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Practices and Procedures in Clinical Pediatric Exercise Laboratories in North America
Kelli M Teson1,2, Jessica S Watson1, Wayne A Mays3
1Pediatric Physical Activity and Cardiac Exercise Science Program, Ward Family Heart Center, Children's Mercy Kansas City, Kansas City, MO,USA.
Insights
Clinical pediatric exercise laboratories (CPELs) show significant practice variations. CPELs employing exercise physiologists report higher exercise stress testing volumes and research participation, suggesting a need for standardization.
Area of Science:
- Pediatric Exercise Physiology
- Clinical Research Methodology
- Healthcare Operations
Background:
- Interinstitutional differences in clinical pediatric exercise laboratory (CPEL) practices can impact patient care.
- Variations in CPEL practices may affect the efficacy and comparability of multicenter research studies.
Purpose of the Study:
- To delineate current practices and procedures within North American CPELs.
- To investigate differences in CPEL operations based on the employment of exercise physiologists.
Main Methods:
- A survey with 40 items was administered to CPELs across North America.
- The survey focused on staffing, exercise stress testing (EST) volumes, reporting, interpretation, and protocols.
Main Results:
- Exercise physiologists were employed in 56% of surveyed CPELs, with most holding advanced degrees.
- CPELs with exercise physiologists demonstrated higher EST volumes, greater likelihood of performing metabolic ESTs, increased research involvement, and broader service offerings.
Conclusions:
- Significant heterogeneity exists in the staffing and operational practices of CPELs.
- Standardization of CPEL practices is warranted to improve consistency in patient care and research.
Abstract:
Interinstitutional differences in clinical pediatric exercise laboratory (CPEL) practices may affect patient care and efficacy of multicenter research.
Purpose:
To describe current practices/procedures in CPELs and explore differences in CPELs employing exercise physiologists to those that do not.
Methods:
A 40-item survey was distributed to CPELs in North America focusing on (1) staffing; (2) exercise stress testing (EST) volumes, reporting, and interpretation; and (3) EST procedures/protocols.
Results:
Of the 55 responses, 89% were in the United States, 85% were children's hospitals with university affiliation, and 58% were cardiology specific. Exercise physiologists were employed in 56% of CPELs, and 78% had master's degrees or higher. Certifications were required in most CPELs (92% emergency life-support, 27% professional, and 21% clinical). Median volume was 201 to 400 ESTs per year, 80% used treadmill, and 10% used cycle ergometer as primary modalities. Ninety-three percent of CPELs offered metabolic ESTs, 87% offered pulmonary function testing, 20% used institution-specific EST protocols, and 72% offered additional services such as cardiac/pulmonary rehabilitation. CPELS staffing exercise physiologists performed higher volumes of ESTs (P = .004), were more likely to perform metabolic ESTs (P = .028), participated in more research (P < .001), and provided services in addition to ESTs (P = .001).
Conclusions:
Heterogeneity in CPELs staffing and operation indicates need for standardization.
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Related Concept Videos
01:26Exercise Stress Test
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
01:27Exercise and Muscle Performance
Endurance exercises
Endurance exercises involve running, swimming, or cycling, which require repetitive movements with low force output. When a person engages in endurance exercise, a few noticeable changes occur in their skeletal muscles. For instance, the number of capillaries...