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155 Physical activity levels of children and adolescents with cystic fibrosis in Wales
S98
7. Physiotherapy
Posters
155 Physical activity levels of children and adolescents with cystic fibrosis in Wales
157 Pulmonary and extrapulmonary determinants of physical activity in adults with cystic fibrosis
K.A. Mackintosh1 , R.E. Evans2 , M. Barry2 , J. Clarke2 , M.A. McNarry1 . 1 ASTEM, College of Engineering, Swansea University, SA2 8PP, Swansea, United Kingdom; 2 Abertawe Bro Morgannwg University Health Board, Swansea, United Kingdom
D. Hubert1 , C. Cormier1 , N. Neveux1 , F. Aissat1 , I. Honor´e1 , J. Chapron1 , P.-R. Burgel1 . 1 Cochin Hospital, APHP, Paris, France
Objectives: Physical activity (PA) is associated with numerous physiological and psychological health benefits. Current physical activity guidelines recommend that children aged 5−18 years engage in at least 60 minutes moderate-to-vigorous physical activity (MVPA) every day. Regular PA has become increasingly important and widely accepted as part of the therapy and rehabilitation programs in Cystic Fibrosis (CF) management; however, there has been relatively little research objectively evaluating PA levels. Therefore, the aim of the study was to ascertain PA levels in children and adolescents with CF in Wales. Methods: Eighteen children and adolescents (8 boys; 12.4±2.8 years; 1.46±0.14 m; 41.2±12.5 kg) wore a GT3X+ ActiGraph accelerometer for 7 consecutive days, measuring at 100Hz. Inclusion criteria were set at 10 hours for 2 weekdays and 1 weekend day. Time spent in sedentary behaviour (SED), and light (LPA), moderate (MPA), moderate-to-vigorous and vigorous physical activity (VPA) were calculated. Lung function was assessed using standard spirometry tests. Results: Contrary to previous research, 90% of children and adolescents with CF met recommended guidelines. Specifically, 90% and 80% of children with CF in comparison to the national average of 41% and 30% of boys and girls in Wales, respectively, met guidelines. Significant moderate correlations were found between FEV1:FVC and PA, irrespective of intensity (all r = 0.6, p < 0.01). Conclusion: These findings suggest the need to promote more intense exercise interventions targeted at improving cardiorespiratory fitness and lung function in children and adolescents with CF.
Background: Physical inactivity is a prognostic factor in various respiratory diseases, yet little data exist on activity levels in adults with CF. We planned to measure daily physical activity with activity monitors and to investigate the determinants of physical activity with a focus on extrapulmonary factors. Methods: In this prospective cross-sectional single center study, CF patients wore a multi-sensor SenseWear armband for 7 consecutive days, which evaluated the intensity of physical activity in metabolic equivalents (METS) and steps per day. In addition, nutritional biological parameters, data on body composition and bone mineral density (dual X ray absorptiometry), body plethysmography and 6 minute walk test, were collected. Quality of life, and anxiety and depression were assessed using validated questionnaires. Linear regression models will assess factors associated with physical activity, adjusting for different variables related to patient demographics and behavioral, clinical (respiratory and non-respiratory) and biological parameters. Results: 80 adults with CF (46 males − mean±SD age: 32.0±8.9 years; BMI 21.7±3.0 kg/m2 ; FEV1 58.7±20.6% pred) were included between February 2011 and January 2015. 90% had pancreatic insufficiency and 25% had diabetes. Mean daily physical activity level was 1.7±0.3 METS and the mean number of steps per day was 7,960±3,842. Mean daily total and active (>3 METS) energy expenditure were 10,193±1,929 J and 3,082±1,555 J respectively. Mean daily activity (>3 METS) lasted 199±110 minutes. Multivariate regression analyses will be performed to identify variables associated with reduced physical activity in adult CF patients.
156 Exercise performance in children with mild cystic fibrosis (CF): Are there arguments to enhance physical activity?
158 Exercise in non-exercising adult cystic fibrosis patients − a year long lottery funded project, Ninewells Hospital, Dundee
M. Keyzer1 , J. Cornette1 , F. Pyl2 , I. Coomans1 , S. Van Daele2 , K. Vandekerckhove1 . 1 Ghent University Hospital, Dept Pediatric Cardiology, Gent, Belgium; 2 Ghent University Hospital, Cystic Fibrosis Centre, Gent, Belgium
A. Smith1 . 1 NHS Tayside, Adult Cystic Fibrosis, Dundee, United Kingdom
Objectives: Physical activity is strongly recommended in children with CF to improve exercise capacity and quality of life. The aim of this study is to investigate exercise performance and oxygen consumption in children with CF and mild respiratory involvement. Methods: Children with mild CF (FEV1 > 60%) who where referred for cardiopulmonary exercise testing (CPET) were enrolled. Maximal heart rate (HR), oxygen consumption (VO2max), respiratory exchange ratio (RER), VO2 at anaerobic threshold (AT) and HR at AT were analysed. Data were compared with a healthy control group. Results: 20 CF patients (9 boys, 12.5±2.7 yrs, weight 47.1±11.2 kg, length 156.1±14.7cm) performed a CPET. FEV1 was 91.8±15.9%, not different from a normal population. They were compared with 60 healthy controls (30 boys, age 11.5±2.3 yrs, weight 43.6±12.4 kg, length 151.2±13.6cm). MaxHR was 180.7±13.7 bpm in CF and 185.2±12.7 in controls (P > 0.05). RER at maximal exercise was 1.1±0.1 in CF versus 1±0.1(P < 0.05). Test duration (9.4±2.3 versus 10.3±2.5, P < 0.05) and maximal load were not different (113.8±45.2 vs 108.2±41.0 Watt). VO2max/kg was less in CF (36.2±7 vs 41.3±9.7 ml/kg/min, P < 0.05). VO2 at AT (1264.6±547.1 vs 1598.6±494.5 ml, P < 0.05) and HR at AT (153.0±21.5 vs 166.9±18.6 ml, P < 0.05) were lower in CF group. Conclusion: Children with mild CF have lower VO2max despite equal maximal load, test duration and HR. They reach AT at a lower HR and VO2, which highlights the impaired condition. We can conclude that it is important to stimulate physical activity in children with mild CF to improve VO2 during exercise.
Objectives: To increase physiotherapy staffing in Dundee to provide exercise to more patients for a year and review outcomes to see if this a cost effective treatment plan for adult CF patients. Methods: External funding was sourced from the National Lottery “Awards for All” scheme. A physiotherapy assistant was recruited for 1 year to carry out 2 weekly exercise sessions with CF patients who did no exercise. He travelled to the patient’s preferred location for exercise. In total 7 patients were recruited. Subjective and objective outcomes were measured prior to exercise starting and at the end of the study. They included resting heart rate, SpO2, FEV1, cycle ergometry and number of IV antibiotics. Results: 5 patients were removed early from the project due to frequent nonattendance. 2 patients completed the year but only 1 of those attended twice weekly. Her ventilatory response improved by 5% and heart rate reduced from 114 b/min to 72 b/min. In total there were 83 cancelled appointments. Conclusion: This was a very small study made smaller by the level of nonadherence. All the patients stated they enjoyed the exercise sessions and felt better when they performed exercise regularly although we were unable to reflect this in our outcomes. It would appear that our adult CF patients who do not perform regular exercise find if difficult to commit to long term exercise despite the staff supporting these patients as much as possible. We currently offer patients shorter blocks of exercise and are keen to investigate why patients do not exercise, and work more with families of children with CF to see if it is more likely that these patients as adults will continue with regular exercise.
7. Physiotherapy
Posters
155 Physical activity levels of children and adolescents with cystic fibrosis in Wales
157 Pulmonary and extrapulmonary determinants of physical activity in adults with cystic fibrosis
K.A. Mackintosh1 , R.E. Evans2 , M. Barry2 , J. Clarke2 , M.A. McNarry1 . 1 ASTEM, College of Engineering, Swansea University, SA2 8PP, Swansea, United Kingdom; 2 Abertawe Bro Morgannwg University Health Board, Swansea, United Kingdom
D. Hubert1 , C. Cormier1 , N. Neveux1 , F. Aissat1 , I. Honor´e1 , J. Chapron1 , P.-R. Burgel1 . 1 Cochin Hospital, APHP, Paris, France
Objectives: Physical activity (PA) is associated with numerous physiological and psychological health benefits. Current physical activity guidelines recommend that children aged 5−18 years engage in at least 60 minutes moderate-to-vigorous physical activity (MVPA) every day. Regular PA has become increasingly important and widely accepted as part of the therapy and rehabilitation programs in Cystic Fibrosis (CF) management; however, there has been relatively little research objectively evaluating PA levels. Therefore, the aim of the study was to ascertain PA levels in children and adolescents with CF in Wales. Methods: Eighteen children and adolescents (8 boys; 12.4±2.8 years; 1.46±0.14 m; 41.2±12.5 kg) wore a GT3X+ ActiGraph accelerometer for 7 consecutive days, measuring at 100Hz. Inclusion criteria were set at 10 hours for 2 weekdays and 1 weekend day. Time spent in sedentary behaviour (SED), and light (LPA), moderate (MPA), moderate-to-vigorous and vigorous physical activity (VPA) were calculated. Lung function was assessed using standard spirometry tests. Results: Contrary to previous research, 90% of children and adolescents with CF met recommended guidelines. Specifically, 90% and 80% of children with CF in comparison to the national average of 41% and 30% of boys and girls in Wales, respectively, met guidelines. Significant moderate correlations were found between FEV1:FVC and PA, irrespective of intensity (all r = 0.6, p < 0.01). Conclusion: These findings suggest the need to promote more intense exercise interventions targeted at improving cardiorespiratory fitness and lung function in children and adolescents with CF.
Background: Physical inactivity is a prognostic factor in various respiratory diseases, yet little data exist on activity levels in adults with CF. We planned to measure daily physical activity with activity monitors and to investigate the determinants of physical activity with a focus on extrapulmonary factors. Methods: In this prospective cross-sectional single center study, CF patients wore a multi-sensor SenseWear armband for 7 consecutive days, which evaluated the intensity of physical activity in metabolic equivalents (METS) and steps per day. In addition, nutritional biological parameters, data on body composition and bone mineral density (dual X ray absorptiometry), body plethysmography and 6 minute walk test, were collected. Quality of life, and anxiety and depression were assessed using validated questionnaires. Linear regression models will assess factors associated with physical activity, adjusting for different variables related to patient demographics and behavioral, clinical (respiratory and non-respiratory) and biological parameters. Results: 80 adults with CF (46 males − mean±SD age: 32.0±8.9 years; BMI 21.7±3.0 kg/m2 ; FEV1 58.7±20.6% pred) were included between February 2011 and January 2015. 90% had pancreatic insufficiency and 25% had diabetes. Mean daily physical activity level was 1.7±0.3 METS and the mean number of steps per day was 7,960±3,842. Mean daily total and active (>3 METS) energy expenditure were 10,193±1,929 J and 3,082±1,555 J respectively. Mean daily activity (>3 METS) lasted 199±110 minutes. Multivariate regression analyses will be performed to identify variables associated with reduced physical activity in adult CF patients.
156 Exercise performance in children with mild cystic fibrosis (CF): Are there arguments to enhance physical activity?
158 Exercise in non-exercising adult cystic fibrosis patients − a year long lottery funded project, Ninewells Hospital, Dundee
M. Keyzer1 , J. Cornette1 , F. Pyl2 , I. Coomans1 , S. Van Daele2 , K. Vandekerckhove1 . 1 Ghent University Hospital, Dept Pediatric Cardiology, Gent, Belgium; 2 Ghent University Hospital, Cystic Fibrosis Centre, Gent, Belgium
A. Smith1 . 1 NHS Tayside, Adult Cystic Fibrosis, Dundee, United Kingdom
Objectives: Physical activity is strongly recommended in children with CF to improve exercise capacity and quality of life. The aim of this study is to investigate exercise performance and oxygen consumption in children with CF and mild respiratory involvement. Methods: Children with mild CF (FEV1 > 60%) who where referred for cardiopulmonary exercise testing (CPET) were enrolled. Maximal heart rate (HR), oxygen consumption (VO2max), respiratory exchange ratio (RER), VO2 at anaerobic threshold (AT) and HR at AT were analysed. Data were compared with a healthy control group. Results: 20 CF patients (9 boys, 12.5±2.7 yrs, weight 47.1±11.2 kg, length 156.1±14.7cm) performed a CPET. FEV1 was 91.8±15.9%, not different from a normal population. They were compared with 60 healthy controls (30 boys, age 11.5±2.3 yrs, weight 43.6±12.4 kg, length 151.2±13.6cm). MaxHR was 180.7±13.7 bpm in CF and 185.2±12.7 in controls (P > 0.05). RER at maximal exercise was 1.1±0.1 in CF versus 1±0.1(P < 0.05). Test duration (9.4±2.3 versus 10.3±2.5, P < 0.05) and maximal load were not different (113.8±45.2 vs 108.2±41.0 Watt). VO2max/kg was less in CF (36.2±7 vs 41.3±9.7 ml/kg/min, P < 0.05). VO2 at AT (1264.6±547.1 vs 1598.6±494.5 ml, P < 0.05) and HR at AT (153.0±21.5 vs 166.9±18.6 ml, P < 0.05) were lower in CF group. Conclusion: Children with mild CF have lower VO2max despite equal maximal load, test duration and HR. They reach AT at a lower HR and VO2, which highlights the impaired condition. We can conclude that it is important to stimulate physical activity in children with mild CF to improve VO2 during exercise.
Objectives: To increase physiotherapy staffing in Dundee to provide exercise to more patients for a year and review outcomes to see if this a cost effective treatment plan for adult CF patients. Methods: External funding was sourced from the National Lottery “Awards for All” scheme. A physiotherapy assistant was recruited for 1 year to carry out 2 weekly exercise sessions with CF patients who did no exercise. He travelled to the patient’s preferred location for exercise. In total 7 patients were recruited. Subjective and objective outcomes were measured prior to exercise starting and at the end of the study. They included resting heart rate, SpO2, FEV1, cycle ergometry and number of IV antibiotics. Results: 5 patients were removed early from the project due to frequent nonattendance. 2 patients completed the year but only 1 of those attended twice weekly. Her ventilatory response improved by 5% and heart rate reduced from 114 b/min to 72 b/min. In total there were 83 cancelled appointments. Conclusion: This was a very small study made smaller by the level of nonadherence. All the patients stated they enjoyed the exercise sessions and felt better when they performed exercise regularly although we were unable to reflect this in our outcomes. It would appear that our adult CF patients who do not perform regular exercise find if difficult to commit to long term exercise despite the staff supporting these patients as much as possible. We currently offer patients shorter blocks of exercise and are keen to investigate why patients do not exercise, and work more with families of children with CF to see if it is more likely that these patients as adults will continue with regular exercise.