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Perez M.,European University at Madrid | Groeneveld I.F.,Rijnlands Rehabilitation Center | Santana-Sosa E.,European University at Madrid | Fiuza-Luces C.,European University at Madrid | And 6 more authors.
Pediatric Pulmonology

Background Children with cystic fibrosis (CF) often have to be hospitalized because of acute exacerbation of their respiratory symptoms. Given the fact that improved peak oxygen uptake (VO2peak) is positively associated with lung function and overall health in children with CF, this study examined the association between VO2peak and the need for hospitalization in a cohort of pediatric CF patients. Methods In a 3-year study, 77 CF children with mild-to-moderately severe CF (forced expiratory volume in 1-sec [FEV 1]-≥-50%) underwent a maximal exercise test to determine VO 2peak. Anthropometric, lung function and muscle strength measurements were also conducted and dates of hospitalization were recorded for the study period. Associations were then determined between the variables recorded and hospitalization by univariate and multivariate Cox proportional hazards regression analyses. Results VO2peak was 38.6-±-6.7-ml-kg -1-min-1 for boys and 31.9-±-6.9-ml-kg -1-min-1 for girls. In multivariate analyses, VO 2peak was the only variable significantly associated with time to hospitalization (hazard ratio 0.91, P-=-0.03). Conclusion A significant association was detected between greater aerobic fitness, and lower risk of hospitalization. Because hospitalization due to respiratory exacerbation is a powerful prognostic factor, our findings provide further support for the importance of aerobic fitness evaluation in the management of children with mild-to-moderately severe CF. © 2013 Wiley Periodicals, Inc. Source

Aznar S.,University of Castilla - La Mancha | Gallardo C.,Santo Tomas University of Chile | Fiuza-Luces C.,European University at Madrid | Santana-Sosa E.,European University at Madrid | And 7 more authors.
Journal of Cystic Fibrosis

Background: Physical activity (PA) is recommended as part of the treatment regimen for cystic fibrosis (CF) although objective methods have been scarcely used to monitor achievement of PA guidelines. Methods: PA was measured by accelerometer in outpatient CF children (n. = 47) and results were compared with those obtained in age- and gender-matched healthy controls (n. = 39). Results: 2.1% of the outpatients fulfilled PA guidelines (i.e. ≥60min·day-1 of moderate-to-vigorous PA (MVPA)) vs. 34.2% of controls. Overall, lower MVPA levels were observed in CF patients than controls despite the former undergoing more light or total PA. Peak oxygen uptake was also lower in the CF group than in controls (37.5±7.8 vs. 43.5±7.6ml·kg-1·min-1, p=0.002) and was correlated with MVPA and vigorous PA in the former. Conclusions: These findings support a need to promote PA interventions (including MVPA) targeted at improving cardiorespiratory fitness in CF children. © 2013 European Cystic Fibrosis Society. Source

Fiuza-Luces C.,European University at Madrid | Fiuza-Luces C.,Research Institute i12 | Soares-Miranda L.,University of Porto | Gonzalez-Murillo A.,Jesus University | And 10 more authors.
Medicine and Science in Sports and Exercise

INTRODUCTION: Chronic graft versus host disease (cGVHD) is a life-threatening complication of allogeneic hematopoietic stem cell transplantation that generates considerable morbidity and compromises the physical capacity of patients. We determined the effects of an exercise training program performed after allogeneic hematopoietic stem cell transplantation on clinical and biological variables in a minor histocompatibility antigen-driven murine model of cGVHD treated with cyclosporine A. METHODS: Recipient BALB/C female mice (age 8 wk) received bone marrow cells and splenocytes from donor B10.D2 male mice and were randomly assigned to an exercise (n = 11) or control group (n = 12). For approximately 11 wk after transplant, the exercise group completed a moderate-intensity treadmill program. Variables assessed were clinical severity scores, survival, physical fitness, cytokine profile, immune cell reconstitution, molecular markers of muscle exercise adaptations, and histological scores in affected tissues. RESULTS: Exercise training increased survival (P = 0.011), diminished total clinical severity scores (P = 0.002), improved physical fitness (P = 0.030), and reduced blood IL-4 and tumor necrosis factor α levels (P = 0.03), while increasing circulating B220 (P = 0.008) and CD4 lymphocytes (P = 0.043). CONCLUSIONS: A moderate-intensity exercise program that mimics widely accepted public health recommendations for physical activity in human adults was well tolerated and positive effects on survival as well as on clinical and biological indicators of cGVHD. Copyright © 2013 by the American College of Sports Medicine. Source

Santalla A.,Pablo De Olavide University | Santalla A.,Research Institute i12 | Munguia-Izquierdo D.,Pablo De Olavide University | Brea-Alejo L.,Research Institute i12 | And 9 more authors.
Frontiers in Aging Neuroscience

We analyzed the effects of a 4-month resistance (weight lifting) training program followed by a 2-month detraining period in 7 adult McArdle patients (5 female) on: muscle mass (assessed by DXA), strength, serum creatine kinase (CK) activity and clinical severity. Adherence to training was ≥84% in all patients and no major contraindication or side effect was noted during the training or strength assessment sessions. The training program had a significant impact on total and lower extremities' lean mass (P < 0.05 for the time effect), with mean values increasing with training by +855 g (95% confidence interval (CI): 30, 1679) and +547 g (95%CI: 116, 978), respectively, and significantly decreasing with detraining. Body fat showed no significant changes over the study period. Bench press and half-squat performance, expressed as the highest value of average muscle power (W) or force (N) in the concentric-repetition phase of both tests showed a consistent increase over the 4-month training period, and decreased with detraining. Yet muscle strength and power detraining values were significantly higher than pre-training values, indicating that a training effect was still present after detraining. Importantly, all the participants, with no exception, showed a clear gain in muscle strength after the 4-month training period, e.g., bench press: +52 W (95% CI: 13, 91); half-squat: +173 W (95% CI: 96, 251). No significant time effect (P > 0.05) was noted for baseline or post strength assessment values of serum CK activity, which remained essentially within the range reported in our laboratory for McArdle patients. All the patients changed to a lower severity class with training, such that none of them were in the highest disease severity class (3) after the intervention and, as such, they did not have fixed muscle weakness after training. Clinical improvements were retained, in all but one patient, after detraining, such that after detraining all patients were classed as class 1 for disease severity. © 2014 Santalla, Munguía-Izquierdo, Brea-Alejo, Pagola-Aldazábal, Díez-Bermejo, Fleck, Ara and Lucia. Source

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