Original Articles
A randomized controlled trial of a 3-year home exercise program in cystic fibrosis,☆☆

Abstract presented at the 1995 North American Cystic Fibrosis Conference, Dallas, Texas, Oct 12-15, 1995.
https://doi.org/10.1067/mpd.2000.103408Get rights and content

Abstract

Objectives: To evaluate the effects of a 3-year home exercise program on pulmonary function and exercise tolerance in mildly to moderately impaired patients with cystic fibrosis (CF) and to assess whether regular aerobic exercise is a realistic treatment option. Study design: Seventy-two patients with CF (7-19 years) were randomly assigned to an exercise group (a minimum of 20 minutes of aerobic exercise, at a heart rate of approximately 150 beats/min, 3 times weekly) or a control group (usual physical activity participation). Pulmonary function, exercise tolerance, clinical status, hospitalizations, and compliance with therapy were monitored during scheduled visits to the hospital’s CF clinic. Results: Sixty-five patients were included in the analyses. The control group demonstrated a greater annual decline in percent of predicted forced vital capacity compared with the exercise group (mean slope ± SD, –2.42 ± 4.15 vs –0.25 ± 2.81; P =.02), with a similar trend for forced expiratory volume in 1 second (–3.47 ± 4.93 vs –1.46 ± 3.55; P =.07). Patients remained compliant with the exercise program over the study period. An improved sense of well-being was reported with exercise. Conclusions: Pulmonary function declined more slowly in the exercise group than in the control group, suggesting a benefit for patients with CF participating in regular aerobic exercise. Consistent compliance with the home exercise program and a self-reported positive attitude toward exercise provide further evidence of the feasibility and value of including an aerobic exercise program in the conventional treatment regimen of patients with CF. (J Pediatr 2000;136:304-10)

Section snippets

Patients

For this investigation, 72 mildly to moderately impaired patients with CF (FEV1 ≥40%), ranging in age from 7 to 19 years, were recruited at the CF clinic at The Hospital for Sick Children in Toronto. Although 162 patients met the eligibility criteria, not all were available to participate because of enrollment in other studies, a history of noncompliance with study protocols, or irregularity of visits to the clinic. Before commencement of the study, the protocol was approved by the Human

RESULTS

Of 72 patients with CF who entered this study, 4 (3 girls and 1 boy) dropped out of the exercise group (1 moved and 3 quit) before completion of year 1, and 3 patients (2 girls from the exercise group and 1 boy from the control group) withdrew before completion of year 2 (1 had poor health, 1 was incarcerated, and 1 was pregnant). Subsequently, one girl in the control group died before completion of year 3. Data for the 7 subjects who did not complete at least 2 years of follow-up in the study

DISCUSSION

A 3-year program of exercise therapy slowed the rate of decline in pulmonary function for a group of mildly to moderately impaired patients with CF. Rates of decline in the exercise group were less than those of the control group, which were similar to those previously reported in another sample of patients with comparable disease severity from the same CF population.24 In another randomized controlled trial35 in which patients were allocated to receive either ibuprofen or a placebo, rates of

Acknowledgements

This article was prepared with the assistance of Editorial Services, The Hospital for Sick Children, Toronto, Ontario, Canada.

References (41)

  • Cystic Fibrosis Foundation

    Patient Registry annual report 1996

    (1997)
  • E Kerem et al.

    Prediction of mortality in patients with cystic fibrosis

    N Engl J Med

    (1992)
  • FJ Cerny

    Relative effects of bronchial drainage and exercise for in-hospital care of patients with cystic fibrosis

    Phys Ther

    (1989)
  • LD Edlund et al.

    Effects of a swimming program on children with cystic fibrosis

    Am J Dis Child

    (1986)
  • B Andréasson et al.

    Long-term effects of physical exercise on working capacity and pulmonary function in cystic fibrosis

    Acta Paediatr Scand

    (1987)
  • FJ Holzer et al.

    The effect of a home exercise programme in children with cystic fibrosis and asthma

    Aust Paediatr J

    (1984)
  • W Salh et al.

    Effect of exercise and physiotherapy in aiding sputum expectoration in adults with cystic fibrosis

    Thorax

    (1989)
  • M Zach et al.

    Cystic fibrosis: physical exercise versus chest physiotherapy

    Arch Dis Child

    (1982)
  • HGM Heijerman et al.

    Oxygen-assisted exercise training in adult cystic fibrosis patients with pulmonary limitation to exercise

    Int J Rehabil Res

    (1991)
  • JK Stanghelle et al.

    Effect of daily short bouts of trampoline exercise during 8 weeks on the pulmonary function and the maximal oxygen uptake of children with cystic fibrosis

    Int J Sports Med

    (1988)
  • Cited by (224)

    • Respiratory physiotherapy in pediatric practice

      2022, Revue des Maladies Respiratoires
    • The effectiveness of exercise interventions to increase physical activity in Cystic Fibrosis: A systematic review

      2022, Journal of Cystic Fibrosis
      Citation Excerpt :

      This was a home-based intervention whereby participants completed strength training three times per week for one year. Three studies consisted of aerobic interventions [26,36,46]. Hommerding and colleagues [26] provided a manual to participants with guidelines for aerobic exercise, while Schneiderman-Walker et al. [46] conducted a three-year home exercise programme where participants were expected to engage in a minimum of 20 minutes of aerobic exercise three times a week.

    View all citing articles on Scopus

    Supported by a grant from the Canadian Cystic Fibrosis Foundation.

    ☆☆

    Reprint requests: J. Joseph Reisman, MD, Paediatric Respiratory Medicine, The Hospital for Sick Children, 555 University Ave, Toronto ON M5G 1X8, Canada.

    View full text