Clinical application

1. Dx exercise intolerance1.1 VO2max VO2 AT

1.2 RER >1.2 (HRmax is not achieved)1.3 breathing reserve < 20% (N=20-40%)1.4 SaO2

1.5 VE/VO2 (ventilatory equivalent for oxygen) > 40

2. Dx exercise-induced bronchospasm (EIB)3. Aerobic fitness evaluation

Research study

Optimal level of physical activity in children and adolescent with chronic lung disease

Objectives

To study the optimal level of physical activity in children and adolescents with CLD

Normal (n=18)

CLD (n=18)

Hx & PE

PFT

- Spirometry

- Lung volumes

- DLco

Exercise stress test

VO2 at AT correlate with physical activity

Experimental design

Results

- Chronic interstitial lung 1

- Post lobectomy 5 - Pulmonary hemosiderosis 1 - Fibrotic lung 3

- BPD 2 - Asthma moderate persistent 6

Chronic lung diseases:

Abnormal PFT

• Obstructive lung 7 (FEV1 80.0 +

12.9%pred)

• Restrictive lung 7 (TLC 63.7 + 12.5%pred)

• Diffusion defect 1 (DLco/VA = 77 %pred)

• Hyperinflation 9 (RV/TLC 38.9 + 6.5%pred)

CLD(n = 18)

Control(n = 18)

P

FVC 77.3 + 22.6 97.9 + 12.5 0.002

FEV1 74.3 + 17.6 104.0 + 12.6 < 0.001

FEV1/FVC 83.4 + 12.7 90.1 + 3.8 0.047

FEF25-75% 49.9 + 23.1 75.6 + 18.6 0.001

TLC 82.8 + 18.6 95.6 + 9.8 0.015

RV/TLC 30.8 + 10.2 24.4 + 5.9 0.027

DLco/VA 113.2 + 27.3 109.1 + 30.3 0.671