title: Short term effects of aerobic training in the clinical management of moderate to severe asthma in children Effects of Aerobic Versus Resistance Exercise Without Caloric Restriction on Abdominal Fat, Intrahepatic Lipid, and Insulin Sensitivity in Obese Adolescent Boys Strength vs aerobic training in children with cystic fibrosis: a randomized controlled trial. The pilot study. Voluntary dehydration and heat intolerance in cystic fibrosis Symptoms, lactate and exercise limitation at peak cycle ergometry in adults with cystic fibrosis School-based exercise program improves fitness, body composition and cardiovascular risk profile in overweight/obese children. The effects of vigorous exercise training on physical function in children with arthritis: a randomized, controlled, single-blinded trial. Physical activity reduces systemic blood pressure and improves early markers of atherosclerosis in pre-pubertal obese children. Short- and Long-Term Beneficial Effects of a Combined Dietary–Behavioral–Physical Activity Intervention for the Treatment of Childhood Obesity Effects of anaerobic training in children with cystic fibrosis: a randomized controlled study. Exercise Interventions in Children with Cancer: A Review Intrahospital weight and aerobic training in children with cystic fibrosis: a randomized controlled trial. Exercise training improves activity in adolescents with congenital heart disease Training of aerobic and anaerobic fitness in children with asthma. Cardiovascular disease risk factors and blood pressure response during exercise in healthy children and adolescents: the European Youth Heart Study. Exercise training on disease control and quality of life in asthmatic children. Effects of high-intensity intermittent running exercise in overweight children Higher Self-reported Physical Activity Is Associated With Lower Systolic Blood Pressure: The Dietary Intervention Study in Childhood (DISC) Wingate test performance in children with asthma: aerobic or anaerobic limitation? Benefits of intrahospital exercise training after pediatric bone marrow transplantation. Pilot study of fitness training and exercise testing in polyarticular childhood arthritis. 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 Outpatient exercise training in children with cystic fibrosis: physiological effects, perceived competence, and acceptability. Improvement of early vascular changes and cardiovascular risk factors in obese children after a six-month exercise program. The prevalence of overweight and obesity among Polish pre-school-aged children. Right ventricular dysfunction in adolescents with mild cystic fibrosis. Fitness of Children With Standard-risk Acute Lymphoblastic Leukemia During Maintenance Therapy: Response to a Home-based Exercise and Nutrition Program Effectiveness of a 5-year school-based intervention programme to reduce adiposity and improve fitness and lifestyle in Indian children; the SYM-KEM study Effects of resistance training on insulin sensitivity in overweight Latino adolescent males. Effects of physical exercise on quality of life, exercise capacity and pulmonary function in children with asthma. Effects of exercise training and montelukast in children with mild asthma. Effects of physical therapy intervention for children with acute lymphoblastic leukemia.
abstract: BACKGROUND Aerobic training has a number of well known beneficial effects in both normal and asthmatic children . However , the impact of training on the clinical management of the underlying bronchial asthma remains controversial , particularly in the most severe patients . METHODS Clinical evaluation , spirometric tests , symptom limited maximum exercise testing , and exercise challenge tests were performed in a group of children with stable moderate to severe asthma . Forty two patients ( 24 boys ) aged 8–16 were evaluated twice : before and after supervised aerobic training ( group 1 , n = 26 ) and two months apart ( untrained group 2 , n = 16 ) . RESULTS Spirometric and maximal exercise variables in the initial evaluation were significantly reduced in group 1 ( p<0.05 ) but medication and clinical scores and the occurrence of exercise induced bronchospasm ( EIB ) did not differ between the two groups . Aerobic improvement with training ( maximal oxygen uptake and /or anaerobic threshold increment > 10 % and 100 ml ) was inversely related to the baseline level of fitness and was independent of disease severity . Although the clinical score and the occurrence of EIB did not change after training , aerobic improvement was associated with a significant reduction in the medication score and the daily use of both inhaled and oral steroids ( p<0.05 ) . CONCLUSIONS Aerobic improvement with training in less fit asthmatic children is related to a short term decrease in the daily use of inhaled and oral steroids , independent of the severity of the disease The optimal exercise modality for reductions of abdominal obesity and risk factors for  type 2 diabetes in youth is unknown . We examined the effects of aerobic exercise ( AE ) versus resistance exercise ( RE ) without caloric restriction on abdominal adiposity , ectopic fat , and insulin sensitivity and secretion in youth . Forty-five obese adolescent boys were r and omly assigned to one of three 3-month interventions : AE , RE , or a nonexercising control . Abdominal fat was assessed by magnetic resonance imaging , and intrahepatic lipid and intramyocellular lipid were assessed by proton magnetic resonance spectroscopy . Insulin sensitivity and secretion were evaluated by a 3-h hyperinsulinemic-euglycemic clamp and a 2-h hyperglycemic clamp . Both AE and RE prevented the significant weight gain that was observed in controls . Compared with controls , significant reductions in total and visceral fat and intrahepatic lipid were observed in both exercise groups . Compared with controls , a significant improvement in insulin sensitivity ( 27 % ) was observed in the RE group . Collapsed across groups , changes in visceral fat were associated with changes in intrahepatic lipid ( r = 0.72 ) and insulin sensitivity ( r = −0.47 ) . Both AE and RE alone are effective for reducing abdominal fat and intrahepatic lipid in obese adolescent boys . RE but not AE is also associated with significant improvements in insulin sensitivity STUDY OBJECTIVE Exercise has the potential to improve the ability of a patient with cystic fibrosis ( CF ) to cope with the physical dem and s of everyday life , and may improve prognosis . The purpose of this study was to compare the effects of a home-based , semi-supervised , upper-body strength-training regimen with a similarly structured aerobic training regimen . DESIGN Data were collected during a 1-year r and omized clinical trial . SETTING Counselors conducted in-home visits with the participants once per week for the first 8 weeks followed by monthly visits for the remainder of the study . PATIENTS Sixty-seven patients with CF , aged 8 to 18 years , participated in the trial . INTERVENTION Participants in both exercise conditions were encouraged to exercise at least three times per week for 1 year . Each child in the aerobic group was given a stair-stepping machine , and each child in the upper-body strength training group was given an upper-body-only weight-resistance machine . MEASURES AND RESULTS Aerobic fitness , pulmonary function , quality of life , and strength were measured at baseline , at 6 months , and at 12 months . Strength training increased the maximum weight lifted for biceps curls significantly more than aerobic training ( p < 0.02 ) . However , this differential did not remain significant after control for increase in height . Both training procedures were associated with increased strength ( p < 0.002 ) and physical work capacity ( PWC ) [ p < 0.033 ] . CONCLUSIONS We concluded that strength and aerobic training may increase upper-body strength , and that both types of training may increase PWC for children with CF . Future trials should be conducted with no-training control subjects and larger sample s to increase statistical power This pilot aims to better underst and the market for childcare in Saudi Arabia – both the supply and dem and sides – and to design a r and omized controlled experiment to test whether access to affordable day care ( in the form of subsidies , for example ) would incentivize Saudi mothers to search actively for employment and to remain employed once they are hired . In addition , the study seeks to underst and the degree to which employment early on in one ’s life impacts employment in later stages . The pilot will provide information on the groups of women the experiment should target , appropriate levels for the childcare subsidy , and the quality and current geographic locations of daycare sites . Expected Impact Determine the effects of facilitating childcare access on Saudi women ’s employment . PRINCIPAL INVESTIGATORS  Boston University Patricia Cortes  Harvard University Claudia Goldin  Swarthmore College Jennifer Although exercise may be beneficial in cystic fibrosis ( CF ) , patients ' low tolerance to climatic heat stress means that physical exertion can increase morbidity and mortality . We postulated that the high salt content of CF patients ' sweat and the consequent absence of body-fluid hyperosmolality during a long episode of sweating might deprive such patients of a thirst stimulus . Eight children with CF ( four boys , four girls ; aged 9.5 - 14.1 years ) and eight controls , matched for age and sex , attended two r and omly ordered sessions of exercise ( cycling ) in a chamber at 31 - 33 degrees C , relative humidity 43 - 47 % . 20 min bouts of exercise ( at 45 % of predetermined maximum oxygen uptake ) were interspersed with 25 min rest periods . At one session , chilled water was given every 15 - 20 min to replace fluid lost ; at the other , drinking was guided by the child 's thirst . At the thirst-guided session , CF patients drank much less than the controls did ( 0.80 % vs 1.73 % initial body weight ) and lost twice as much fluid ( 1.57 % vs 0.78 % initial body weight ) . The recovery of heart rate after exercise was slower in CF patients , but there were no other signs of heat strain . The groups did not differ in any variable during the forced drinking session . We conclude that children with CF underestimate their fluid needs and undergo excessive dehydration during extended exposure to hot conditions The purpose of this study was to investigate symptoms , lactate accumulation and limiting factors at peak exercise in cystic fibrosis ( CF ) patients . In total , 104 CF adults attending an adult CF centre and 27 controls performed progressive cycle ergometry to a symptom-limited maximum . Measurements taken at peak exercise included : heart rate , ventilation , oxygen uptake , carbon dioxide output , oxygen saturation and blood lactate . Symptom scores of perceived breathlessness and muscle effort were recorded using Borg scales . The CF subjects had a lower mean body mass index , forced expiratory volume in one second ( FEV1 ) and peak oxygen uptake than controls . Peak lactate concentrations were very similar to controls ( mean±sd 6.8±2.0 mmol·L−1 versus 7.4±1.0 mmol·L−1 ) . Symptom scores were no different to controls for either breathlessness ( 4.5±2.0 versus 4.3±1.0 ) or perceived muscle effort ( 6.1±2.0 versus 6.5±1.0 ) , with higher scores for muscle effort than breathlessness in both groups . In addition , peak ventilation was lower than the predicted maximum , and high peak heart rates were recorded supporting nonpulmonary factors as important in limiting peak exercise . Peak oxygen uptake was correlated with FEV1 . Comparison of CF subjects with mild or moderate pulmonary disease and controls revealed similar exercise responses . In contrast , those CF patients with severe lung disease ( FEV1 < 40 % predicted ) had significantly higher breathlessness , lower muscle effort scores , lower peak lactate , lower peak heart rate and a mean ventilation exceeding predicted , thus confirming that ventilation was the major factor limiting exercise . In conclusion , cystic fibrosis subjects have a reduced peak exercise capacity , but their exercise response is similar to controls in generating high blood-lactate concentrations and symptoms of muscle effort in excess of dyspnoea . Nonpulmonary factors influence peak performance more in those without severe disease We determined the effect of a school-based exercise training ( ET ) without dietary intervention , on body composition , fitness and cardiovascular risk in overweight/obese children . Subjects were 51 overweight/obese 6.5- to 12.5-year-old children ( 23 boys , 28 girls ; BMI 25.6+/-4.3 kg/m 2 ) , of whom 48 completed the program . Participants were enrolled in a 15-week aerobic training ( three 60-minute sessions/week ) . Working heart rate was between 120 - 185 beats/minute . Participation rate was 87 % . BMI , waist circumference , body composition ( bioimpedance ) , aerobic capacity ( treadmill ) , blood pressure , lipids and insulin sensitivity ( HOMA ) were assessed . Waist circumference ( 85.9+/-12.4 vs. 80.9+/-10.2 cm ) , muscle mass ( 32.4+/-6.2 vs. 33.7+/-6.1 kg ) , maximal oxygen consumption ( 37.0+/-3.9 vs. 42.6+/-11.2 ml/kg per minute ) , systolic blood pressure ( 113.3+/-11.2 vs. 106.7+/-11.6 mmHg ) and LDL cholesterol ( 2.4+/-0.6 vs. 1.9+/-0.6 mM/l ) improved significantly . Number of children with abdominal obesity ( 29 vs. 20 ) , hypertension ( 10 vs. 5 ) and elevated triglyceride ( 18 vs. 14 ) also declined significantly over time . We concluded that as a result of high attendance and appropriate training program , cardiovascular fitness and abdominal obesity improved in overweight/obese children along with the improvement in metabolic risk factor profile OBJECTIVE To examine the effectiveness of high-intensity aerobic training compared with low-intensity training in terms of energy cost of locomotion , peak oxygen uptake , peak power , and self-reported physical function in children with juvenile idiopathic arthritis ( JIA ) . METHODS Eighty children with JIA , ages 8 - 16 years , were enrolled in a r and omized , single-blind controlled trial . Both groups participated in a 12-week , 3-times-weekly training program consisting of high-intensity aerobics in the experimental group and qigong in the control group . Subjects underwent exercise testing measuring submaximal oxygen uptake at 3 km/hour ( VO(2submax ) ) as the primary outcome , maximal oxygen uptake , and peak power at the beginning and end of the program . Physical function was measured using the Child Health Assessment Question naire ( C-HAQ ) . RESULTS The exercise program was well tolerated in both groups . There was no difference in VO(2submax ) or any other exercise testing measures between the groups through the study period and no indication of improvement . Both groups showed significant improvements in C-HAQ with no difference between the groups . Adherence was higher in the control group than the experimental group . CONCLUSION Our findings suggest that activity programs with or without an aerobic training component are safe and may result in an important improvement in physical function . The intensity of aerobic training did not seem to provide any additional benefits , but higher adherence in the qigong program may suggest that less intensive regimens are easier for children with JIA to comply with , and provide a degree of benefit equivalent to more intensive programs OBJECTIVES The aim of this study was to determine the effects of physical activity on systemic blood pressure ( BP ) and early markers of atherosclerosis in pre-pubertal obese children . BACKGROUND Hypertension and endothelial dysfunction are premature complications of obesity . METHODS We performed a 3-month r and omized controlled trial with a modified crossover design : 44 pre-pubertal obese children ( age 8.9 + or - 1.5 years ) were r and omly assigned ( 1:1 ) to an exercise ( n = 22 ) or a control group ( n = 22 ) . We recruited 22 lean children ( age 8.5 + or - 1.5 years ) for baseline comparison . The exercise group trained 60 min 3 times/week during 3 months , whereas control subjects remained relatively inactive . Then , both groups trained twice/week during 3 months . We assessed changes at 3 and 6 months in office and 24-h BP , arterial intima-media thickness ( IMT ) and stiffness , endothelial function ( flow-mediated dilation ) , body mass index ( BMI ) , body fat , cardiorespiratory fitness ( maximal oxygen consumption [ VO(2)max ] ) , physical activity , and biological markers . RESULTS Obese children had higher BP , arterial stiffness , body weight , BMI , abdominal fat , insulin resistance indexes , and C-reactive protein levels , and lower flow-mediated dilation , VO(2)max , physical activity , and high-density lipoprotein cholesterol levels than lean subjects . At 3 months , we observed significant changes in 24-h systolic BP ( exercise -6.9 + or - 13.5 mm Hg vs. control 3.8 + or - 7.9 mm Hg , -0.8 + or - 1.5 st and ard deviation score [ SDS ] vs. 0.4 + or - 0.8 SDS ) , diastolic BP ( -0.5 + or - 1.0 SDS vs. 0 + or - 1.4 SDS ) , hypertension rate ( -12 % vs. -1 % ) , office BP , BMI z-score , abdominal fat , and VO(2)max . At 6 months , change differences in arterial stiffness and IMT were significant . CONCLUSIONS A regular physical activity program reduces BP , arterial stiffness , and abdominal fat ; increases cardiorespiratory fitness ; and delays arterial wall remodeling in pre-pubertal obese children . ( Effects of Aerobic Exercise Training on Arterial Function and Insulin Resistance Syndrome in Obese Children : A R and omized Controlled Trial ; NCT00801645 ) Background . Obesity has become the most common pediatric chronic disease in the modern era . Early prevention and treatment of childhood and adolescent obesity is m and ated . Surprisingly , however , only a minor fraction of obese children participate in weight reduction interventions , and the longer-term effects of these weight-reduction interventions among children have not been eluci date d. Objective . To examine prospect ively the short- and long-term effects of a 3-month , combined dietary-behavioral-physical activity intervention on anthropometric measures , body composition , dietary and leisure-time habits , fitness , and lipid profiles among obese children . Methods . In this r and omized prospect i ve study , 24 obese subjects completed the 3-month intervention and were compared with 22 obese , age- and gender-matched , control subjects . Results . At 3 months , there were significant differences in changes in body weight ( −2.8 ± 2.3 kg vs 1.2 ± 2.2 kg ) , BMI ( −1.7 ± 1.1 kg/m2 vs −0.2 ± 1.0 kg/m2 ) , body fat percentage ( from skinfold tests ; −3.3 ± 2.6 % vs 1.4 ± 4.7 % ) , serum total cholesterol level ( −24.6 ± 15.1 mg/dL vs 0.8 ± 18.7 mg/dL ) , low-density lipoprotein cholesterol level ( −23.3 ± 15.2 mg/dL vs −3.7 ± 17.3 mg/dL ) , and fitness ( 215 ± 107 seconds vs 50 ± 116 seconds ) in the intervention group versus the control group . After a 1-year follow-up period , there were significant differences between the intervention group ( n = 20 ) and the control group ( n = 20 ) in body weight ( 0.6 ± 6.0 kg vs 5.3 ± 2.7 kg ) , BMI ( −1.7 ± 2.3 kg/m2 vs 0.6 ± 0.9 kg/m2 ) , and body fat percentage . There was a significant increase in leisure-time physical activity among the intervention participants , compared with a decrease among the control subjects . Conclusions . Our data demonstrate the short- and longer-term beneficial effects of a combined dietary-behavioral-physical activity intervention among obese children . These results highlight the importance of multidisciplinary programs for the treatment of childhood obesity and emphasize their encouraging long-term effects 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 The purpose of this review is to summarize literature that describes the impact of exercise on health and physical function among children during and after treatment for cancer . Relevant studies were identified by entering the following search terms into Pubmed : aerobic training ; resistance training ; stretching ; pediatric ; children ; AND cancer . Reference lists in retrieved manuscripts were also review ed to identify additional trials . We include fifteen intervention trials published between 1993 and 2011 that included children younger than age 21 years with cancer diagnoses . Nine included children with an acute lymphoblastic leukemia ( ALL ) diagnosis , and six children with mixed cancer diagnoses . Generally , interventions tested were either in-hospital supervised exercise training or home based programs design ed to promote physical activity . Early evidence from small studies indicates that the effects of exercise include increased cardiopulmonary fitness , improved muscle strength and flexibility , reduced fatigue and improved physical function . Generalizations to the entire childhood cancer and childhood cancer survivor population s are difficult as most of the work has been done in children during treatment for and among survivors of ALL . Additional r and omized studies are needed to confirm these benefits in larger population s of children with ALL , and in population s with cancer diagnoses other than ALL 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 Objectives To ascertain if motivational techniques and a structured exercise programme can increase activity in adolescents afflicted with congenital heart disease ( CHD ) . Design Prospect i ve r and omised controlled trial . Setting One hundred and forty-three patients aged 12–20 years attending the tertiary centre for paediatric cardiology in Northern Irel and . Main outcome measures Increase in exercise capacity as assessed by duration of exercise stress test , and number of minutes spent in moderate to vigorous physical activity ( MVPA ) per day . Results Eighty-six patients were men ( 60 % ) , mean age was 15.60±2.27 years . Seventy-three percent were considered to have major CHD . Seventy-two participants were r and omised to the intervention group . Following intervention , duration of exercise test increased by 1 min 5 s for the intervention group ( p value 0.02 ) along with increase in predicted VO2Max ( p value 0.02 ) . There was a significant increase in minutes of MVPA per day for the intervention group from baseline to re assessment ( p value < 0.001 ) while MVPA remained much the same for the control group . Fourteen patients met the current recommendation for more than 60 min MVPA per day at baseline . This doubled to 29 participants at re assessment . There were no adverse effects or mortalities reported . Conclusions Exercise training  is safe , feasible and beneficial in adolescents with CHD . Psychological techniques can be employed to maximise the impact of interventions . Trial Registration Number IS RCT N27986270 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 Raised blood pressure ( BP ) response during exercise independently predicts future hypertension . Subjects with higher BP in childhood also have elevated BP later in life . Therefore , the factors related to the regulation of exercise BP in children needs to be well understood . We hypothesized that physiological cardiovascular disease ( CVD ) risk factors would influence BP response during exercise in children and adolescents . This is a cross-sectional study of 439 Danish third- grade children and 364 ninth- grade adolescents .  Systolic blood pressure ( SBP ) was measured with sphygmomanometer during a maximal aerobic fitness test . Examined CVD risk factors were high-density lipoprotein (HDL)- and low-density lipoprotein (LDL)-cholesterol , triglyceride , homeostasis model of assessment of insulin resistance ( HOMA-IR ) score , body mass index ( BMI ) , waist circumference , and aerobic fitness . A r and om effect model was used to test the hypotheses . In boys  , HOMA-IR score and BMI were positively related to SBP response during exercise ( β = 1.03 , P = 0.001 , and β = 0.58 , P = 0.017 , respectively ) . The effects sizes of HOMA-IR score and BMI and the significance levels only changed slightly ( β = 0.91 , P = 0.004 , and β = 0.43 , P = 0.08 , respectively ) when the two variables were added in the same model . A significant positive association was observed between aerobic fitness and SBP response in girls ( β = 3.13 and P = 0.002 ) . HOMA-IR score and BMI were found to be positively related to the SBP response in male children and youth . At least partly , adiposity and insulin sensitivity seem to influence exercise SBP through different mechanisms . The positive relationship observed between aerobic fitness and SBP response in girls remains unexplainable for us , although post hoc analyses revealed that it was the case in the ninth grade rs only 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 Abstract This study examined the effects of a 6-week intermittent exercise training , at different intensities , on body composition , functional walking and aerobic endurance in overweight children . Forty-eight overweight children ( age : 10.4 ± 0.9 years ) were r and omly assigned to either intervention or control group . Lower and higher intensity intermittent exercise groups ( LIIE and HIIE ) performed intermittent running three times a week . LIIE performed more intervals at a lower intensity [ 16 intervals at 100 % of individual maximal aerobic speed ( MAS ) , 8 minutes in total ] , and HIIE performed fewer intervals at a higher intensity ( 12 intervals at 120 % of MAS , 6 minutes in total ) . Each interval consisted of a 15-second run at the required speed , followed by a 15-second passive recovery . After 6 weeks , HIIE had a significantly ( p < 0.05 ) higher percentage reduction in sum of skinfolds ( i.e. calf and triceps ) , and significantly ( p < 0.05 ) fewer steps during the functional obstacle performance , as compared with LIIE and control group . Significant improvement ( p < 0.05 ) was found in intermittent aerobic endurance for HIIE as compared to the control group . Higher intensity intermittent training is an effective and time-efficient intervention for improving body composition , functional walking and aerobic endurance in overweight children OBJECTIVE . Children participating in a dietary clinical trial were studied to ( 1 ) assess physical activity patterns in boys and girls longitudinally from late childhood through puberty and ( 2 ) determine the association of level of physical activity on systolic blood pressure , low-density lipoprotein cholesterol , and BMI . PATIENTS AND METHODS . In the Dietary Intervention Study in Childhood , a r and omized clinical trial of a reduced saturated fat and cholesterol diet in 8- to 10-year-olds with elevated low-density lipoprotein , a question naire that determined time spent in 5 intensity levels of physical activity was completed at baseline and at 1 and 3 years . An estimated-metabolic-equivalent score was calculated for weekly activity ; hours per week were calculated for intense activities . We hypothesized that weekly self-reported physical activity would be associated with lower systolic blood pressure , low-density lipoprotein , and BMI over 3 years . Longitudinal data analyses were performed for each outcome ( systolic blood pressure , low-density lipoprotein , and BMI ) by using generalized estimating equations with estimated-metabolic-equivalent score per week as the independent variable adjusted for visit , gender , and Tanner stage ( BMI was included in models for systolic blood pressure and low-density lipoprotein ) . RESULTS . The initial study cohort comprised 663 youths ( 362 boys [ mean age : 9.7 years ] and 301 girls [ mean age : 9.0 years ) , of whom 623 ( 94 % ) completed the 3-year visit . For every 100 estimated-metabolic-equivalent hours of physical activity , there was a decrease of 1.15 mmHg of systolic blood pressure . There was a 1.28 mg/dL decline in low-density lipoprotein for a similar energy expenditure . For BMI , an analysis of intense physical activity showed that for every 10 hours of intense activity , there was a trend toward significance with a 0.2 kg/m2 decrease . CONCLUSIONS . Children with elevated cholesterol levels who lead a more physically active lifestyle have lower systolic blood pressure and a trend toward lower low-density lipoprotein over a 3-year interval . Long-term participation in intense physical activity may reduce BMI as well To investigate the anaerobic capacity in children with bronchial asthma , eight male children with atopic asthma ( age : 12 + /- 1.7 yr ) and seven healthy control subjects ( age : 12 + /- 1 yr ) performed a 30-s all-out exercise test : the Wingate anaerobic test ( WanT ) .  Post-exercise plasma epinephrine ( E ) , norepinephrine ( NE ) , venous blood lactate ( La ) , and blood pH levels were determined . Peak power ( Ppeak ) , mean power ( Pm ) , and total energy expenditure ( Wtot ) during the WanT were assessed . The relative importance of aerobic ( WO2 ) and anaerobic ( Wana ) energy release during the WanT was also evaluated . In comparison with control subjects , the children with asthma exhibited lower Ppeak ( W.kg-1 ) : 6 + /- 1.14 vs 7.3 + /- 0.5 , P < 0.05 ; lower Pm ( W.kg-1 ) : 4.7 + /- 0.8 vs 5.9 + /- 0.5 , P < 0.05 ; and lower Wtot ( Jg-1 ) : 140.3 + /- 25 vs 176.9 + /- 19 , P < 0.05 . The relative contribution of WO2 ( 26 % ) and Wana ( 74 % ) to the Wtot was identical in both groups . Blood lactate and pH kinetics revealed significantly lower La values and less acidosis in the asthmatic group ( P < 0.001 ) . Lastly , E ( pg.ml-1 ) concentrations were lower in the asthmatic group : 274.96 + /- 84.58 vs 901.28 + /- 604.76 , P < 0.05 . These results suggest a reduced anaerobic capacity in children with asthma . A diminished adrenergic response to exhausting exercise , leading to a decreased anaerobic glycolysis , could partly account for this phenomenon The purpose of this study was to determine if an eight-week intrahospital supervised , conditioning program improves functional capacity and quality of life ( QOL ) in children ( 4 boys , 4 girls ) ( mean [ SD ] age : 10.9 [ 2.8 ] years [ range : 8 - 16 ] ) who have undergone bone marrow transplantation ( BMT ) for leukemia treatment within the last 12 months . A group of 8 age and gender-matched healthy children served as controls . The experimental group performed 3 weekly sessions of resistance and aerobic training inside an intra-hospital gymnasium . A significant combined effect of group and time ( p < 0.05 ) was observed for muscle functional capacity ( Timed Up and Down Stairs [ TUDS ] test ) and peak oxygen uptake ( V.O(2peak ) ) , i.e. , with BMT children showing greater improvements than controls ( V.O(2peak ) at pre- and post-training of 25.9 ( 8.2 ) and 31.1 ( 7.6 ) mL/kg/min in diseased children ) . Muscle strength ( 6 RM test for bench and leg press and seated row ) also improved after training ( p < 0.05 ) in the BMT group . Concerning QOL , a significant combined effect of group and time ( p < 0.05 ) was also observed for children 's self-report of comfort and resilience and for parents ' report of their children 's satisfaction and achievement . In summary , children who have received BMT  experience physical and overall health benefits after a relatively short-term ( 8 weeks ) supervised exercise training program OBJECTIVE To 1 ) assess the safety and feasibility of laboratory-based exercise testing in juvenile idiopathic arthritis ( JIA ) , 2 ) test the safety and feasibility of a 3-month exercise program in JIA , 3 ) assess pain during exercise in JIA , 4 ) compare ratings of perceived effort ( RPE ) with heart rate ( HR ) achieved , and 5 ) estimate the training effect on metabolic efficiency of gait as measured by submaximal exercise testing . METHODS Nine children with JIA were enrolled in a 12-week circuit training program involving pool , stationary bicycle , treadmill , and Fitball . They underwent formal exercise testing before and after the program , underwent a full joint assessment , were administered the Childhood Health Assessment Question naire and Juvenile Arthritis Functional Status Index , and were assessed for overall quality of life and health-related quality of life . A visual analog scale was used to assess pain during testing and training , and the Borg scale was used to measure RPE . RESULTS Children with JIA were able to participate in exercise testing without any significant problems . Children with severe hip disease dropped out of the exercise program due to  pain  during the exercise sessions and worsened arthritis symptoms . Target HR was achieved and correlated with RPE in the bicycle and treadmill sessions . Submaximal exercise testing showed an improvement with a small to moderate effect size . CONCLUSION This study suggests that it is safe , feasible , and acceptable for children with arthritis , in the absence of severe hip involvement , to participate in formal exercise testing and structured fitness programs 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 Exercise training is currently advocated as part of the treatment of patients with cystic fibrosis ( CF ) . However , data are few that document physiologic benefits or changes in patients ' perceptions of long-term training programs in children with CF . The aim of this study was to investigate the effects and acceptability of a home cycling program in children with CF . Fourteen patients ( 9 boys , 5 girls ) with CF , mean ( SD ) age 14.1 ( 2.0 ) years , with mild to moderate impairment of lung function ( forced expiratory volume in 1 s , mean ( SD ) 58.3 (16.3)% of predicted ) were studied for 1 year . The first half of the study year was used to obtain baseline values at 0 and 6 months . During the second half of the year , a cycle program was carried out 5 times a week , for 20 min each day at a level of work that result ed in a heart rate of 140 - 160 beats/min . Once a week the cycle program was supervised by a physiotherapist . Measurements were repeated at 12 months . Effects of the exercise program were measured in terms of lung function , nutritional status , growth , muscle strength , exercise performance , perceived competence , and attitude towards the training program . Differences between the changes during the 6-month training period as compared to the 6-month control period were analyzed by multivariate statistics and nonparametric tests . Statistically significant differences ( P < 0.05 ) between the two periods were found with respect to muscle strength of knee extensors and ankle dorsiflexors , and with respect to maximal oxygen consumption per kg body weight as well as per kg fat free mass . All changes were positive . No adverse effects were found . Perceived competence showed significant positive changes in feelings about physical appearance , general self-worth , and Total Perceived Competence Score . Scores concerning perceived acceptability of the program were significantly lower at the end of the training period ; however , patients reported that they did want to continue with other sorts of training . We conclude that an exercise training program in the home can produce beneficial effects on oxygen consumption , muscle force , and perceived competence in children with CF . However , acceptability of the program was low , suggesting that long-term adherence would be poor , and hence , other sorts of training need to be identified OBJECTIVES The present study aim ed to assess the effect of a 6-month exercise program  in obese children on flow-mediated vasodilation ( FMD ) carotid intima-media thickness ( IMT ) and cardiovascular risk factors ( RF ) . BACKGROUND Childhood obesity contributes to adult obesity and subsequent cardiovascular disease . Physical inactivity is a major RF for obesity , endothelial dysfunction , and elevated carotid IMT , culminating in early atherosclerotic disease . METHODS Sixty-seven obese subjects ( age 14.7 + /- 2.2 years ) were r and omly assigned to 6 months ' exercise or non-exercise protocol . We examined the influence of exercises ( 1 h , 3 times/week ) on FMD , IMT , and cardiovascular risk profile . RESULTS Compared with lean control subjects , obese children demonstrated at baseline significantly impaired FMD ( 4.09 + /- 1.76 % vs. 10.65 + /- 1.95 % , p < 0.001 ) , increased IMT ( 0.48 + /- 0.08 mm vs. 0.37 + /- 0.05 mm , p < 0.001 ) , and a number of obesity-related cardiovascular RF . Significant improvements were observed in the exercise group for IMT ( 0.44 + /- 0.08 mm , p = 0.012 , -6.3 % ) and FMD ( 7.71 + /- 2.53 % , p < 0.001 , + 127 % ) . This improvement correlated with reduced RF , such as body mass index st and ard deviation scores , body fat mass , waist/hip ratio , ambulatory systolic blood pressure , fasting insulin , triglycerides , low-density lipoprotein/high-density lipoprotein ratio , and low-degree inflammation ( C-reactive protein , fibrinogen ) . CONCLUSIONS The present study documented increased IMT , impaired endothelial function , and various elevated cardiovascular RF in young obese subjects . Regular exercise over 6 months restores endothelial function and improves carotid IMT associated with an improved cardiovascular risk profile in obese children UNLABELLED The aim of this study is to estimate the prevalence of overweight and obesity in a current , nationally representative , r and om sample of pre-school-aged children in Pol and and to compare their overweight and obesity rates with their peers from the US and Norway . MATERIAL AND METHODS The height and weight were measured in a total of 5026 r and omly sample d children aged 2 - 6 years and their Body Mass Index was calculated . The prevalence of overweight including obesity was determined using three definitions , i.e. those formulated by the International Obesity Task Force ( IOTF ) , the World Health Organization ( WHO ) and the Centers for Disease Control and Prevention ( CDC ) . RESULTS The overall prevalence of overweight including obesity in boys was 12.2 % , 12.2 % , 17.2 % and in girls 15.0 % , 10.0 % , 19.1 % according to the IOTF , WHO , CDC definition , respectively , and did not significantly differ in comparison with their US and Norwegian peers . The overall prevalence of obesity in boys was : 4.4 % , 4.9 % , 8.9 % and in girls : 3.8 % , 3.4 % , 7.6 % , according to the IOTF , WHO , CDC definition , respectively . Among Polish girls the obesity rate was higher compared to the female US peers . The obesity rate was higher in Polish boys compared to their Norwegian peers . CONCLUSION The estimates of the prevalence of overweight and obesity varied substantially by age group , gender and depending on the definition used .  Obesity rates among Polish girls and boys were higher compared to their American and Norwegian peers . The influence of overweight definitions should be taken into account when study ing childhood overweight and obesity . Overweight and obesity preventive programs should be implemented at preschool age BACKGROUND In cystic fibrosis ( CF ) patients the right ventricle ( RV ) suffers a progressive deterioration , but it is not clear when these changes begin . The aim of this study was to analyze the RV function in CF patients with mild respiratory disease . METHODS Color-Doppler-Echocardiographic studies were prospect ively performed in CF adolescent patients and an age-matched control group . Findings were correlated with pulmonary function tests ( PFT ) , genotype , chronic bacterial colonization , pancreatic status and clinical scores .  Only patients with mild CF were selected . RESULTS Thirty seven CF patients and 40 healthy controls were recruited . In CF patients all echocardiographic parameters were abnormal compared to controls . Doppler analysis showed slightly elevated pulmonary artery pressure values , and abnormal relaxation and systolic function for all indexes . No correlation was found with any of the features studied . CONCLUSIONS In CF patients , abnormalities in the structure and function of the RV may be present at early stages of the disease . These abnormalities are sub clinical and do not correlate with clinical scores , PFT , genotype , chronic bacterial colonization or pancreatic insufficiency Background Altered nutrient intake and decreased exercise in response to cancer therapies and their side effects , particularly corticosteroids , may be key factors in the increased body weight and differences in physical fitness reported in survivors of childhood acute lymphoblastic leukemia ( ALL ) . Purpose To assess ( 1 ) the effect of a home-based nutrition and exercise intervention program on cardiovascular fitness , strength , and flexibility in children with ALL during maintenance therapy and ( 2 ) the feasibility of conducting and evaluating a home-based exercise and nutrition program in this patient population . Design Children ages 4 to 10 years with st and ard-risk ALL were r and omized when starting maintenance therapy to a 12-month home-based exercise and nutrition program ( n=6 , 3 males/3 females ) or control ( n=7 , 4 males/3 females ) group . Assessment of anthropometrics , dietary intake , physical activity , and fitness was performed at baseline and 6 and 12 months of study . Results Although age , body size , and nutrient intakes were similar between both subject groups at 0 , 6 , and 12 months , exercise and nutrition program children had greater improvement in physical activity and cardiovascular fitness between 6 and 12 months than control children . Conclusions These results suggest that a home-based exercise intervention during maintenance therapy encouraged greater physical activity and improved cardiovascular fitness in children with st and ard-risk ALL . Further investigation involving larger population s of children with ALL is warranted Design Non-r and omised non-blinded school-based intervention study . Setting Two schools in the cities of Pune and Nasik , India . Participants The intervention group comprised children attending a Pune school from 7–10 years until 12–15 years of age . Two control groups comprised children of the same age attending a similar school in Nasik , and children in the Pune intervention school but aged 12–15 years at the start of the study . Intervention A 5-year multi-intervention programme , covering three domains : physical activity , diet and general health , and including increased extracurricular and intracurricular physical activity sessions ; daily yoga-based breathing exercises ; making physical activity a ‘ scoring ’ subject ; nutrition education ; healthier school meals ; removal of fast-food hawkers from the school environs ; and health and nutrition education for teachers , pupils and families . Main outcome measures Body mass index ( BMI ) , waist circumference , physical fitness according to simple tests of strength , flexibility and endurance ; diet ; and lifestyle indicators ( time watching TV , study ing and actively playing ) . Results After 5 years the intervention children were fitter than controls in running , long jump , sit-up and push-up tests ( p<0.05 for all ) . They reported spending less time sedentary ( watching TV and study ing ) , more time actively playing and eating fruit more often ( p<0.05 ) . The intervention did not reduce BMI or the prevalence of overweight/obesity , but waist circumference was lower than in the Pune controls ( p=0.004 ) . Conclusions It was possible to achieve multiple health-promoting changes in an academically competitive Indian school . These changes result ed in improved physical fitness , but had no impact on the children 's BMI or on the prevalence of overweight/obesity PURPOSE Insulin resistance is thought to be a core defect in the pathophysiology of obesity-related comorbidities in children , such as type 2 diabetes . Exercise training is known to improve insulin resistance and reduce the risk of type 2 diabetes in adults . However , very little is known regarding the effects of exercise on insulin resistance in youth . Therefore , we examined the effects of a 16-wk resistance training exercise intervention on insulin sensitivity in youth at high risk for developing type 2 diabetes . METHODS Twenty-two overweight Latino adolescent males were r and omly assigned to either a twice-per-week resistance training group ( RT=11 ) or a nonexercising control group ( C=11 ) for 16 wk . Strength was assessed by one-repetition maximum , body composition was quantified by dual-energy x-ray absorptiometry , and insulin sensitivity was determined by the frequently sample d intravenous glucose tolerance test with minimal modeling . RESULTS Significant increases in upper- and lower-body strength were observed in the RT compared with the C group . The RT group significantly increased insulin sensitivity compared with the C group ( P<0.05 ) , and this increase remained significant after adjustment for changes in total fat mass and total lean tissue mass ( P<0.05 ) . Compared with baseline values , insulin sensitivity increased 45.1+/-7.3 % in the RT group versus -0.9+/-12.9 % in controls ( P<0.01 ) . CONCLUSION A twice-per-week 16-wk resistance training program can significantly increase insulin sensitivity in overweight Latino adolescent males independent of changes in body composition 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 PURPOSE Data from the general population suggest that habitual exercise decreases bronchial responsiveness , but the possible role of exercise in asthmatics is undefined . The leukotriene receptor antagonist montelukast decreases bronchial responsiveness and exercise-induced symptoms in asthmatic children . This r and omized study in children with mild asthma evaluated the combined effects of aerobic training for 12 wk and montelukast or placebo on bronchial responsiveness ( BHR ) to methacholine , exercise-induced bronchoconstriction ( EIB ) , inflammatory markers in exhaled breath condensate ( EBC ) , and asthma exacerbations . METHODS Fifty children ( mean age + /- SD : 10.2 + /- 2.4 yr ) with mild stable asthma were r and omly assigned to placebo ( N = 25 ) or montelukast ( N = 25 ) . Before and after training , we assessed BHR and EIB and markers of airway inflammation-that is , exhaled nitric oxide ( eNO ) , pH , and cysteinyl-leukotriene concentration-in EBC . RESULTS Training increased maximal workload and peak minute ventilation . After training , the methacholine dose causing a 20 % fall in FEV1 ( PD20 ) increased in both groups . A decreased slope of FEV1 decline at increasing methacholine dose was found only in montelukast-treated children . EIB prevalence halved after training in both groups ( EIB + children , placebo group : 10 pretraining , 4 posttraining ; EIB + children , montelukast group : 8 pretraining , 5 posttraining ; P < 0.05 by chi on all children ) . Resting eNO was unaffected , whereas the pH of EBC decreased after training in both groups . Cysteinyl-leukotriene concentrations were low in most children at both times . During training , montelukast-treated children showed fewer asthma exacerbations compared with the same period of the previous year . CONCLUSIONS In children with mild stable asthma , exercise training decreased bronchial responsiveness to methacholine . Montelukast also decreased bronchial reactivity ( FEV1 slope ) and protected against exacerbations , suggesting a beneficial synergistic action of these two interventions in mild asthma BACKGROUND The purpose of this study was to examine the effects of physical therapy intervention in children with acute lymphoblastic leukemia ( ALL ) . PROCEDURE Twenty-eight children aged 4 - 15 years were r and omly assigned to an intervention or control group . The intervention group received five sessions of physical therapy and was instructed to perform an individualized home exercise program consisting of ankle dorsiflexion stretching , lower extremity strengthening , and aerobic exercise . RESULTS After 4 months children who received physical therapy intervention had significantly improved ankle dorsiflexion active range of motion and knee extension strength ( P < 0.01 ) . Differences were not found between the two groups for any of the other dependent variables . CONCLUSIONS Physical therapy intervention for children with ALL receiving maintenance chemotherapy improved two body functions important for normal gait .  Physical therapy programs initiated earlier in treatment and with greater emphasis on endurance activities may also improve stamina and quality of life ( QOL )
target: Results Overall , exercise intolerance is prevalent in pediatric chronic disease .
background: Background Physical activity ( PA ) is associated with a diverse range of health benefits .
  International guidelines suggest that children should be participating in a minimum of 60 min of moderate to vigorous intensity PA per day to achieve these benefits .
  However , current guidelines are intended for healthy children , and thus may not be applicable to children with a chronic disease .
  Specifically , the dose of PA and disease specific exercise considerations are not included in these guidelines , leaving such children with few , if any , evidence -based informed suggestions pertaining to PA .
  Thus , the purpose of this narrative review was to consider current literature in the area of exercise as medicine and provide practical applications for exercise in five prevalent pediatric chronic diseases : respiratory , congenital heart , metabolic , systemic inflammatory/autoimmune , and cancer .