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Published on: August 24, 2019
Optimal level of physical activity in children with chronic lung diseases
Suchada Sritippayawan1, Chanthana Harnruthakorn, Jitladda Deerojanawong
1Division of Pulmonology and Critical Care, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. suchadacu@hotmail.com
Insights
Children with chronic lung disease (CLD) maintain optimal physical activity levels comparable to healthy peers. Disease severity did not impact this optimal activity, but exceeding anaerobic threshold during exercise is not recommended for CLD patients.
Area of Science:
- Pediatric Pulmonology
- Exercise Physiology
- Chronic Lung Disease Research
Background:
- Children with chronic lung diseases (CLD) often face limitations in physical activity.
- Understanding the relationship between physical activity and disease severity is crucial for managing CLD in pediatric populations.
Purpose of the Study:
- To determine the optimal level of physical activity in children with CLD.
- To investigate the relationship between physical activity and the severity of chronic lung diseases in children.
Main Methods:
- Compared pulmonary function and exercise test results between 18 children with CLD and 18 healthy controls.
- Assessed lung function parameters including forced vital capacity (FVC) and total lung capacity (TLC).
- Evaluated exercise performance by measuring oxygen consumption at anaerobic threshold (AT) and metabolic equivalents (METs).
Main Results:
- Children with CLD exhibited significantly lower lung function (FVC, FEV1, FEF25-75%, TLC) and a higher residual volume (RV)/TLC ratio compared to controls.
- The optimal level of physical activity, indicated by oxygen consumption at AT and METs, was similar between CLD children and healthy controls.
- CLD children showed poorer exercise performance beyond the anaerobic threshold compared to controls, irrespective of disease severity.
Conclusions:
- Children with CLD can achieve an optimal level of physical activity comparable to healthy children, despite reduced lung function.
- The optimal physical activity level in these children is not correlated with the severity of their chronic lung disease.
- Exercise testing and prolonged exercise beyond the anaerobic threshold should be approached cautiously in children with CLD, with proper testing to determine safe activity levels.
Aim:
To determine the optimal level of physical activity and its relationship with disease severity in children with chronic lung diseases (CLD).
Methods:
Pulmonary function and exercise tests were compared between 18 CLD children (aged 13.5 +/- 2.4 years, 33% male) and 18 healthy controls without any history of lung diseases (age and sex matched).
Results:
CLD children had lower forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV)(1), forced expiratory flow rate between 25% and 75% of vital capacity (FEF)(25-75%) and total lung capacity (TLC) and higher residual volume (RV)/TLC ratio than controls (77.3 +/- 22.6 vs. 97.9 +/- 12.5%pred; p = 0.002, 74.3 +/- 17.6 vs. 104.0 +/- 12.6%pred; p < 0.001, 49.9 +/- 23.1 vs. 75.6 +/- 18.6%pred; p < 0.001, 82.8 +/- 18.6 vs. 95.6 +/- 9.8%pred; p = 0.04, 30.8 +/- 10.2 vs. 24.4 +/- 5.9%; p = 0.04, respectively). Oxygen consumption at anaerobic threshold (AT) and optimal level of physical activity (metabolic equivalents [METs] at AT) were not different between the two groups and between mild and moderate to severe CLD. However, when the exercise was continued beyond the AT, CLD children demonstrated poorer exercise performance than normal controls.
Conclusion:
Children with CLD demonstrated the same level of optimal physical activity as normal children despite their lower lung function. The optimal level of physical activity was not related to disease severity. The exercise test and exercise should not be performed beyond the AT by the CLD children. Proper exercise test should be done to determine their optimal exercise activity.
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