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Assessing the Utility of an Outpatient Exercise Program for Children With Cystic Fibrosis: A Quality Improvement

Dionne Adair1, Ahmad Hider2, Amy G Filbrun1

  • 1Department of Pediatrics, Division of Pediatric Pulmonology, University of Michigan, Ann Arbor, MI, United States.

Frontiers in Pediatrics
|January 31, 2022
PubMed

Insights

Moderate physical activity, even if not high-intensity interval training (HIIT), significantly improved handgrip strength (HGS) and lung function (FEV1) in children with cystic fibrosis (CF). This highlights the importance of exercise for these patients.

Area of Science:

  • Pediatric Pulmonology
  • Exercise Physiology
  • Clinical Research

Background:

  • Children with cystic fibrosis (CF) often experience poor weight gain, failure to thrive, and muscle weakness, potentially due to disuse atrophy.
  • Handgrip strength (HGS) serves as a reliable indicator of muscle strength and lean body mass in this population.
  • Previous data indicated a correlation between low HGS and reduced forced expiratory volume in 1 second (FEV1) in children with CF.

Purpose of the Study:

  • To evaluate the feasibility and impact of a home-based high-intensity interval training (HIIT) program on improving physical strength in children with CF (cwCF).
  • Specifically, the study aimed to assess improvements in HGS, FEV1, and body mass index (BMI) percentile in cwCF with HGS at or below the 50th percentile.

Main Methods:

  • A home-based HIIT program was designed, with participants instructed to complete 3-5 sessions weekly.
  • Statistical analysis using Wilcoxon matched-pairs signed-rank tests compared baseline and follow-up measurements of HGS, FEV1, and BMI percentile.
  • Due to COVID-19 pandemic limitations, follow-up was restricted, and adherence to the prescribed HIIT protocol was assessed.

Main Results:

  • Adherence to the home HIIT regimen was low; however, 13 participants engaged in some form of moderate physical activity and were included in the final analysis.
  • A statistically significant increase in absolute grip strength (AGS) was observed in the participants who engaged in moderate activity.
  • Significant improvements in FEV1 were also noted in this subgroup, suggesting a positive impact on lung function.

Conclusions:

  • While the specific home HIIT protocol was not consistently followed, the study demonstrated that moderate physical activity can lead to significant improvements in HGS and overall physical strength in children with CF.
  • These findings underscore the importance of encouraging regular physical activity for managing muscle weakness and improving functional outcomes in pediatric CF patients.

Keywords:
CFFEV1exercisegrip strengthpediatrics-children

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