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Longitudinal determinants of peak aerobic performance in children with cystic fibrosis

Peter H C Klijn1, Janjaap van der Net, Jan L Kimpen

  • 1Departments of Pediatric Physical Therapy, Wilhelmina Children's Hospital, University Medical Center Utrecht, 3508 AB Utrecht, The Netherlands.

Chest
|December 11, 2003
PubMed

Insights

In children with cystic fibrosis (CF), changes in lung function and nutritional status longitudinally impact peak aerobic capacity (peak oxygen uptake). Exercise and nutrition interventions may improve long-term outcomes.

Area of Science:

  • Pediatric Pulmonology
  • Exercise Physiology
  • Nutritional Science

Background:

  • Cross-sectional studies link nutritional status and lung function to peak aerobic capacity in cystic fibrosis (CF).
  • Longitudinal relationships between these factors in pediatric CF populations require further investigation.

Purpose of the Study:

  • To determine the longitudinal relationship between changes in nutritional status, lung function, and peak aerobic capacity (peak oxygen uptake [O(2)peak]) in children with CF.
  • To identify key predictors of changes in O(2)peak over a two-year period.

Main Methods:

  • Assessed fat-free mass (FFM), lung function (FEV(1)), and O(2)peak in 65 children with CF at baseline and after 2 years.
  • Utilized skinfold thickness for FFM calculation and age-appropriate incremental exercise testing for O(2)peak.
  • Measured lung function prior to exercise testing.

Main Results:

  • Observed significant increases in absolute FFM, FEV(1), and O(2)peak over two years.
  • Noted decreases in predicted FEV(1) and O(2)peak values.
  • Change in O(2)peak correlated most strongly with change in FEV(1) (r=0.619) and secondarily with change in FFM (r=0.506).
  • FEV(1) and FFM changes explained 47% of the variation in O(2)peak changes.

Conclusions:

  • Longitudinal changes in peak oxygen uptake in children with CF are associated with concurrent changes in lung function and, to a lesser extent, nutritional status.
  • Exercise training and nutritional interventions are recommended to potentially enhance long-term clinical outcomes in pediatric CF patients.
Abstract

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