Risks associated with exercise testing and sports participation in cystic fibrosis

Ruf, Katharina; Winkler, Bernd; Hebestreit, Alexandra; Gruber, Wolfgang; Hebestreit, Helge

doi:10.1016/j.jcf.2010.05.006

Cited by 37 publications

(28 citation statements)

References 13 publications

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“…Risk factors include older age, poor pulmonary function and infections [77]. However, there is also anecdotal evidence that exercise, and especially high intrathoracic pressure with pressure breath hold during weight training, may lead to a pneumothorax [78]. …”

Section: Exercise-related Risksmentioning

confidence: 99%

“…Conceivably, the risk for fractures should even be increased in people with CF given the relatively high incidence of osteopaenia and osteoporosis in this population [83]. However, a recent survey found a surprisingly low incidence of fractures with exercise in CF [78]. …”

Section: Exercise-related Risksmentioning

confidence: 99%

“…Therefore, adverse events may occur which are specific to CF. These include fluid and electrolyte losses from sweating [85]; injury to the spleen and oesophageal haemorrhage in patients with portal hypertension, and hypoglycaemia in patients with CF-related diabetes mellitus [78]. Nevertheless, exercise is possible and encouraged for all patients with CF but requires appropriate guidance [86], i.e.…”

Section: Exercise-related Risksmentioning

confidence: 99%

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Rehabilitation in Patients with Chronic Respiratory Disease Other than Chronic Obstructive Pulmonary Disease: Exercise and Physical Activity Interventions in Cystic Fibrosis and Non-Cystic Fibrosis Bronchiectasis

Burtin

Hebestreit

2015

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A relevant proportion of children and adults with cystic fibrosis (CF) have a marked decrease in exercise tolerance, which can be partly related to impaired muscle function and decreased physical activity levels in daily life, in addition to lung disease. Preliminary findings suggest that patients with non-CF bronchiectasis face the same problems. These patients might be excellent candidates for exercise and physical activity interventions. This review elaborates on the rationale for exercise training and activity behaviour changes and summarizes the existing evidence for these rehabilitation strategies in patients with bronchiectasis, both CF and non-CF bronchiectasis. Furthermore, practical considerations and safety aspects are discussed.

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Section: Exercise-related Risksmentioning

confidence: 99%

Section: Exercise-related Risksmentioning

confidence: 99%

Section: Exercise-related Risksmentioning

confidence: 99%

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Rehabilitation in Patients with Chronic Respiratory Disease Other than Chronic Obstructive Pulmonary Disease: Exercise and Physical Activity Interventions in Cystic Fibrosis and Non-Cystic Fibrosis Bronchiectasis

Burtin

Hebestreit

2015

Respiration

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“…3 Moreover, the recurrence rate of a pneumothorax in patients has been reported to be >80%. 3 Changes in intrathoracic pressure, such as those associated with pulmonary function testing, [4][5][6] air travel, 7 incentive spirometry, 8 and exercise testing, 9 may increase the risk of pneumothorax, especially in patients with cystic lung diseases. Indeed, occurrences of pneumothorax or pneumomediastinum have been reported in patients with lung diseases and normal subjects undergoing pulmonary function tests and exercise studies.…”

mentioning

confidence: 99%

“…Indeed, occurrences of pneumothorax or pneumomediastinum have been reported in patients with lung diseases and normal subjects undergoing pulmonary function tests and exercise studies. [9][10][11] However, retrospective studies have shown that the actual risk of a pneumothorax in patients with LAM during air travel does not appear to exceed the risk of pneumothorax during other means of travel. 7 The current study was prompted by concerns expressed by patients with LAM regarding the risk of pneumothorax during pulmonary function testing (PFT) and cardiopulmonary exercise testing (CPET).…”

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confidence: 99%

Incidence of Pneumothorax in Patients With Lymphangioleiomyomatosis Undergoing Pulmonary Function and Exercise Testing

Taveira-DaSilva

Julien-Williams

Jones

et al. 2016

Chest

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Physical exercise training for cystic fibrosis

Radtke

Nolan

Hebestreit

et al. 2015

Cochrane Database of Systematic Reviews

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BACKGROUND: Physical exercise training may form an important part of regular care for people with cystic fibrosis. This is an update of a previously published review. OBJECTIVES: To assess the effects of physical exercise training on exercise capacity by peak oxygen consumption, pulmonary function by forced expiratory volume in one second, health-related quality of life and further important patient-relevant outcomes in people with cystic fibrosis. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.Date of the most recent search: 04 May 2017.We searched ongoing trials registers (clinicaltrials.gov and the WHO ICTRP). Date of most recent search: 10 August 2017. SELECTION CRITERIA: All randomised and quasi-randomised controlled clinical trials comparing exercise training of any type and a minimum duration of two weeks with conventional care (no training) in people with cystic fibrosis. DATA COLLECTION AND ANALYSIS: Two authors independently selected studies for inclusion, assessed methodological quality and extracted data. The quality of the evidence was assessed using the GRADE system. MAIN RESULTS: Of the 83 studies identified, 15 studies which included 487 participants, met the inclusion criteria. The numbers in each study ranged from nine up to 72 participants; two studies were in adults, seven were in children and adolescents and six studies included all age ranges. Four studies of hospitalised participants lasted less than one month and 11 studies were outpatient-based, lasting between two months and three years. The studies included participants with a wide range of disease severity and employed differing levels of supervision with a mixture of types of training. There was also wide variation in the quality of the included studies.This systematic review shows very low-to low-quality evidence from both short-and long-term studies that in people with cystic fibrosis aerobic or anaerobic physical exercise training (or a combination of both) has a positive effect on aerobic exercise capacity, pulmonary function and health-related quality of life. No study reported on mortality; two studies reported on adverse events (moderate-quality evidence); one of each study reported on pulmonary exacerbations (low-quality evidence) and diabetic control (very low-quality evidence). Although improvements were not consistent between studies and ranged from no effects to clearly positive effects, the most consistent effects of the heterogeneous exercise training modalities and durations were found for maximal aerobic exercise capacity (in four out of seven studies) with unclear effects on forced expiratory volume in one second (in two out of 11 studies) and health-related quality of life (in two out of seven studies). AUTHORS' CONCLUSIONS: Evidence about the efficacy of physical exercise training in cystic fibros...

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Risks associated with exercise testing and sports participation in cystic fibrosis

Abstract: Exercise testing is safe in patients with CF. Despite the limitations in quality of data, the incidence of exercise-related SARs appears low in this population.

Cited by 37 publications

References 13 publications

Rehabilitation in Patients with Chronic Respiratory Disease Other than Chronic Obstructive Pulmonary Disease: Exercise and Physical Activity Interventions in Cystic Fibrosis and Non-Cystic Fibrosis Bronchiectasis

Rehabilitation in Patients with Chronic Respiratory Disease Other than Chronic Obstructive Pulmonary Disease: Exercise and Physical Activity Interventions in Cystic Fibrosis and Non-Cystic Fibrosis Bronchiectasis

Incidence of Pneumothorax in Patients With Lymphangioleiomyomatosis Undergoing Pulmonary Function and Exercise Testing

Physical exercise training for cystic fibrosis

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