Physical Activity and Exercise in Children with Respiratory Problems

Öz

Structuring regular physical activity and exercise in children with chronic respiratory disease is a subject that requires special attention, which varies according to the current disease and the child’s health and physical fitness. Cystic fibrosis and asthma groups are often included in the related literature. In both groups, exercise capacity is affected by different mechanisms, and the importance of physical activity and exercise is suggested. The present review covers the mechanisms affecting exercise capacity in children with respiratory problems, especially in cystic fibrosis and asthma, the importance of physical activity in these children and the current physical activity and exercise approaches specifically recommended for disease groups. It is important for clinicians to be aware of the physical fitness levels in children with respiratory problems and to direct them to regular physical activity programs.

Anahtar Kelimeler

• Children
• exercise
• physical activity
• respiratory problems

Solunum Problemi Olan Çocuklarda Fiziksel Aktivite ve Egzersiz

Öz

Kronik solunumsal hastalığa sahip çocuklarda düzenli fiziksel aktivite ve egzersizin yapılandırılması, mevcut hastalık ve çocuğun sağlık ve fiziksel uygunluk durumuna göre değişiklik gösteren, özel ilgi gerektiren bir konudur. İlgili literatürde sıklıkla kistik fibrozis ve astım grupları yer almaktadır. Her iki grupta da egzersiz kapasitesi farklı mekanizmalarla etkilenmekte ve fiziksel aktivite ve egzersizin önemi öne sürülmektedir. Bu derleme, kistik fibrozis ve astım başta olmak üzere solunumsal problemi olan çocuklarda egzersiz kapasitesini etkileyen mekanizmaları, fiziksel aktivitenin bu çocuklardaki önemini ve hastalık gruplarına özel olarak önerilen güncel fiziksel aktivite ve egzersiz yaklaşımlarını kapsamaktadır. Klinisyenlerin solunum problemi olan çocuklardaki fiziksel uygunluk düzeylerinin farkında olmaları ve çocukları düzenli fiziksel aktivite programlarına yönlendirmeleri önem taşımaktadır.

Anahtar Kelimeler

• çocuk
• fiziksel aktivite
• egzersiz
• solunumsal problemler

Kaynakça

1. Tremblay MS, Warburton DE, Janssen I, Paterson DH, Latimer AE, Rhodes RE, et al. New Canadian physical activity guidelines. Appl Physiol Nutr Metab. 2011;36(1):36–46 7-58.
2. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334–59.
3. World Health Organization. Global Recommendations on Physical Activity for Health. Geneva: World Health Organization; 2010.
4. West SL, Banks L, Schneiderman JE, Caterini JE, Stephens S, White G, et al. Physical activity for children with chronic disease; a narrative review and practical applications. BMC Pediatr. 2019 Jan 8;19(1):12.
5. Riner, WF, Sellhorst, SH. Physical activity and exercise in children with chronic health conditions. Journal of Sport and Health Science, 2013;2(1): 12-20.
6. Klijn PH, van der Net J, Kimpen JL, Helders PJ, van der Ent CK. Longitudinal determinants of peak aerobic performance in children with cystic fibrosis. Chest. 2003;124(6):2215–9.
7. Lands LC, Heigenhauser GJ, Jones NL. Analysis of factors limiting maximal exercise performance in cystic fibrosis. Clin Sci. 1992;83(4):391–7.
8. Coates AL, Boyce P, Muller D, Mearns M, Godfrey S. The role of nutritional status, airway obstruction, hypoxia, and abnormalities in serum lipid composition in limiting exercise tolerance in children with cystic fibrosis. Acta Paediatr Scand. 1980;69(3):353–8.

9. Marcotte JE, Canny GJ, Grisdale R, Desmond K, Corey M, Zinman R, et al. Effects of nutritional status on exercise performance in advanced cystic fibrosis. Chest. 1986;90(3):375–9.
10. Godfrey S, Mearns M. Pulmonary function and response to exercise in cystic fibrosis. Arch Dis Child. 1971;46(246):144–51.
11. Moorcroft AJ, Dodd ME, Morris J, Webb AK. Symptoms, lactate and exercise limitation at peak cycle ergometry in adults with cystic fibrosis. Eur Respir J. 2005;25(6):1050–6.
12. Regnis JA, Donnelly PM, Robinson M, Alison JA, Bye PT. Ventilatory mechanics at rest and during exercise in patients with cystic fibrosis. Am J Respir Crit Care Med. 1996;154(5):1418–25.
13. Hull JH, Ansley L, Bolton CE, Sharman JE, Knight RK, Cockcroft JR, et al. The effect of exercise on large artery haemodynamics in cystic fibrosis. J Cyst Fibros. 2011;10(2):121–7.
14. Poore S, Berry B, Eidson D, McKie KT, Harris RA. Evidence of vascular endothelial dysfunction in young patients with cystic fibrosis. Chest. 2013;143(4):939–45.
15. Bano-Rodrigo A, Salcedo-Posadas A, Villa-Asensi JR, Tamariz-Martel A, Lopez-Neyra A, Blanco-Iglesias E. Right ventricular dysfunction in adolescents with mild cystic fibrosis. J Cyst Fibros. 2012;11(4):274–80.
16. Ionescu AA, Payne N, Obieta-Fresnedo I, Fraser AG, Shale DJ. Subclinical right ventricular dysfunction in cystic fibrosis. A study using tissue Doppler echocardiography. Am J Respir Crit Care Med. 2001;163(5):1212–8.
17. Wells GD, Wilkes DL, Schneiderman JE, Rayner T, Elmi M, Selvadurai H, et al. Skeletal muscle metabolism in cystic fibrosis and primary ciliary dyskinesia. Pediatr Res. 2011;69(1):40–5.
18. Dufresne V, Knoop C, Van Muylem A, Malfroot A, Lamotte M, Opdekamp C, et al. Effect of systemic inflammation on inspiratory and limb muscle strength and bulk in cystic fibrosis. Am J Respir Crit Care Med. 2009;180(2):153–8.
19. Pinet C, Cassart M, Scillia P, Lamotte M, Knoop C, Casimir G, et al. Function and bulk of respiratory and limb muscles in patients with cystic fibrosis. Am J Respir Crit Care Med. 2003;168(8):989–94.
20. Gulmans VA, de Meer K, Brackel HJ, Faber JA, Berger R, Helders PJ. Outpatient exercise training in children with cystic fibrosis: physiological effects, perceived competence, and acceptability. Pediatr Pulmonol. 1999;28(1):39–46.
21. Turchetta A, Salerno T, Lucidi V, Libera F, Cutrera R, Bush A. Usefulness of a program of hospital-supervised physical training in patients with cystic fibrosis. Pediatr Pulmonol. 2004;38(2):115–8.
22. Orenstein DM, Hovell MF, Mulvihill M, Keating KK, Hofstetter CR, Kelsey S, et al. Strength vs aerobic training in children with cystic fibrosis: a randomized controlled trial. Chest. 2004;126(4):1204–14.
23. Selvadurai HC, Blimkie CJ, Meyers N, Mellis CM, Cooper PJ, Van Asperen PP. Randomized controlled study of in-hospital exercise training programs in children with cystic fibrosis. Pediatr Pulmonol. 2002;33(3):194–200.
24. Klijn PH, Oudshoorn A, van der Ent CK, van der Net J, Kimpen JL, Helders PJ. Effects of anaerobic training in children with cystic fibrosis: a randomized controlled study. Chest. 2004;125(4):1299–305.
25. Barak A, Wexler ID, Efrati O, Bentur L, Augarten A, Mussaffi H, et al. Trampoline use as physiotherapy for cystic fibrosis patients. Pediatr Pulmonol. 2005;39(1):70–3.
26. Oldenburg FA Jr, Dolovich MB, Montgomery JM, Newhouse MT. Effects of postural drainage, exercise, and cough on mucus clearance in chronic bronchitis. Am Rev Respir Dis. 1979;120(4):739–45.
27. Zach MS, Purrer B, Oberwaldner B. Effect of swimming on forced expiration and sputum clearance in cystic fibrosis. Lancet. 1981;2(8257):1201–3.
28. Santana Sosa E, Groeneveld IF, Gonzalez-Saiz L, Lopez-Mojares LM, Villa- Asensi JR, Barrio Gonzalez MI, et al. Intrahospital weight and aerobic training in children with cystic fibrosis: a randomized controlled trial. Med Sci Sports Exerc. 2012;44(1):2–11.
29. Santana-Sosa E, Gonzalez-Saiz L, Groeneveld IF, Villa-Asensi JR, Barrio Gomez de Aguero MI, Fleck SJ, et al. Benefits of combining inspiratory muscle with ‘whole muscle’ training in children with cystic fibrosis: a randomised controlled trial. Br J Sports Med. 2014;48(20):1513–7.
30. Schneiderman-Walker J, Pollock SL, Corey M, Wilkes DD, Canny GJ, Pedder L, et al. A randomized controlled trial of a 3-year home exercise program in cystic fibrosis. J Pediatr. 2000;136(3):304–10.
31. Hebestreit H, Arets HG, Aurora P, Boas S, Cerny F, Hulzebos EH, et al. Statement on exercise testing in cystic fibrosis. Respiration. 2015;90(4):332–51
32. Bar-Or O, Blimkie CJ, Hay JA, MacDougall JD, Ward DS, Wilson WM. Voluntary dehydration and heat intolerance in cystic fibrosis. Lancet. 1992; 339(8795):696–9.
33. Orenstein DM, Henke KG, Costill DL, Doershuk CF, Lemon PJ, Stern RC. Exercise and heat stress in cystic fibrosis patients. Pediatr Res. 1983;17(4):267–9.
34. Durstine JL, American College of Sports Medicine. ACSM’s exercise management for persons with chronic diseases and disabilities. In: Human Kinetics, vol. xv. 3rd ed. Champaign: American College of Sports Medicine; 2009. p. 440.
35. van Doorn N. Exercise programs for children with cystic fibrosis: a systematic review of randomized controlled trials. Disabil Rehabil. 2010;32(1):41–9.
36. Swisher AK, Hebestreit H, Mejia-Downs A, Lowman JD, Bruber W, Nippins M, Alison J, Schneiderman J. Exercise and habitual physical activity for people with cystic fibrosis: Expert-consensus, evidence-based guide for advising patients. Cardiopulm Phys Ther J. 2015;26(4):85–98.
37. Radtke T, Nevitt SJ, Hbestreit H, Kreimler S. Physical exercise training for cyctic fibrozis. Cochrane Database of Systematic Reviews 2017, Issue 11. Art. No.:CD002768.
38. Eijkemans M, Mommers M, Draaisma JM, Thijs C, Prins MH. Physical activity and asthma: a systematic review and meta‐analysis. PLOS One. 2012;7(12):e50775.
39. Lochte L, Nielsen KG, Petersen PE, Platts Mills TA. Childhood asthma and physical activity: a systematic review with meta analysis and graphic appraisal tool for epidemiology assessment. BMC Pediatr. 2016;16:50.
40. Eijkemans M, Mommers M, Remmers T, Draaisma JMT, Prins MH, Thijs C. Physical activity and asthma development in childhood: Prospective birth cohort study. Pediatr Pulmonol. 2020 Jan;55(1):76-82.
41. Wilkerson LA. Exercise-induced asthma. J AmOsteopath Assoc. 1998;98(4):211–5.
42. Kippelen P, Anderson SD. Pathogenesis of exercise-induced bronchoconstriction. Immunol Allergy Clin N Am. 2013;33(3):299–312 vii.
43. Parsons JP, Hallstrand TS, Mastronarde JG, Kaminsky DA, Rundell KW, Hull JH, et al. An official American Thoracic Society clinical practice guideline: exercise-induced bronchoconstriction. Am J Respir Crit Care Med. 2013;187(9):1016–27.
44. Stickland MK, Rowe BH, Spooner CH, Vandermeer B, Dryden DM. Effect of warm-up exercise on exercise-induced bronchoconstriction. Med Sci Sports Exerc. 2012;44(3):383–91.
45. Driessen JM, van der Palen J, van Aalderen WM, de Jongh FH, Thio BJ. Inspiratory airflow limitation after exercise challenge in cold air in asthmatic children. Respir Med. 2012;106(10):1362–8.
46. Cassim R, Koplin JJ, Dharmage SC, Senaratna BC, Lodge CJ, Lowe AJ, Russell MA. The difference in amount of physical activity performed by children with and without asthma: A systematic review and metaanalysis. J Asthma. 2016;53(9):882–92.
47. Vahlkvist S, Pedersen S. Fitness, daily activity and body composition in children with newly diagnosed, untreated asthma. Allergy. 2009;64(11):1649–55.
48. Lu KD, Manoukian K, Radom-Aizik S, Cooper DM, Galant SP. Obesity, Asthma, and Exercise in Child and Adolescent Health. Pediatr Exerc Sci. 2015;28(2):264–74.
49. Welsh L, Kemp JG, Roberts RG. Effects of physical conditioning on *children and adolescents with asthma. Sports Med. 2005;35(2):127–41.
50. Neder JA, Nery LE, Silva AC, Cabral AL, Fernandes AL. Short-term effects of aerobic training in the clinical management of moderate to severe asthma in children. Thorax. 1999;54(3):202–6.
51. Bonsignore MR, La Grutta S, Cibella F, Scichilone N, Cuttitta G, Interrante A, et al. Effects of exercise training and montelukast in children with mild asthma. Med Sci Sports Exerc. 2008;40(3):405–12.
52. Fanelli A, Cabral AL, Neder JA, Martins MA, Carvalho CR. Exercise training on disease control and quality of life in asthmatic children. Med Sci Sports Exerc. 2007;39(9):1474–80.
53. Basaran S, Guler-Uysal F, Ergen N, Seydaoglu G, Bingol-Karakoc G, Ufuk AD. Effects of physical exercise on quality of life, exercise capacity and pulmonary function in children with asthma. J Rehabil Med. 2006;38(2):130–5.
54. Ram FS, Robinson SM, Black PN. Effects of physical training in asthma: a systematic review. Br J Sports Med. 2000;34(3):162–7.