Effects of an Educational Intervention of Physical Activity for Children and Adolescents With Cystic Fibrosis: A Randomized Controlled Trial Evidence for physiotherapy practice: a survey of the Physiotherapy Evidence Database (PEDro). Dynamics of obesity and chronic health conditions among children and youth. Long-term effects of a partially supervised conditioning programme in cystic fibrosis The efficacy of aerobic training in improving the inflammatory component of asthmatic children. Randomized trial. The effectiveness of an indoor intermittent training program for improving lung function, physical capacity, body composition and quality of life in children with asthma Effects of swimming on spirometric parameters and bronchial hyperresponsiveness in children and adolescents with moderate persistent atopic asthma. Effects of anaerobic training in children with cystic fibrosis: a randomized controlled study. Relative effects of bronchial drainage and exercise for in-hospital care of patients with cystic fibrosis. Intrahospital weight and aerobic training in children with cystic fibrosis: a randomized controlled trial. Physical training does not increase allergic inflammation in asthmatic children Comparison of morning and afternoon exercise training for asthmatic children. Training of aerobic and anaerobic fitness in children with asthma. The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. Exercise training on disease control and quality of life in asthmatic children. Cardiorespiratory fitness evaluation by the shuttle test in asthmatic subjects during aerobic training. The effects of a swimming intervention for children with asthma. Children with asthma and physical exercise: effects of an exercise programme Physical exercise recommendations improve postural changes found in children and adolescents with cystic fibrosis: a randomized controlled trial. Randomized controlled study of in-hospital exercise training programs in children with cystic fibrosis. Benefits of combining inspiratory muscle with ‘whole muscle’ training in children with cystic fibrosis: a randomised controlled trial Effects of swimming training on aerobic capacity and exercise induced bronchoconstriction in children with bronchial asthma Effect of Physiotherapy in Asthmatic Children–A One‐year Follow‐up after Physical Training Once a Week Effects of physical exercise on quality of life, exercise capacity and pulmonary function in children with asthma.
BACKGROUND : Regular aerobic exercise in patients with cystic fibrosis ( CF ) improves aerobic conditioning and delays disease progression , result ing in better quality of life . The purpose of this study was to evaluate the effect of an aerobic exercise program based on verbal and written guidelines on maximum exercise capacity using a cardiopulmonary exercise test , quality of life , and the self-reported aerobic exercise practice of children and adolescents with CF . METHODS : This r and omized controlled trial followed guidelines for physical exercise in a CF center . Subjects were assigned to 2 groups : intervention ( group 1 ) , with 17 subjects ; and control ( group 2 ) , also with 17 subjects . Data were collected from October 2010 to October 2011 , and the study population comprised 7–20-y-old children and adolescents with CF . The intervention consisted of h and ing out a manual with guidelines for aerobic physical exercises and reinforcing recommendations in telephone calls every 2 weeks . RESULTS : Thirty-four subjects were included in the study , 20 of whom were boys ( 58.5 % ) . The groups were similar at baseline . In group 1 , 6 subjects ( 35.2 % ) reported practicing physical exercises regularly . The mean age was 13.4 ± 2.8 y , the  mean percent-of-predicted FEV1 was 95.5 ± 17.9 % , and the mean peak oxygen uptake ( V̇O2 ) relative to body mass was 34.9 ± 9.0 mL/kg/min . In group 2 , 4 subjects ( 23.5 % ) reported practicing physical exercises regularly . The mean age was 12.7 ± 3.3 y , the mean percent-of-predicted FEV1 was 100.1 ± 21.2 % , and the mean peak V̇O2 was 33.2 ± 8.2 mL/kg/min . In group 1 , there was a significant increase in physical exercise practice as reported by subjects after 3 months of intervention compared with group 2 ( P = .01 ) . No statistically significant differences were found for the other variables . CONCLUSIONS : Verbal and written guidelines for aerobic exercise , together with supervision over the telephone , had a positive impact on the self-reported regular physical exercise practice of children and adolescents . However , no improvement was found in lung function and maximum exercise capacity or domains of the quality of life question naire Evidence -based practice involves the use of evidence from systematic review s and r and omised controlled trials , but the extent of this evidence in physiotherapy has not previously been surveyed . The aim of this survey is to describe the quantity and quality of r and omised controlled trials and the quantity of systematic review s relevant to physiotherapy . The Physiotherapy Evidence Data base ( PEDro ) was search ed . The quality of trials was assessed with the PEDro scale . The search identified a total of 2,376 r and omised controlled trials and 332 systematic review s. The first trial was published in 1955 and the first review was published in 1982 . Since that time , the number of trials and review s has grown exponentially . The mean PEDro quality score has increased from 2.8 in trials published between 1955 and 1959 to 5.0 for trials published between 1995 and 1999 . There is a substantial body of evidence about the effects of physiotherapy . However , there remains scope for improvements in the quality of the conduct and reporting of clinical trials CONTEXT Rates of  obesity  and other childhood chronic conditions  have increased over recent decades . Patterns of how conditions change over time have not been widely examined . OBJECTIVE To evaluate change in prevalence of obesity and other chronic conditions  in US children , including incidence , remission , and prevalence . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve study using the National Longitudinal Survey of Youth-Child Cohort ( 1988 - 2006 ) of 3 nationally representative cohorts of children . Children were aged 2 through 8 years at the beginning of each study period , and cohorts were followed up for 6 years , from 1988 to 1994 ( cohort 1 , n = 2337 ) , 1994 to 2000 ( cohort 2 , n = 1759 ) , and 2000 to 2006 ( n = 905 ) . MAIN OUTCOME MEASURES Parent report of a child having a health condition that limited activities or schooling or required medicine , special equipment , or specialized health services and that lasted at least 12 months . Obesity was defined as a body mass index at or above the 95th percentile for age . Chronic conditions were grouped into 4 categories : obesity , asthma , other physical conditions , and behavior/learning problems . RESULTS The end- study prevalence of any chronic health condition was 12.8 % ( 95 % confidence interval [ CI ] , 11.2%-14.5 % ) for cohort 1 in 1994 , 25.1 % ( 95 % CI , 22.7%-27.6 % ) for cohort 2 in 2000 , and 26.6 % ( 95 % CI , 23.5%-29.9 % ) for cohort 3 in 2006 . There was substantial turnover in chronic conditions : 7.4 % ( 95 % CI , 6.5%-8.3 % ) of participants in all cohorts had a chronic condition at the beginning of the study that persisted to the end , 9.3 % ( 95 % CI , 8.3%-10.3 % ) reported conditions at the beginning that resolved within 6 years , and 13.4 % ( 95 % CI , 12.3%-14.6 % ) had new conditions that arose during the 6-year study period . The prevalence of having a chronic condition during any part of the 6-year study period was highest for cohort 3 ( 51.5 % ; 95 % CI , 47.3%-55.0 % ) , and there were higher rates among male ( adjusted odds ratio [ AOR ] , 1.24 ; 95 % CI , 1.07 - 1.42 ) , Hispanic ( AOR , 1.36 ; 95 % CI , 1.11 - 1.67 ) , and black ( AOR , 1.60 ; 95 % CI , 1.35 - 1.90 ) youth . CONCLUSIONS Prevalence of chronic conditions among children and youth increased from 1988 to 2006 . However , presence of these conditions was dynamic over each 6-year cohort Little is known about the long-term persistence of positive effects induced by a physical conditioning programme in cystic fibrosis . Therefore , this study determined the effects of a 6-month conditioning programme on peak oxygen uptake ( primary outcome ) and other markers of fitness , physical activity , anthropometry , lung function and quality of life ( secondary outcomes ) , 18 and 24 months after the programme was initiated . Patients with cystic fibrosis aged 12–40 yrs were r and omly assigned to an  intervention ( n = 23 ) and a  control ( n = 15 ) group . The intervention group consented to add 3 h of sports per week for ≥6 months to their previous activities . Controls were asked to maintain their level of activity for 12 months . Patients were seen at baseline and after 3 , 6 , 12 , 18 and 24 months . There was no significant difference between groups at baseline . The intervention induced positive effects on peak oxygen uptake ( difference in changes from baseline to the 18- and 24-month assessment s between groups : 3.72±1.23 mL·min−1·kg−1 ; p<0.01 ) , maximal workload ( 0.37±0.11 W·kg−1 ; p<0.01 ) , vigorous physical activity ( 1.63±0.82 h·week−1 ; p<0.05 ) , forced vital capacity ( 6.06±2.87 % predicted ; p<0.05 ) and perceived health ( 9.89±4.72 ; p<0.05 ) . A home-based partially supervised physical conditioning programme  can improve physical fitness , lung function and perceived health long after the intervention has ended Few studies have been conducted on the effects of aerobic exercise in children with asthma , particularly on the inflammatory component and functional outcomes . This study evaluated the effect of aerobic exercise on inflammation , functional capacity , respiratory muscle strength , quality of life and symptoms scores in asthmatic children . This was a 6-week r and omized trial ( NCT0192052 ) of 33 moderately asthmatic children ( 6 - 17 years ) . Patients were r and omized aerobic training ( exercise group ; n = 14 ) , while another group did not exercise ( control ; n = 19 ) . Primary endpoint was evaluations serum cytokines ( IL-17 , IFN , TNF , IL-10 , IL-6 , IL-4 and IL-2 ) assessed by flow cytometry . The six-minute walk test , pulmonary function , quality of life and symptoms ( asthma-free days ) were secondary endpoint . The Mann-Whitney test was used to evaluate the independent variables and the Wilcoxon test for paired variables . The t-test was used for the remaining calculations . Significance was determined at 5 % . Aerobic training failed to modify the inflammatory component . In the exercise group , an increase occurred in functional capacity ( p < 0.01 ) and peak expiratory flow ( p = 0.002 ) , and maximal inspiratory ( p = 0.005 ) and expiratory pressure ( p < 0.01 ) improved . Furthermore , there was a significant increase in all the domains of the PAQLQ . The children who exercised had more asthma-free days than the controls ( p = 0.012 ) and less sensation of dyspnea at the end of the study ( p < 0.01 ) . In conclusion , six weeks of aerobic exercise no changes in plasma cytokine patterns in asthmatic children and adolescents ; however , an improvement was found in functional capacity , maximal respiratory pressure , quality of life and asthma-related symptoms . Clinical Trials.gov Identifier : NCT0192052 Abstract Objective : The objective of this study is to analyze the effects of a 12-week indoor intermittent training program on lung function , physical capacity , body composition and quality of life in children with asthma . Methods : Participants were r and omized in an experimental group ( EG , 58 children , age = 11.55 ± 1.01 years ) and in a control group ( CG , 47 children , age = 11.51 ± 1.42 years ) . The training program was conducted indoors and consisted of alternating high- and low-intensity stimuli , for three sessions of 60 min/week , for 12 weeks . Physical exercise and sports activities were organized to follow the criteria of the American College of Sports Medicine ( 1999 ) and previous interventions ’ studies . Results : In EG , there was a significant improvement ( p < 0.05 ) in FEV1 , FEV6 , 6MWT , h and grip strength , CMJ and flexibility . Reductions in BMI and fat mass as well as an increase in quality of life were all shown . The dyspnea index decreased significantly and there were no episodes of EIA . There is a significant positive correlation ( p < 0.01 ) between the ΔFEV1 with Δh and grip strength and Δ6MWT and a negative correlation with Δfat mass . Conclusions : An indoor intermittent training program with these characteristics has improved lung function , physical capacity , body composition and quality of life in children with asthma . These training adaptations are particularly relevant for those patients suffering from asthma as a regular physical exercise routine will greatly improve their quality of life OBJECTIVE To investigate the medium-term benefits of a swimming program in schoolchildren and adolescents with moderate persistent atopic asthma ( MPAA ) . METHODS A r and omized , prospect i ve study of children and adolescents ( age 7 - 18 years ) with MPAA was carried out at the Hospital de Clínicas of Universidade Estadual de Campinas ( UNICAMP ) , Campinas , Brazil . After a 1-month run-in period , 61 patients ( 34 female ) were r and omized into two groups , a swimming group ( n = 30 ) and a control group ( n = 31 ) , and followed for 3 months . Both patient groups received inhaled fluticasone ( dry powder , 250 mcg twice a day ) and salbutamol as needed . The swim training program consisted of two weekly classes over a 3-month period for a total of 24 sessions . Both groups underwent  spirometric assessment  and methacholine challenge test -- provocative concentration of methacholine causing a 20 % fall in FEV1 (PC₂₀)--before and after the study period . Maximal inspiratory pressure ( MIP ) and maximal expiratory pressure ( MEP ) were measured only in the swimming group . RESULTS Significant increases in PC₂₀ ( pre-training , 0.31±0.25 ; post-training , 0.63±0.78 ; p = 0.008 ) , MIP ( pre-training , 67.08±17.13 cm H₂O ; post-training 79.46±18.66 ; p < 0.001 ) , and MEP ( pre-training , 71.69±20.01 cm H₂O ; post-training , 78.92±21.45 cm H₂O ; p < 0.001 ) were found in the swimming group . CONCLUSION Children and adolescents with MPAA subjected to a swim training program experienced a significant decrease in bronchial hyperresponsiveness , as determined by increased PC₂₀ values , when compared with asthmatic controls who did not undergo swim training . Participants in the swimming group also showed improvement in elastic recoil of the chest wall BACKGROUND Children 's physical activity patterns are characterized by short-term anaerobic activities . Anaerobic exercise performance in children with cystic fibrosis ( CF ) has received little attention compared to aerobic performance . This study investigated the effects of anaerobic training in children with CF . DESIGN AND METHODS Twenty patients were r and omly assigned to the training group ( TG ) [ 11 patients ; mean ( + /- SD ) age , 13.6 + /- 1.3 years ; mean FEV(1 ) , 75.2 + /- 20.7 % predicted ] or the control group ( CG ) [ 9 patients ; mean age , 14.2 + /- 2.1 years ; FEV(1 ) , 82.1 + /- 19.1 % predicted ] . The TG trained 2 days per week for 12 weeks , with each session lasting 30 to 45 min . The training program consisted of anaerobic activities lasting 20 to 30 s. The control subjects were asked not to change their normal daily activities . Body composition , pulmonary function , peripheral muscle force , habitual physical activity , aerobic and anaerobic exercise performance , and quality of life were reevaluated at the end of the training program , and again after a 12-week follow-up period . RESULTS Patients in the TG significantly improved their anaerobic performance , aerobic performance , and quality of life . No significant changes were seen in other parameters , and no improvements were found in CG . After the follow-up period , only anaerobic performance and quality of life in TG were significantly higher compared to pretraining values . CONCLUSIONS Anaerobic training has measurable effects on aerobic performance ( although not sustained ) , anaerobic performance , and health-related quality of life in children with CF . Therefore , anaerobic training could be an important component of therapeutic programs for CF patients Bronchial hygiene therapy is a st and ard part of the treatment of patients with cystic fibrosis ( CF ) . Coughing alone promotes sputum expectoration and is probably the primary effective component of st and ard bronchial hygiene therapy . The purpose of this study was to determine whether substituting regular exercise , which also promotes coughing , for two of three daily bronchial hygiene treatments would affect the expected improvements in pulmonary function and exercise response in hospitalized patients with CF . Seventeen patients with CF hospitalized ( means length of stay = 13.0 + /- 2.6 days ) for an acute exacerbation of their pulmonary disease participated in the study . The patients were r and omly assigned to either a group that participated in two cycle ergometer exercise sessions and one bronchial hygiene treatment session per day ( EX Group [ n = 9 ] ) or a group that participated in three bronchial hygiene treatment sessions per day ( PD Group [ n = 8 ] ) . Pulmonary functions and responses to a progressive , incremental cycle ergometer exercise test were measured on admission and before discharge . Bronchial hygiene therapy consisted of postural drainage , in six positions , with chest percussion and vibration . Therapeutic exercise was of moderate intensity and was individually adjusted based on the patient 's heart rate and arterial oxygen saturation response to the admission exercise test . Coughing was encouraged during and after all treatments . Pulmonary function and exercise response were significantly improved over the period of hospitalization in both groups ; the improvements were the same in the two groups . These results indicate that , in some hospitalized patients with CF , exercise therapy may be substituted for at least part of the st and ard protocol of bronchial hygiene therapy PURPOSE The purpose of our study was to assess the effects of an 8-wk intrahospital combined circuit weight and aerobic training program performed by children with cystic fibrosis ( of low-moderate severity and stable clinical condition ) on the following outcomes : cardiorespiratory fitness ( VO2peak ) and muscle strength ( five-repetition maximum ( 5RM ) bench press , 5RM leg press , and 5RM seated row ) ( primary outcomes ) and pulmonary function ( forced vital capacity , forced expiratory volume in 1 s ) , weight , body composition , functional mobility ( Timed Up and Down Stairs and 3-m Timed Up and Go tests ) , and quality of life ( secondary outcomes ) . We also determined the effects of a detraining period ( 4 wk ) on the aforementioned outcomes . METHODS We performed a r and omized controlled trial design . Eleven participants in each group ( controls : 7 boys , age = 11 ± 3 yr , body mass index = 17.2 ± 0.8 kg · m(-2 ) ( mean ± SEM ) ; intervention : 6 boys , age = 10 ± 2 yr , body mass index = 18.4 ± 1.0 kg · m(-2 ) ) started the study .  RESULTS Adherence to training averaged 95.1 % ± 7.4 % . We observed a significant group × time interaction effect ( P = 0.036 ) for VO2peak . In the intervention group , VO2peak significantly increased with training by 3.9 mL · kg(-1 ) · min(-1 ) ( 95 % confidence interval = 1.8 - 6.1 mL · kg(-1 ) · min(-1 ) , P = 0.002 ) , whereas it decreased during the detraining period ( -3.4 mL · kg(-1 ) · min(-1 ) , 95 % confidence interval = -5.7 to -1.7 mL · kg(-1 ) · min(-1 ) , P = 0.001 ) . In contrast , no significant changes were observed during the study period within the control group . Although significant improvements were also observed after training for all 5RM strength tests ( P < 0.001 for the interaction effect ) , the training improvements were not significantly decreased after the detraining period in the intervention group ( all P > 0.1 for after training vs detraining ) . We found no significant training benefits in any of the secondary outcomes . CONCLUSIONS A short-term combined circuit weight and aerobic training program performed in a hospital setting induces significant benefits in the cardiorespiratory fitness and muscle strength of children with cystic fibrosis The effects of a 3-month physical training programme on airway inflammation and clinical outcomes were studied in school-aged children with asthma . Subjects with persistent allergic asthma ( aged 12.7±3.4 yrs ; n = 34 ) were r and omly allocated into training and control groups . Exercise consisted of twice-weekly 50-min sessions for 12 weeks . Inflammation was assessed by levels of exhaled nitric oxide , blood eosinophils , eosinophil cationic protein , C-reactive protein , and total and mite-specific immunoglobulin (Ig)E. Lung volumes and bronchial responsiveness to methacholine were determined . The Paediatric Asthma Quality of Life Question naire and Paediatric Asthma Caregiver 's Quality of Life Question naire were used to evaluate activity restrictions , symptoms and emotional stress . The efficacy of the training was assessed by accelerometry . Following the programme , the exercise group spent twice as much time as the controls undertaking moderate-to-vigorous activities . No differences in changes were seen between groups for asthma outcomes . However , total IgE decreased more in the exercise group , as did mite-specific IgE. Training did not increase inflammation in children with persistent asthma , and may have decreased both total and allergen-specific immunoglobulin E levels . It is concluded that there is no reason to discourage asthmatic children with controlled disease to exercise Fitness improvement was used to compare morning with afternoon exercise periods for asthmatic children . Children with persistent moderate asthma ( according to GINA criteria ) , 8 to 11 years old , were divided into 3 groups : morning training group ( N = 23 ) , afternoon training group ( N = 23 ) , and non-training group ( N = 23 ) . The program was based on twice a week 90-min sessions for 4 months . We measured the 9-min running distance , resting heart rate and abdominal muscle strength ( sit-up number ) before and after the training . All children took budesonide , 400 microg/day , and an on dem and inhaled ss-agonist . The distance covered in 9 min increased ( mean + /- SEM ) from 1344 + /- 30 m by 248 + /- 30 m for the morning group , from 1327 + /- 30 m by 162 + /- 20 m for the afternoon group , and from 1310 + /- 20 m by 2 + /- 20 m for the control group ( P < 0.05 for the comparison of morning and afternoon groups with the control group by ANOVA and P > 0.05 for morning with afternoon comparison ) . The reduction of resting heart rate from 83 + /- 1 , 85 + /- 2 and 86 + /- 1 bpm was 5.1 + /- 0.8 bpm in the morning group , 4.4 + /- 0.8 bpm in the afternoon group , and -0.2 + /- 0.7 bpm in the control group ( P > 0.05 for morning with afternoon comparison and P < 0.05 versus control ) . The number of sit-ups in the morning , afternoon and control groups increased from 22.0 + /- 1.7 , 24.3 + /- 1.4 and 23 + /- 1.1 sit-ups by 9.8 + /- 0.9 , 7.7 + /- 1.4 , and 1.9 + /- 0.7 sit-ups , respectively ( P > 0.05 for morning with afternoon comparison and P < 0.05 versus control ) . No statistically significant differences were detected between the morning and afternoon groups in terms of physical training of asthmatic children OBJECTIVE To assess the effect of a training protocol on aerobic and anaerobic fitness in children with asthma . STUDY DESIGN Sixteen boys ( mean age : 13 years ; range : 10 - 16 years ) with mild-to-moderate asthma participated in a rehabilitation program that included 6 weeks of individualized training on a cycle ergometer . Two groups were r and omly formed : the control group ( CG , n = 7 ) and the training group ( TG , n = 9 ) , which exercised at an intensity set at the heart rate corresponding to the ventilatory threshold , with 1-minute sprints against the maximal aerobic power ( MAP ) every 4 minutes . Session duration was 45 minutes , 3 sessions per week . Changes in maximal oxygen uptake ( VO(2)max ) , MAP , short-term peak power ( PP ) , and pulmonary function were assessed . RESULTS Two patients of the training group did not complete the study . Pulmonary function remained unchanged in both groups . Improvement in both aerobic and anaerobic fitness was significant only in the training group ( TG vs CG ) : VO(2)max + 18 % + /- 2.1 % versus + 9 % + /- 4.5 % ( P < .05 ) , MAP + 32 % + /- 5 % versus 12 % + /- 7 % ( P < .05 ) , PP + 21 % + /- 5.7 % versus + 8.8 % + /- 10 % ( P < .01 ) . CONCLUSION Exercise training with high-intensity bouts is well tolerated in children with mild-to-moderate asthma . When included in a global rehabilitation program , this type of training improves both aerobic and anaerobic fitness . Anaerobic activities should be considered in sports rehabilitation programs for children with asthma Most systematic review s rely substantially on the assessment of the method ological quality of the individual trials . The aim of this study was to obtain consensus among experts about a set of generic core items for quality assessment of r and omized clinical trials ( RCTs ) . The invited participants were experts in the field of quality assessment of RCTs . The initial item pool contained all items from existing criteria lists . Subsequently , we reduced the number of items by using the Delphi consensus technique . Each Delphi round comprised a question naire , an analysis , and a feedback report . The feedback report included staff team decisions made on the basis of the analysis and their justification . A total of 33 international experts agreed to participate , of whom 21 completed all question naires . The initial item pool of 206 items was reduced to 9 items in three Delphi rounds . The final criteria list ( the Delphi list ) was satisfactory to all participants . It is a starting point on the way to a minimum reference st and ard for RCTs on many different research topics . This list is not intended to replace , but rather to be used alongside , existing criteria lists PURPOSE Aerobic training has been shown to be effective in improving cardiopulmonary fitness in asthmatic children . However , the actual impact of physical training on clinical indicators of disease control remains controversial . METHODS Thirty-eight children with moderate to severe persistent asthma were r and omly assigned to control ( N=17 ) and training ( N=21 ) groups . Spirometry , exercise challenge , and maximum incremental cardiopulmonary exercise tests were performed 16 wk apart . Daily doses of inhaled steroids and Pediatric Asthma Quality of Life Question naire ( PAQLQ ) scores were also recorded . RESULTS Physical training was associated with significant improvements in physiological variables at peak and submaximal exercise ( P<0.05 ) ; in contrast , no significant changes were found in controls . Severity of exercise-induced bronchoconstriction ( EIB ) and postexercise breathlessness were significantly lessened in trained patients ; improvement in fitness and EIB , however , were not linearly related ( P>0.05 ) . In addition , PAQLQ scores improved only in trained children ( P<0.01 ) . Daily doses of inhaled steroids were reduced in trained patients ( 52 % ) , but they remained unchanged or increased in controls ( 70.6 % ) ( P=0.07 ) . CONCLUSION Supervised exercise training might be associated with beneficial effects on disease control and quality of life in asthmatic children . These data suggest an adjunct role of physical conditioning on clinical management of patients with more advanced disease PURPOSE The purpose of this study was to assess the validity of the 20-m shuttle test with 1-min stages ( 20-MST ) to estimate maximal oxygen uptake ( VO2 max ) and its ability to register cardiorespiratory modifications over the course of an individualized aerobic training program for mild to moderately asthmatic children acclimatized to moderate altitude . METHODS Forty-eight asthmatic subjects aged 12 to 17 years performed both a maximal incremental exercise test on a cycle ergometer and the 20-MST . Ten of the subjects were then r and omly chosen and trained three times per week at their ventilatory threshold ( Vth ) intensity level for three months . Another group of ten asthmatic subjects served as control subjects . Training intensity was adjusted monthly ; heart rate values at Vth were increased by the same proportion as the increase in Vo2 max as measured by the 20-MST . At the end of training , both groups were again evaluated with the two tests . The Vo2 max values by direct measurement and by the 20-MST were not significantly different for the entire population ( 46.5 + /- 1.6 vs 47.2 + /- 2.1 ml.min-1.kg-1 ) . In addition , the two test results were in close agreement ( r = 0.84 ; p < 0.01 ) . After training , a sharp improvement in the direct Vo2 max ( 44.1 + /- 2.4 to 51.2 + /- 1.9 ml.min-1.kg-1 ) was noted in the training group as well as an increase in the Vth ( 25.6 + /- 1.9 to 32.1 + /- 3.4 ml.min-1.kg-1 ) , the maximal power ( 152 + /- 7.1 to 185 + /- 3.8 W ) , and the maximal oxygen pulse ( 0.24 + /- 0.007 to 0.27 + /- 0.008 ml.beat-1.kg-1 ) . CONCLUSION The indirect measure confirmed these results : a simultaneous increase in VO2 max ( 43.7 + /- 2.5 to 53.8 + /- 2.1 ml.min-1.kg-1 ) , maximal oxygen pulse ( 0.22 + /- 0.004 to 0.27 + /- 0.006 ml.beat-1.kg-1 ) , and the number of stages completed ( 7 + /- 1.4 to 10.1 + /- 1.3 ) was observed . It was concluded that the 20-MST has sufficient validity to assess VO2 max and to register cardiorespiratory modifications over the course of individualized aerobic training programs in mild and moderately asthmatic children . It thus may be used to adjust training intensities during these programs BACKGROUND AND OBJECTIVE Asthma is a common paediatric airway disease with increasing prevalence . Studies comparing swimming with other sports have found that swimming is unlikely to provoke unstable asthma but possible benefits are not defined . This study investigated the benefits of a 6 week swimming intervention on pulmonary function tests ( PFT ) , PEF and severity of asthma in children . METHODS Young asthmatics were r and omly assigned to the experimental or the control group , with 15 subjects in each group . In addition to regular treatment for asthma , the experimental group received swimming training for 6 weeks . PFT , PEF and severity of asthma were measured . RESULTS There was a significant improvement ( P < 0.01 ) in PEF in the experimental group compared with the control group ( 330 L/min , 95 % CI : 309 - 351 vs. 252 L/min , 95 % CI : 235 - 269 ) after the swimming intervention . There was also a significant improvement ( P < 0.05 ) in the severity of asthma in the experimental group compared with the control group . CONCLUSIONS These data suggest that a swimming programme for asthmatic children can improve some disease parameters ( PEF and the severity of asthma ) .  Swimming may be an effective non-pharmacological intervention for the child or adolescent with asthma Objective : To evaluate the effects of a physical exercise programme for children with asthma on an outpatient basis . Design : Intervention study : a r and omized pretest – post-test control group design . Setting and subjects : Forty-seven children with clinical ly diagnosed asthma participated in the intervention study , including 34 boys and 13 girls , from 8 to 13 years of age ( mean age 10.6 ) . Interventions : The physical exercise programme consisted of regular group exercises and home exercises for a period of three months . It was based on a theoretical model describing the relationships between physical competence ( condition ) , perceived physical competence , self-esteem and coping behaviour . Main outcome measures : Maximum incremental exercise test , endurance test , the Self-Perception Profile for Children ( CBSK ) , the Asthma Coping Test ( ACBT ) , lung function and exercise-induced bronchoconstriction . Results : The results showed significant effects of the intervention programme on physical condition . There was a significant improvement of 15 W on the maximal workload ( Wmax ) ( p < 0.001 ) , of 7 % on VO 2max ( oxygen uptake ) ( p = 0.002 ) and a significant decrease on heart rate submaximal of 6 % ( p = 0.001 ) . There was also a significant improvement of 50 % in running time measured with the endurance test ( p = 0.021 ) . Furthermore , a significant effect of the intervention was seen on coping with asthma ( p = 0.003 ) . Conclusion : It was concluded that participation in the physical exercise programme not only enhanced physical fitness , but also improved coping behaviour with asthma OBJECTIVE To evaluate postural changes and the distribution of plantar pressures in patients with cystic fibrosis ( CF ) . We also sought to evaluate the effects of an educational guideline for physical activity on body posture in children and adolescents with CF . STUDY DESIGN This was a 2-phase study of individuals between age 7 and 20 years . Phase I was a cross-sectional study in which healthy subjects were selected for postural evaluation and baropodometry , aim ing to perform a later comparison with patients with CF . In phase II , we performed a r and omized controlled clinical trial to assess the influence of the exercise guideline on the postural changes . Patients were assigned to 2 groups : control and intervention . The intervention consisted of a h and book with instructions for aerobic exercise and stretching . Main outcomes were postural abnormalities , plantar pressure distribution , and lung function . RESULTS In phase I , 34 patients with CF and 34 healthy matched individuals were included . No significant baseline differences were identified . Children with CF presented more postural deviations compared with healthy subjects ( P < .05 ) , as to alignment of the head , shoulder girdle , and pelvis , increased cervical lordosis , and lateral chest distance . In phase II ( n = 34 ) , there were no baseline differences between groups . The intervention caused ( P < .05 ) a decrease in cervical lordosis , thoracic kyphosis , lumbar lordosis , lateral chest distance , and abdominal protrusion , as well as in the baropodometric mean pressure and contact area . CONCLUSIONS Children and adolescents with CF present postural changes when compared with healthy individuals . The educational guideline for exercise practice helped to improve posture , preventing the progression of some postural disorders The aim of this study was to compare aerobic and resistance training in children with cystic fibrosis ( CF ) admitted to hospital with an intercurrent pulmonary infection with a control group . The subjects were r and omized into three groups on the first day of admission . The fat-free mass ( FFM ) was calculated , using the skin fold thickness from four sites ( biceps , triceps , subscapular , and iliac crest ) . Pulmonary function tests were performed within 36 hr of admission and repeated on discharge from the hospital , and again at 1 month after discharge . All subjects performed an incremental treadmill exercise test , using a modified Bruce protocol .  Lower limb strength was measured using a Cybex dynamometer . An assessment of quality of life was made using the Quality of Well Being Scale , as previously reported . Activity levels were measured using a 7-day activity diary , and subjects also wore an accelerometer on their hips . There were no significant differences between the three groups in terms of disease severity , and length of stay in hospital . Subjects in all three groups received intravenous antibiotics and nutritional supplementation as determined by the physician . Children r and omized to the aerobic training group participated in aerobic activities for five sessions , each of 30-min duration , a week . The children r and omized to the resistance training group exercised both upper and lower limbs against a grade d resistance machine . Subjects in the control group received st and ard chest physiotherapy . Our study demonstrated that children who received aerobic training had significantly better peak aerobic capacity , activity levels , and quality of life than children who received the resistance training program . Children who received resistance training had better weight gain ( total mass , as well as fat-free mass ) , lung function , and leg strength than children who received aerobic training . A combination of aerobic and resistance training may be the best training program , and future studies to assess optimal training programs for CF patients are indicated Background The purpose of this study ( r and omised controlled trial ) was to assess the effects of an 8-week combined ‘ whole muscle ’ ( resistance+aerobic ) and inspiratory muscle training ( IMT ) on lung volume , inspiratory muscle strength ( PImax ) and cardiorespiratory fitness ( VO2 peak ) ( primary outcomes ) , and dynamic muscle strength , body composition and quality of life in paediatric out patients with CF ( cystic fibrosis , secondary outcomes ) . We also determined the effects of a detraining period . Methods Participants were r and omly allocated with a block on gender to a control ( st and ard therapy ) or intervention group ( initial n=10 ( 6 boys ) in each group ; age 10±1 and 11±1 years ) . The latter group performed a combined programme ( IMT ( 2 sessions/day ) and aerobic+strength exercises ( 3 days/week , in-hospital ) ) that was followed by a 4-week detraining period . All participants were evaluated at baseline , post-training and detraining . Results Adherence to the training programme averaged 97.5%±1.7 % . There was a significant interaction ( group × time ) effect for PImax , VO2peak and five-repetition maximum strength ( leg-press , bench-press , seated-row ) ( all ( p<0.001 ) , and also for % fat ( p<0.023 ) and % fat-free mass ( p=0.001 ) , with training exerting a significant beneficial effect only in the intervention group , which was maintained after detraining for PImax and leg-press . Conclusion The relatively short-term ( 8-week ) training programme used here induced significant benefits in important health phenotypes of paediatric patients with CF . IMT is an easily applicable intervention that could be included , together with supervised exercise training in the st and ard care of these patients BACKGROUND A study was undertaken to determine whether swimming training improved aerobic capacity , exercise induced bronchoconstriction ( EIB ) , and bronchial responsiveness to inhaled histamine in children with asthma . METHODS Eight children with mild or moderate asthma participated in swimming training every day for six weeks . The intensity of training was individually determined and set at 125 % of the child ’s lactate threshold ( LT ) , measured using a swimming ergometer .  Another group of eight asthmatic children served as control subjects .  Aerobic capacity and the degree of EIB were assessed by both cycle ergometer and swimming ergometer before and after swimming training . RESULTS The mean ( SD ) aerobic capacity at LT increased by 0.26 ( 0.11 ) kp after training when assessed with the swimming ergometer and by 10.6 ( 4.5 ) W when assessed with the cycle ergometer , and these changes were significantly different from the control group . The mean ( SD ) maximum % fall in forced expiratory volume in one second ( FEV1 ) to an exercise challenge ( cycle ergometer ) set at 175 % of LT decreased from 38.7 (15.4)% before training to 17.9 (17.6)% after training , but with no significant difference from the control group . There was , however , no difference in histamine responsiveness when compared before and after the training period . CONCLUSION A six week swimming training programme has a beneficial effect on aerobic capacity but not on histamine responsiveness in children with asthma Physiotherapy is an established treatment in asthmatic children . One purpose is to increase tolerance towards physical activity , decrease broncho-obstruction and promote elimination of secretions . A positive effect of physical training in asthmatic children has been reported in many studies . An improved working capacity has e.g. been shown after supervised physical training at least twice a week for a period of three months ( 1 ) . This was not a realistic level of training intensity in our clinical practice . Therefore , the goal of this study was to test whether physiotherapy combined with physical training once a week had any effect on working capacity or lung function tests in asthmatic children OBJECTIVE To investigate the effects of regular submaximal exercise on quality of life , exercise capacity and pulmonary function in asthmatic children . PATIENTS AND METHODS Sixty-two children with mild-moderate asthma ( mean age 10.4 ( SD 2.1 ) years ) were r and omly allocated into exercise and control groups . The exercise group underwent a moderately intensive basketball training program for 8 weeks . A home respiratory exercise program was advised to both groups . Pediatric Asthma Quality of Life Question naire ( PAQLQ ) was used for the evaluation of activity limitation , symptoms and emotional functions . Exercise capacity was evaluated through the physical work capacity ( PWC 170 test ) on a cycle ergometer and 6-minute walk test . Spirometric tests were also performed and medication and symptom scores were recorded . RESULTS Although PAQLQ scores improved in both groups , the improvement in the exercise group was significantly higher . The exercise group performed better in the PWC 170 and 6-minute walk tests , whereas no improvement was detected in the control group at the end of the trial . Medication scores improved in both groups , but symptom scores improved only in the exercise group . No significant changes were detected in pulmonary function in either group , except for peak expiratory flow values in the exercise group . CONCLUSION Eight weeks of regular submaximal exercise has beneficial effects on quality of life and exercise capacity in children with asthma .  Submaximal basketball training is an effective alternative exercise program for asthmatic children
Introduction Chronic disease in children is increasing , including the prevalence of chronic respiratory diseases such as asthma , cystic fibrosis ( CF ) , bronchiectasis and bronchopulmonary dysplasia ( BPD ) .
The aim of this systematic review and meta- analysis was to evaluate the effects of exercise training on health outcomes in children with chronic respiratory disease .