Exercise testing in a paediatric chronic pain cohort - A cross-sectional observation study

The utility of exercise testing in an interdisciplinary paediatric chronic pain assessment is unknown. The aims of this study were to explore exercise testing results in a paediatric chronic pain cohort and associations with baseline patient-reported outcome measures (PROMs), including various measures of pain experience and functioning.

There were 153 participants, aged 6-17 years, attending the Sydney Children's Hospital Interdisciplinary Chronic and Complex Pain Clinic with data analysed retrospectively. Exercise tests included the six-minute walk test (6MWT), plank, prone extension and pushups. Results were described and stratified by age, and Spearmen correlation coefficients (r _s) were determined between baseline exercise testing results and PROMs, and between different exercise tests.

The 6MWT distances were greater in the younger subgroup, however, there were no other differences in exercise tests between age groups. Associations between baseline exercise testing results and baseline PROMs ranged from very weak to moderate (r _s's = .18-.40). Associations between different exercise testing results ranged from very weak to moderate (r _s's = .17-.52). The 6MWT, plank and pushups each had at least five weak to moderate associations with PROMs and the prone extension test had one weak association.

Exercise testing results in a paediatric chronic pain cohort are presented, including with age stratification. The results of the current study suggest that exercise testing provides unique information to supplement other forms of assessment. There is a need for standardised exercise protocols with normative datasets, so that clinical and research findings are more comparable across settings.