Sex Differences in Habitual Physical Activity and Lung Function Decline in Children with Cystic Fibrosis

doi:10.1016/j.jpeds.2005.03.043

The Journal of Pediatrics

Volume 147, Issue 3, September 2005, Pages 321-326

https://doi.org/10.1016/j.jpeds.2005.03.043 Get rights and content

Objectives

To evaluate the feasibility of measuring habitual physical activity (HPA) in children with cystic fibrosis (CF) and to assess the relation between HPA and the rate of decline in FEV₁ over a period of 2 years.

Study design

At regular clinic visits, 109 patients (7 to 17 years; 56 girls) performed pulmonary function testing and completed the Habitual Activity Estimation Scale (HAES). Patients were divided into quartiles, based on activity levels derived from the HAES.

Results

Girls in the two lowest activity quartiles had a more rapid rate of decline FEV₁ (−3.40% and −3.05% predicted, respectively) than girls in the two highest activity quartiles (−0.93% and +1.17% predicted, respectively) (P = .02). In boys, the rate of decline of FEV₁ was similar in all activity quartiles (−1.95% predicted). Patients reported significantly more activity in summer compared with spring, winter, and fall (P < .0001), and boys reported greater activity than girls (6.5 ± 2.9 vs 5.4 ± 2.5 h/d, P < .05).

Conclusions

The annual rate of change of FEV₁ was related to activity quartile in girls but not in boys. This research suggests that an inactive lifestyle may partially explain the poorer survival of female patients with CF. The HAES is a feasible tool for routine follow-up of HPA in our CF clinic.

Section snippets

Subject Selection

Patients 7 to 17 years of age who had reported participating in their “typical habitual” activity during the past week were recruited from the HSC and Montreal Children's Hospital (MCH) CF clinics. Children arriving at the clinic unwell, displaying symptoms such as an increased cough, purulent sputum, malaise, fever, and/or inability to participate in regular habitual physical activity, were recruited at a later visit. The Research Ethics Boards of HSC and MCH approved the study protocol, and

Results

Of the 153 eligible children from the HSC and MCH CF clinics who were approached to participate in the study, 116 agreed to participate (n = 103 HSC; n = 13 MCH). Reasons for nonparticipation included enrollment in other studies, irregularity of visits to the clinic, inadequate cognitive function, or lack of interest.

Since mean values and frequencies of baseline characteristics such as sex, initial FEV₁, and age were found to be comparable in the two centers, all analyses are reported for the

Discussion

This longitudinal study investigated the relation between habitual activity and lung function decline in children with CF. Mixed-model regression analysis showed that the rate of decline of FEV₁ was related to the level of habitual physical activity in girls but not in boys. Female subjects in the lower two activity quartiles (Q1, Q2) were characterized by much steeper rates of decline than those in Q3 and Q4. This relation of FEV₁ and activity quartile persisted even when the quartiles were

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Original ArticleSex Differences in Habitual Physical Activity and Lung Function Decline in Children with Cystic Fibrosis

Objectives

Study design

Results

Conclusions

Section snippets

Subject Selection

Results

Discussion

Chest

J Pediatr

J Pediatr

Am J Clin Nutr

Gender gap in cystic fibrosis mortality

Am J Epidemiol

Prediction of mortality in patients with cystic fibrosis

N Engl J Med

Cystic fibrosis: physical exercise versus chest physiotherapy

Arch Dis Child

Ventilatory muscle endurance training in normal subjects and patients with cystic fibrosis

Am Rev Respir Dis

Validation and calibration of physical activity monitors in children

Obesity Res

Age and gender differences in objectively measured physical activity in youth

Med Sci Sports Exerc

Measuring physical activity in children: a comparison of four different methods

Pediatr Exerc Sci

Preliminary evaluation of a video questionnaire to assess activity levels of children

Med Sci Sports Exerc

A 7-day activity diary for the assessment of daily energy expenditure validated by the doubly labelled water method in adolescents

Eur J Clin Nutr

Activity levels and the relationship to lung function and nutritional status in children with cystic fibrosis

Am J Phys Med Rehabil

Habitual physical activity in children and adolescents with cystic fibrosis

Med Sci Sports Exerc

Pulmonary function and oxygen uptake during exercise in 11-year -old patients with cystic fibrosis

Acta Paediatr Scand

Development and testing of the habitual activity estimation scale

Proceedings of the XIXth International Symposium of the European Group of Pediatric Work Physiology

The influence of calcium intake and physical activity on bone mineral content and bone size in healthy children and adolescents

Osteoporos Int

Original Article
Sex Differences in Habitual Physical Activity and Lung Function Decline in Children with Cystic Fibrosis