1. Assessment of Aerobic Fitness in Cystic Fibrosis and Asthmatic Children
Burns PD, Jamieson P, Buchan EJ, Paton JY, Royal Hospital for Sick Children, Glasgow
Methods
Results
Introduction
There was no significant difference between any of the groups in VO2peak (p>0.05)
The asthma group had a significantly lower FEV1 Z score than the SOBOE group (p<0.05). CF
Asthma
Airflow obstruction
SOBOE
? Ventilation limitation
Assessment at annual review
Identify reduced fitness
Part of formal workup
Strong indicator of prognosis
Confirm safety of exercise
A retrospective audit of lung function and CPET performed on asthma (n=41), CF (n=28) and unexplained SOBOE (n=18) patients.
Lung function was performed prior to exercise which was either a cycle ergometer ramp (n =73) or a STEEP treadmill protocol (n=5)
Results
Measurement
Asthma CF
SOBOE
Mean VO2peak % pred
104 ±28
108 ± 16
111 ±16
Mean VO2 ml.min-1.kg-1
41.9 ± 10.5
42.7 ± 7.2
44.9 ± 8.9
95% CI's VO2peak
95, 113
102, 114
96, 112
95% CI's VO2 ml.min-1.kg-1
38.7, 45.1
40.0, 45.4
40.8, 49.0
Mean FEV1 Z score
-0.92 ±1.61
-0.61 ±1.09
-0.02 ±0.93
95% CI's FEV1 Z score
-1.41, -0.43
-1.10, -0.12
-0.45, 0.41
Conclusions
The good fitness levels in our CF patients may reflect the fact they are encouraged to perform regular physiotherapy and exercise training as part of their treatment.
The lower fitness levels in some of our asthma patients indicates they may not be physically active enough. Once asthma is controlled they should be actively encouraged to exercise.
CF and Aerobic Fitness
Studies have shown that a higher VO2peak is significantly correlated with survival and lower risk of hospitalization in CF 1,2
Asthma and Aerobic Fitness
Many children with asthma have lower levels of fitness than controls and better fitness levels are associated with better asthma control. 3,4
Anxiety
about
exercise
Exercise
less
Detrained
Reduced
capacity
Breathless on
exertion
Lung Disease
Aims
To assess and compare the peak oxygen uptake ( VO2peak) in three groups of paediatric patients:- Cystic fibrosis, Asthma and referrals for CPET due to unexplained SOBOE
References
1. Nixon PA, Orenstein DM, Kelsey SF, Doershuk CF. The prognostic value of exercise testing in patients with cystic fibrosis. N. Engl. J. Med. 1992;327(25):1785–8
2. Perez M, Groeneveld IF, Santana-Sosa E, et al. Aerobic fitness is associated with lower risk of hospitalization in children with cystic fibrosis. Pediatr. Pulmonol. 2013
3. Villa F, Castro APBM, Pastorino AC, et al. Aerobic capacity and skeletal muscle function in children with asthma. Arch. Dis. Child. 2011;96:554–559
4. Fanelli A, Cabral ALB, Neder JA, Martins MA, Carvalho CRF. Exercise training on disease control and quality of life in asthmatic children. Med. Sci. Sports Exerc. 2007;39:1474–1480.