Physical activity in children and adolescents with cystic fibrosis: A systematic review and meta‐analysis

Abstract

Background: Exercise and physical activity (PA) are essential components of the care of cystic fibrosis (CF) patients. Lower PA levels have been associated with worse pulmonary function, aerobic fitness, glycemic control, and bone mineral density. Most people with CF do not engage in the recommended amounts of PA. Objective: To determine the level of PA in children and adolescents with CF. Methods: A systematic review with meta-analysis was conducted without language restrictions in five databases. Were included studies that analyzed PA measured by objective and subjective instruments in children and adolescents with CF. Two independent reviewers analyzed the studies, extracted the data, and assessed the quality of evidence. The risk of bias of the included studies was assessed with the National Heart, Lung, and Blood Institute's risk-of-bias tool. Results: Of the 1535 reports returned by the initial search, 20 articles reporting on 785 patients were included in the data synthesis. The forest plot showed that the CF group had a similar moderate-to-vigorous PA (MVPA) (mean difference, −7.79; 95% CI, −15.65 to 0.08 min/d; P = .05) and sedentary time (mean difference, −50.81; 95% CI, −109.96 to 8.35 min/d; P = .09) to the control group. Conclusion: Children and adolescents with CF have a similar MVPA and sedentary time compared to controls. There are many options, subjective and objective, for assessing PA in this population. Optimal tool selection should guarantee more valid results.

Levels of physical activity in children and adolescents with asthma: A systematic review and meta‐analysis

“…A probable explanation is the high level of sedentarism observed in children, adolescents, and the general population and other chronic respiratory diseases in recent years. [54][55][56] Healthy girls tend to engage in less PA than healthy boys. Four articles reported lower PA levels in girls with asthma, confirming that this difference is also observed in children and adolescents with asthma.…”

“…If we analyze by year of publication, in the last five years, 80% of studies reported that the participants did not comply with this recommendation, contrary to the articles published before 2015, in which only 12% had a lower MVPA at the recommendation of 60 min/day. A probable explanation is the high level of sedentarism observed in children, adolescents, and the general population and other chronic respiratory diseases in recent years 54‐56 …”

Comparison of Physical Activity and Sedentary Behaviour between Schoolchildren with Cystic Fibrosis and Healthy Controls: A Gender Analysis

“…Some studies detected only differences in vigorous activities, with CF children being less active than the healthy groups [ 30 ], but not in sedentary time [ 39 ]. However, as in this study, a recent systematic review and meta-analysis [ 40 ] concluded that CF children and adolescents have similar MVPA and sedentary time as controls. In fact, this study also did not find any differences between percentages of accomplishment between CF children (36.4%) and the CG (42.2%).…”

“…In the study of Selvadurai et al [ 14 ], only pubescent CF boys were more active than pubescent girls, but no differences by gender were found in prepubescent children. Along the same lines, Puppo et al [ 40 ] highlighted the fact that healthy girls tend to have less PA than healthy boys, as in CF children. According to these authors, one reason could be related to the fact that parents and teachers have lower expectations of girls engaging in regular PA than boys.…”

“…The percentage of accomplishment in the CF group is very close to the 38.9% found in British children with CF [ 19 ], but far from the 2.1% reported in a Spanish sample [ 18 ], and from the 90% detected in another sample of British CF patients [ 41 ]. Although these studies used the same objective method of measuring PA levels (accelerometers), few studies have been conducted on this population, with small samples and high heterogeneity related to the different instruments used, to obtain properly robust information when comparing studies and samples [ 40 , 42 ]. In spite of the scarcity of studies, we must not lose sight of how CF young patients should engage in PA and sports as part of their therapy.…”