1. Clinical application 1.Dx exercise intolerance 1.1  VO 2 max   VO 2 AT 1.2 RER >1.2 (HRmax is not achieved) 1.3  breathing reserve < 20% (N=20-40%) 1.4  SaO 2 1.5 V E /VO 2 (ventilatory equivalent for oxygen) > 40 2.Dx exercise-induced bronchospasm (EIB) 3.Aerobic fitness evaluation

2. Research study Optimal level of physical activity in children and adolescent with chronic lung disease

3. Objectives To study the optimal level of physical activity in children and adolescents with CLD

4. Normal (n=18)CLD (n=18) Hx & PE PFT - Spirometry - Lung volumes - DLco Exercise stress test VO 2 at AT  correlate with physical activity Experimental design

5. Results - Chronic interstitial lung1 - Post lobectomy5 - Pulmonary hemosiderosis1 - Fibrotic lung3 - BPD2 - Asthma moderate persistent6 Chronic lung diseases:

6. Abnormal PFT Obstructive lung7 (FEV 1 80.0 + 12.9%pred) Restrictive lung7 (TLC 63.7 + 12.5%pred) Diffusion defect1 (DLco/VA = 77 %pred) Hyperinflation9 (RV/TLC 38.9 + 6.5%pred)

7. CLD (n = 18) Control (n = 18) P FVC 77.3 + 22.697.9 + 12.5 0.002 FEV 1 74.3 + 17.6104.0 + 12.6 < 0.001 FEV 1 /FVC 83.4 + 12.790.1 + 3.8 0.047 FEF 25-75% 49.9 + 23.175.6 + 18.6 0.001 TLC 82.8 + 18.695.6 + 9.8 0.015 RV/TLC 30.8 + 10.224.4 + 5.9 0.027 DLco/VA 113.2 + 27.3109.1 + 30.3 0.671