Ledger, Sean James;
(2023)
Longitudinal effects of supervised exercise on lung function, exercise capacity and quality of life in children with cystic fibrosis.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Introduction: Inspire-CF was a randomised controlled trial that explored the effects of 24-months of supervised exercise on lung function, exercise capacity and quality of life in children aged 6-15 years with CF. A cost of care analysis was completed to understand differences, if any, between groups after 24-months. Methods: Children were randomised into 2 groups: control and exercise. The control group continued to receive specialist CF care as delivered by the Cystic Fibrosis Unit at Great Ormond Street Hospital for Children. The exercise group continued to receive specialist care plus a once-weekly, individually supervised exercise training session at a local fitness facility. A MBW, spirometry, cycle ergometry-based CPET, 10m-MSWT and the CFQ-R were completed at baseline, 12- and 24-month assessment points. Cost of care, length of stay during hospital admissions, and IV-antibiotic requirements during exacerbations and routine admissions, were also recorded. The primary outcome measure was change in FEV1 z-score at 24-month assessment. Results: 71 children were recruited to Inspire-CF (control=34; exercise=37), of which 4 children dropped out at 12-months. There were no significant between-group differences in outcomes at baseline. At 24-month assessment, there were no significant between-group differences in FEV1 z-score, however there was a significant (p<0.05) dose-related effect of exercise on FEV1, FVC and FEF25-75, which suggested exercise may help to maintain lung function. A 10m-MSWT showed that functional aerobic capacity significantly (p<0.05) improved in the exercise group. CPET markers of Wpeak and VO2peak also improved, but between-group differences were not significant. The perception of ability to cope with treatment burden significantly improved in the exercise group. There were significant differences in overall length of stay and IV-antibiotic requirement in favour of the exercise group, but cost of care was not significantly different. Conclusion: Inspire-CF demonstrated that supervised exercise slowed the rate of deterioration in lung function, particularly in younger children, but this required a commitment to regular attendance to exercise.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Longitudinal effects of supervised exercise on lung function, exercise capacity and quality of life in children with cystic fibrosis |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2022. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| Keywords: | cystic fibrosis, paediatrics, lung function, exercise capacity, quality of life, cost-analysis |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10164704 |
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