Physical activity is essential for maintaining good health and improving the quality of life for all ages.
Participation in physical activity not only benefits during childhood and adolescence by reducing the immediate risk for conditions such as diabetes, obesity, and cardiovascular diseases, but it has been shown that reduce future risk of chronic diseases in adulthood.
Several studies report that physical activity enhances the quality of life in healthy children, as well as in children with several chronic diseases, also positively influencing the psychological health.
However, there has been a recent decline in physical activity levels among children. This lifestyle change has resulted in increased obesity accompanied by a rise in diabetes and cardiovascular risk among otherwise healthy children. These lifestyle changes have been shown to be even more a problem when the child is simultaneously affected by other chronic diseases. So, the role of physical activity and just simply having fun cannot be undervalued but it is always important to consider that much care must be taken to make certain that these children are involved in the appropriate volume and intensity of physical activity due to medical limitations and contraindications.
Depending on the condition, physical activity may need to be adjusted. The changes are often necessary concerning the adjustment of intensity and volume. At the same time, some activities may need to be avoided because of the increased risk of injury specific to the condition. Another factor that must be considered is that some conditions may alter normal growth and development patterns. Therefore, the developmental age may not be on pace with the child’s chronological age.
Exercise testing of children with chronic health conditions can provide useful information for the clinician, parents, and children. The clinician can use the data obtained for diagnosis, establishing a prognosis, and as the basis for decisions regarding recommendations and contraindications for physical activity. Parents and children can gain reassurance about physical activity and participation in sports. Tomassoni, identified the following indications for exercise testing:
- Determining cardiovascular and pulmonary response.
- Evaluating symptoms associated with exercise.
- Evaluation for exercise-induced asthma.
- Assessment of aerobic capacity, either by maximal or submaximal protocols.
- Assessment of muscular endurance or strength.
- Documenting the course of a progressive disease.
- Evaluating the effects of therapy and rehabilitation programs.
Children with chronic health conditions can and should be allowed to participate in physical activity with minimal restrictions. For most chronic health conditions, the American Academy of Pediatrics recommends participation in most athletic activities for children and adolescents with caution regarding increased risk of injury and exacerbation of the child’s medical condition.
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- Fanelli, A.L. Cabral, J.A. Neder, M.A. Martins, C.R. Carvalho – Exercise training on disease control and quality of life in asthmatic children, Med Sci Sports Exerc, 39 (2007), pp. 1474-1480.
- S. Biddle- Children, exercise, and mental health, Int J Sport Psychol, 24 (1993), pp. 200-216.
- P.J. Morris- Physical activity recommendations for children and adolescents with chronic disease- Curr Sports Med Rep, 7 (2008), pp. 353-358.
- T.L. Tomassoni – Conducting the pediatric exercise test. T. Rowland (Ed.), Pediatric laboratory exercise testing, Human Kinetics, Champaign, IL (1993)
- S.G. Rice – Medical conditions affecting sports participation – Pediatrics, 121 (2008), pp. 841-848
