Leonardi-Figueiredo MM1, Crescencio JC2, Gallo-Junior L2, Manso PH3, Catai AM4, Mattiello-Sverzut AC1
1Ribeirão Preto Medical School, University of São Paulo, Health Science Department, Ribeirão Preto, Brazil, 2Ribeirão Preto Medical School, University of São Paulo, Department of Cardiology, Ribeirão Preto, Brazil, 3Ribeirão Preto Medical School, University of São Paulo, Department of Child Care and Pediatrics, Ribeirão Preto, Brazil, 4Federal University of Sao Carlos, Department of Physiotherapy, São Carlos, Brazil
Background: Spina bifida (SB) is characterized by a neural tube defect and leads to sedentary lifestyle and hypomobility, which increase the development of cardiovascular diseases. Maximal oxygen uptake (VO2peak) is the gold standard physiological indicator of aerobic capacity and it is reduced in wheelchair users with SB. Heart rate recovery (HRR) is a prognostic marker of cardiac risk (higher delta HRR decline = lower risk), but has to be explored in this population.
Purpose: To measure the physical fitness of wheelchair-using children with SB by a graded arm ergometry test, correlate physical activity level, VO2peak and HRR, and compare them to the typical children (Control).
Methods: 42 children were assigned to: extremely sedentary wheelchair users with SB (n=12), extremely sedentary controls (n=10), sedentary controls (n=10) and moderately active controls (n=10). Physical fitness was assessed through a maximal exercise test with respiratory gas analyses using a graded arm ergometry test. Heart rate was assessed continuously by ECG. Physical fitness was defined as peak oxygen uptake (VO2peak) and by delta HRR, at the first and second minutes. Physical activity level was assessed by the Physical Activity Questionnaire for Children and Adolescents.
Results: The groups were-homogeneous [mean (SD)] for age 12.0 (2.3) years and body weight 45.1 (15.3) kg. Controls showed no difference between physical fitness and physical activity levels. SB had lower VO2peak (mean difference=-0.44, 95% CI=-0.671 to -0.218, p .001) and lower delta HRR (HRR1stmin mean difference=-15.77, 95% CI=-23.77 to -7.76, p .001; HRR2ndmin mean difference=-21.90, 95% CI=-30.05 to -13.75, p .001), when compared to Controls. A higher delta HRR in the 1st and 2nd minute was correlated to higher VO2peak (r=.52 and r=.50, p .001). However, physical activity level was not correlated to physical fitness.
Conclusion(s): Wheelchair-using children with spina bifida have poor physical fitness and this is correlated a lower decline in HRR after a graded arm ergometry test.
Implications: These results emphasize the importance of increasing physical fitness in children with disabilities, mainly wheelchair users, to prevent the development of cardiovascular diseases.
Keywords: physical fitness, spina bifida, children
Funding acknowledgements: Sao Paulo Research Foundation (FAPESP) (grant number: 2013/05936-4).
Purpose: To measure the physical fitness of wheelchair-using children with SB by a graded arm ergometry test, correlate physical activity level, VO2peak and HRR, and compare them to the typical children (Control).
Methods: 42 children were assigned to: extremely sedentary wheelchair users with SB (n=12), extremely sedentary controls (n=10), sedentary controls (n=10) and moderately active controls (n=10). Physical fitness was assessed through a maximal exercise test with respiratory gas analyses using a graded arm ergometry test. Heart rate was assessed continuously by ECG. Physical fitness was defined as peak oxygen uptake (VO2peak) and by delta HRR, at the first and second minutes. Physical activity level was assessed by the Physical Activity Questionnaire for Children and Adolescents.
Results: The groups were-homogeneous [mean (SD)] for age 12.0 (2.3) years and body weight 45.1 (15.3) kg. Controls showed no difference between physical fitness and physical activity levels. SB had lower VO2peak (mean difference=-0.44, 95% CI=-0.671 to -0.218, p .001) and lower delta HRR (HRR1stmin mean difference=-15.77, 95% CI=-23.77 to -7.76, p .001; HRR2ndmin mean difference=-21.90, 95% CI=-30.05 to -13.75, p .001), when compared to Controls. A higher delta HRR in the 1st and 2nd minute was correlated to higher VO2peak (r=.52 and r=.50, p .001). However, physical activity level was not correlated to physical fitness.
Conclusion(s): Wheelchair-using children with spina bifida have poor physical fitness and this is correlated a lower decline in HRR after a graded arm ergometry test.
Implications: These results emphasize the importance of increasing physical fitness in children with disabilities, mainly wheelchair users, to prevent the development of cardiovascular diseases.
Keywords: physical fitness, spina bifida, children
Funding acknowledgements: Sao Paulo Research Foundation (FAPESP) (grant number: 2013/05936-4).
Topic: Cardiorespiratory; Neurology; Paediatrics
Ethics approval required: Yes
Institution: Ribeirão Preto Medical School of the University of São Paulo
Ethics committee: Medical Ethical Committee of the Clinical Hospital
Ethics number: CAAE number 60154216.7.1001.5440
All authors, affiliations and abstracts have been published as submitted.
