Play-based exercise boosts fitness, fundamental movement in kids with bronchiectasis

Children suffering from bronchiectasis may benefit from a play-based therapeutic exercise regimen, which results in better fitness and fundamental movement skill (FMS), according to a recent pilot trial.

In 11 children who received the 7-week therapeutic exercise program, mean locomotor scores improved significantly from 29.0 at baseline to 35.2 after the intervention (p=0.01). In comparison, scores were mostly unchanged in 10 controls, increasing only slightly from 31.6 to 31.8. [Front Pediatr 2022;doi:10.3389/fped.2022.953429]

The same was true for object control scores, which improved from a mean of 27.0 at baseline to 35.5 after 7 weeks in the exercise program group (p=0.01) while remaining relatively constant in controls (mean, 31.0 to 32.3). Parameters of FMS were measured using the Test of Gross Motor Development.

Researchers likewise assessed participants’ cardiorespiratory fitness by looking at the percent change in heart rate during a submaximal treadmill test, and comparing this before and after the exercise program.

They found that in children allocated to the exercise program, the change in heart rate during the treadmill test dropped by six percentage points after the intervention. In controls, cardiorespiratory fitness remained largely unchanged, with the change in heart rate dropping by only 0.9 percentage points.

“The program had a moderately positive effect on cardiorespiratory fitness,” the researchers said. “Although the small sample size precluded statistical significance, the observed effect size … was commensurate with that reported for improvements in aerobic fitness in asthmatic children completing exercise training.” [Clin Rehabil 2001;15:360-370]

These improvements in cardiorespiratory fitness were not accompanied by perceived athletic competence following the program (p=0.63).

Quality of life was likewise unaffected by the play-based exercise regimen, eliciting no significant changes in physical, emotional, social, and school-related quality of life scores, as well as in the total score of the PedsQL 4.0 questionnaire.

In the present study, patients assigned to the therapeutic exercise program underwent a combination of supervised and unsupervised exercise. Every week, children attended one 60-minute exercise session led by a clinical exercise physiologist, which was then supplemented by a home-based program that the participants were expected to accomplish 2 days per week.

Supervised sessions consisted of six activity stations that children rotated through; each station involved activities and games designed to target specific FMS parameters. Activities were also selected to be developmentally appropriate and tailored to the participants’ fitness and skill level. Home sessions consisted of the two most recent games the child engaged in during the supervised sessions.

“To our knowledge, this is the first study to evaluate the effects of a therapeutic exercise program on proficiency in FMS in children with chronic respiratory disease. Improvements in FMS resulting from the seven-session program were not only statistically significant, but clinically important,” the researchers said.

“The results are sufficiently positive to warrant conducting a larger randomized controlled trial, testing the efficacy of the exercise program in children with bronchiectasis and/or other chronic respiratory conditions,” they added.