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Anaerobic exercise in pediatric cystic fibrosis
Peter H Klijn1, Suzanne W Terheggen-Lagro, Cornelis K Van Der Ent
1Department of Pediatric Physical Therapy, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. pklijn@heideheuvel.nl
Insights
Anaerobic fitness in children with cystic fibrosis (CF) depends on fat-free mass and lung function. Moderate CF patients showed better anaerobic performance than mild cases, suggesting disease progression may enhance it.
Area of Science:
- Pediatric exercise science
- Pulmonary rehabilitation
- Cystic Fibrosis research
Background:
- Anaerobic fitness is crucial for daily activities in children with cystic fibrosis (CF).
- Understanding the factors influencing anaerobic performance is key for targeted interventions.
- Previous research has not fully elucidated these determinants in pediatric CF populations.
Purpose of the Study:
- To identify the primary determinants of anaerobic exercise performance in children with CF.
- To investigate the relationship between body composition, muscle strength, aerobic capacity, and pulmonary function with anaerobic capacity.
- To compare anaerobic performance between children with mild and moderate CF.
Main Methods:
- Wingate anaerobic test administered to 39 children with CF (mean age 13.2 years).
- Assessment of peak power (PP) and mean power (MP).
- Analysis of associations with fat-free mass (FFM), body weight, BMI, maximal isometric muscle force, aerobic capacity, and pulmonary function (FEV(1)).
Main Results:
- Peak power and mean power were significantly associated with FFM, body weight, BMI, muscle force, and aerobic capacity.
- FFM and FEV(1) explained 82% and 86% of the variability in PP and MP, respectively.
- Children with moderate CF (FEV(1) < 80%) exhibited higher PP and MP than those with mild CF (FEV(1) >= 80%) at equivalent FFM.
Conclusions:
- Fat-free mass and pulmonary function are significant determinants of anaerobic performance in pediatric CF.
- Despite reduced lung function, anaerobic performance may be enhanced in children with more advanced CF, particularly when normalized for FFM.
- These findings highlight the complex interplay between body composition, lung health, and exercise capacity in CF.
Abstract:
Anaerobic fitness is important for daily functioning of children with cystic fibrosis (CF). The aim of this study was to assess the determinants of anaerobic performance in CF. Anaerobic performance was measured in 39 children with CF (mean age, 13.2 +/- 1.8 (SD) years, forced expired volume in 1 sec (FEV(1)) 81.6 +/- 22.1% predicted), using a Wingate anaerobic test. Significant associations were found for peak power (PP) and mean power (MP) with fat-free mass (FFM) body weight, body mass index, maximal isometric muscle force, and aerobic capacity. Pulmonary function was correlated with anaerobic indices when controlled for FFM. Multiple regression analysis indicated that FFM and FEV(1) accounted for 82% and 86% of the variability in PP and MP, respectively. Patients with moderate CF (FEV(1) < 80%), as compared to mild CF (FEV(1) >/= 80%), had higher PP (difference = 85 W, 95% CI = 27-144 W) and MP (difference = 53 W, 95% CI = 42-63 W) at equivalent FFM. Our results indicate that FFM and pulmonary function are important determinants of anaerobic exercise performance in children with CF. With progression of pulmonary disease, anaerobic performance may be enhanced.