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Physical activity levels, pulmonary function, and MRI in children born extremely preterm: A comparison between
Rhiana Roeper1,2, Henrietta Blinder3, Lamia Hayawi3
1Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Insights
Children born extremely preterm with bronchopulmonary dysplasia (BPD) have similar physical activity levels to peers. Lung function and MRI measures indicating airflow obstruction are linked to reduced physical activity in these children.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Exercise Physiology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease in preterm infants.
- Previous studies on physical activity in children with BPD history have yielded mixed results.
- Understanding physical activity in this population is crucial for long-term health outcomes.
Purpose of the Study:
- To compare physical activity levels in school-aged children born extremely preterm with and without a history of BPD.
- To investigate the association between physical activity and pulmonary health indicators, including MRI and PFT, in this cohort.
Main Methods:
- A multicentre cross-sectional study involving 7-9 year olds born extremely preterm.
- Physical activity assessed via pedometer and Physical Activity Questionnaire (PAQ).
- Pulmonary MRI and Pulmonary Function Tests (PFTs) were conducted; data analyzed using Spearman correlations and multivariable linear regression.
Main Results:
- No significant differences in physical activity levels were found between children with and without a history of BPD.
- Higher daily step counts and moderate-to-vigorous physical activity (MVPA) correlated with improved PFT (e.g., forced vital capacity) and lung MRI measures.
- Improved forced expiratory volume at 1 second (FEV1) was associated with increased daily steps and MVPA hours.
Conclusions:
- School-aged children born extremely preterm exhibit comparable physical activity levels irrespective of BPD history.
- Pulmonary MRI and PFT findings indicative of gas trapping or airflow obstruction are associated with diminished physical activity.
- These findings highlight the importance of monitoring lung health in relation to physical activity in extremely preterm survivors.
Introduction:
Children with a history of bronchopulmonary dysplasia (BPD) may have lower physical activity levels, but evidence to date is mixed. This study compared physical activity levels between children born extremely preterm with and without history of BPD, and examined their associations with pulmonary magnetic resonance imaging (MRI) and pulmonary function test (PFT) indices.
Methods:
This multicentre cross-sectional study included children aged 7-9 years born extremely preterm, with and without BPD. Children wore a pedometer for 1 week, then completed the Physical Activity Questionnaire (PAQ), pulmonary MRI, and PFT. Spearman correlations and multivariable linear regression modeling were performed.
Results:
Of 45 children, 28 had a history of moderate-severe BPD. There were no differences in any physical activity outcomes by BPD status. Higher average daily step count and higher average daily moderate-to-vigorous physical activity (MVPA) were each correlated with greater forced vital capacity (r = 0.41 and 0.58), greater MRI lung proton density at full expiration (r = 0.42 and 0.49), and lower lung clearance index (r = -0.50 and -0.41). After adjusting for MRI total proton density and BPD status, a 5% increase in forced expiratory volume at 1 s was associated with 738 (95% CI: 208, 1268) more steps per day and 0.1 (0.0, 0.2) more hours of MVPA, respectively.
Conclusion:
School-aged children born extremely preterm have similar physical activity levels to their peers, regardless of history of BPD. MRI and PFT measures suggestive of gas trapping and/or airflow obstruction are associated with lower physical activity levels.
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