp. 3–17, 2009. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus
  55. P. Palange, S. A. Ward, K.-H. Carlsen et al., “Recommendations on the use of exercise testing in clinical practice,” European Respiratory Journal, vol. 29, no. 1, pp. 185–209, 2007. View at Publisher · View at Google Scholar · View at PubMed · View at Scopus