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Hines M, Stotz N, Barnett B. Rounding out the pediatric CF care team: Including the profession of occupational therapy. Pediatr Pulmonol 2023; 58:629-631. [PMID: 36349747 PMCID: PMC10099495 DOI: 10.1002/ppul.26238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/05/2022] [Accepted: 11/05/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Madeline Hines
- Occupational Therapy Doctorate Program, College of Health & Human Services, The University of Toledo, Toledo, Ohio, USA
| | - Nicole Stotz
- Occupational Therapy Doctorate Program, College of Health & Human Services, The University of Toledo, Toledo, Ohio, USA
| | - Bruce Barnett
- Pierre Vauthy Cystic Fibrosis Center of Northwest Ohio, Toledo, Ohio, USA.,ProMedica Russel J. Ebeid Children's Hospital, Toledo, Ohio, USA
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Dillenhoefer S, Stehling F, Welsner M, Schlegtendal A, Sutharsan S, Olivier M, Taube C, Mellies U, Koerner-Rettberg C, Brinkmann F, Gruber W. Barriers for Sports and Exercise Participation and Corresponding Barrier Management in Cystic Fibrosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13150. [PMID: 36293733 PMCID: PMC9603748 DOI: 10.3390/ijerph192013150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Nowadays physical activity (PA)/exercise is an important component of cystic fibrosis (CF) therapy. The aim of the study was to assess the barriers to PA and the barrier management and to explore the effect of supervision on the barriers and barrier management during an exercise program. METHODS In total, 88 people with CF (pwCF) of the ages 6 to 50 years old (mean 24.2 ± 7.9 yrs) participated in the partially supervised 12-month exercise program and filled in a structured and validated questionnaire about barriers to sports and barrier management at baseline. Additionally, 23 pwCF filled in the questionnaire after 6 months and 12 months. The items were clustered into physical and psychosocial barriers and into preventive counter strategies and situational counter strategies and analyzed at baseline and over time. RESULTS Physical barriers were more relevant than psychosocial barriers and no trend could be seen in the situational and preventive counter strategies. When divided in subgroups, the less active pwCF (<7500 steps/day), more active pwCF (>7500 steps/day), physical barriers, and psychosocial barriers showed no significant differences. However physical barriers showed a tendency to have a higher value in the less active group compared to the more active group (p > 0.05). Stratified by age or FEV1%pred between the subgroups, no differences could be seen regarding barriers and counter strategies. CONCLUSIONS Physical barriers seemed to have a higher priority when it comes to not participating in PA/exercise. Supervision over 6 months during an exercise program did not show a beneficial effect on barriers and barrier management. Besides the motivational aspect of sport counselling, the volitional aspect seemed to be more important to incorporate more PA into daily life. Individual barriers and their concrete counter strategies should be discussed with the patient with CF. Sport counselling is needed permanently and should be part of the CF routine care.
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Affiliation(s)
- Stefanie Dillenhoefer
- Department of Pediatric Pulmonology, Cystic Fibrosis Center, University Children’s Hospital of Ruhr University Bochum at St. Josef-Hospital, 44791 Bochum, Germany
| | - Florian Stehling
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children’s Hospital, University of Duisburg-Essen, 45117 Essen, Germany
| | - Matthias Welsner
- Department of Pulmonary Medicine, Adult Cystic Fibrosis Center, University Hospital Essen-Ruhrlandklinik, University of Duisburg-Essen, 45239 Essen, Germany
| | - Anne Schlegtendal
- Department of Pediatric Pulmonology, Cystic Fibrosis Center, University Children’s Hospital of Ruhr University Bochum at St. Josef-Hospital, 44791 Bochum, Germany
| | - Sivagurunathan Sutharsan
- Department of Pulmonary Medicine, Adult Cystic Fibrosis Center, University Hospital Essen-Ruhrlandklinik, University of Duisburg-Essen, 45239 Essen, Germany
| | - Margarete Olivier
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children’s Hospital, University of Duisburg-Essen, 45117 Essen, Germany
| | - Christian Taube
- Department of Pulmonary Medicine, Adult Cystic Fibrosis Center, University Hospital Essen-Ruhrlandklinik, University of Duisburg-Essen, 45239 Essen, Germany
| | - Uwe Mellies
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children’s Hospital, University of Duisburg-Essen, 45117 Essen, Germany
| | | | - Folke Brinkmann
- Department of Pediatric Pulmonology, Cystic Fibrosis Center, University Children’s Hospital of Ruhr University Bochum at St. Josef-Hospital, 44791 Bochum, Germany
| | - Wolfgang Gruber
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children’s Hospital, University of Duisburg-Essen, 45117 Essen, Germany
- Institute of Human Nutrition and Food Science, Christian Albrechts University Kiel, 24118 Kiel, Germany
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Burghard M, Takken T, Nap-van der Vlist MM, Nijhof SL, van der Ent CK, Heijerman HGM, Hulzebos HJE. Physiological predictors of cardiorespiratory fitness in children and adolescents with cystic fibrosis without ventilatory limitation. Ther Adv Respir Dis 2022; 16:17534666211070143. [PMID: 35012387 PMCID: PMC8755930 DOI: 10.1177/17534666211070143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objectives: [1] To investigate the cardiorespiratory fitness (CRF) levels in children and
adolescents with cystic fibrosis (CF) with no ventilatory limitation
(ventilatory reserve ⩾ 15%) during exercise, and [2] to assess which
physiological factors are related to CRF. Methods: A cross-sectional study design was used in 8- to 18-year-old children and
adolescents with CF. Cardiopulmonary exercise testing was used to determine
peak oxygen uptake normalized to body weight as a measure of CRF. Patients
were defined as having ‘low CRF’ when CRF was less than 82%predicted.
Physiological predictors used in this study were body mass index z-score,
P. Aeruginosa lung infection, impaired glucose
tolerance (IGT) including CF-related diabetes, CF-related liver disease,
sweat chloride concentration, and self-reported physical activity. Backward
likelihood ratio (LR) logistic regression analysis was used. Results: Sixty children and adolescents (51.7% boys) with a median age of 15.3 years
(25th–75th percentile: 12.9–17.0 years) and a mean percentage predicted
forced expiratory volume in 1 second of 88.5% (±16.9) participated. Mean
percentage predicted CRF (ppVO2peak/kg) was 81.4% (±12.4, range:
51%–105%). Thirty-three patients (55.0%) were classified as having ‘low
CRF’. The final model that best predicted low CRF included IGT
(p = 0.085; Exp(B) = 6.770) and P.
Aeruginosa lung infection (p = 0.095; Exp(B) = 3.945). This
model was able to explain between 26.7% and 35.6% of variance. Conclusions: CRF is reduced in over half of children and adolescents with CF with normal
ventilatory reserve. Glucose intolerance and P. Aeruginosa
lung infection seem to be associated to low CRF in children and adolescents
with CF.
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Affiliation(s)
- Marcella Burghard
- Child Development, Exercise, and Physical Literacy Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. Box 85090, 3508 EA Utrecht, The Netherlands.,Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tim Takken
- Child Development, Exercise, and Physical Literacy Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Merel M Nap-van der Vlist
- Department of Social Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sanne L Nijhof
- Department of Social Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C Kors van der Ent
- Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Harry G M Heijerman
- Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands.,Division Heart and Lung, Department of Pulmonology, Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H J Erik Hulzebos
- Child Development, Exercise, and Physical Literacy Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.,Cystic Fibrosis Center Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
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