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Early oxygen uptake recovery following exercise testing in children with chronic chest diseases
Author(s) -
Stevens D.,
Oades P.J.,
Armstrong N.,
Williams C.A.
Publication year - 2009
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.21024
Subject(s) - medicine , spirometry , vo2 max , cycle ergometer , cardiology , vital capacity , pediatrics , physical therapy , lung , diffusing capacity , heart rate , lung function , asthma , blood pressure
The value of exercise testing as an objective measure of disease severity in patients with chronic chest diseases (CCD) is becoming increasingly recognized. The aim of this study was to investigate changes in oxygen uptake $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ during early recovery following maximal cardiopulmonary exercise testing (CPXT) in relation to functional capacity and markers of disease severity. Twenty‐seven children with CCD (age 12.7 ± 3.1 years; 17 female) [19 children with Cystic fibrosis (CF) (age 13.4 ± 3.1 years; 10 female) and 8 with other stable non‐CF chest diseases (NON‐CF) (age 11.1 ± 2.2 years; 7 female)] and 27 healthy controls (age 13.2 ± 3.3 years; 17 female) underwent CPXT on a cycle ergometer. On‐line respiratory gas analysis measured $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ before and during CPXT to peak $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ peak , and during the first 10 min of recovery. Early $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ recovery was quantified by the time (sec) to reach 50% of the $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ peak value. Early $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ recovery was correlated against spirometry [forced expiratory volume in 1 sec (FEV 1 ) and forced expiratory flow between 25% and 75% of the forced vital capacity (FEF 25–75 )] and aerobic fitness $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ peak as a measure of functional capacity. Disease severity was graded in the CF patients by the Shwachman score (SS). Compared to controls, children with CCD demonstrated a significantly reduced $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ peak ( P = 0.011), FEV 1 ( P < 0.001), FEF 25–75 ( P < 0.001), and a significantly prolonged early $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ recovery ( P = 0.024). In the CF patients the SS was significantly correlated with early $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ recovery (r = −0.63, P = 0.004), FEV 1 (r = 0.72, P = 0.001), and FEF 25–75 (r = 0.57, P = 0.011). In the children with CCD, FEV 1 , FEF 25–75 , and BMI were not significantly correlated with $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ peak or early $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ recovery. Lung function does not necessarily reflect aerobic fitness and the ability to recover from exercise in these patients. A significant relationship was found between $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ peak and early $({\buildrel {.} \over {\rm V}}{\rm O}_2)$ recovery (r = −0.39, P = 0.044) in the children with CCD, showing that a greater aerobic fitness corresponded with a faster recovery. Pediatr Pulmonol. 2009; 44:480–488. © 2009 Wiley‐Liss, Inc.