Table 1.
Summary of practical applications for the use of exercise as medicine for pediatric chronic disease. Note that these suggestions are not formal exercise recommendations; rather suggesions based on the current narrative review
| Disease | Aerobic Exercise | HIIT Exercise | Resistance Training | Flexibility Training | General Comments |
|---|---|---|---|---|---|
| CF | F: Min 2x/week, progressive up to 7x/week I: Moderate intensity (~ 70% max HR); progressive T: 30–45 min sessions; progressive Ty: Aerobic activities (e.g. Running, swimming, cycling) |
F: 2x/week I: > 75% max HR; progressive T: 30 min sessions; progressive, ensure adequate rest between work sessions (> 2 min); Ty: Interval training |
F: 2-3x/week, non-consecutive days I: Moderate intensity, 70% of peak workload; progressive T: 3–5 sets of 10 repetitions; progressive Ty: body-weight exercises; supervised use of weights |
F: 2x/week I: Not determined T: 15–20 min Ty: Yoga, stretching |
Overall goal for exercise prescription in most chronic diseases is to have the patient achieve PA guidelines of 60 min/day using a combination of types of exercises described. Refer to disease sections for discussion of special considerations during exercise. |
| Asthma | F: Min 3x/week, progressive up to 7x/week I: Moderate intensity (~ 70% max HR); progressive T: Progressive to 60 min/session Ty: Aerobic activities (e.g. indoor soccer, cycling) |
No evidence to support safety. Avoid at this time | F: 2-3x/week, non-consecutive days I: Moderate intensity, 70% of peak workload; progressive T: 1–2 sets of 8–15 repetitions; progressive to more Ty: body-weight exercises; supervised use of weights |
F: 2x/week I: Not determined T: 15–20 min Ty: Yoga, stretching |
|
| CHD | F: Progressive up to 7x/week I: Mild to moderate/high intensity (40–85% max HR); progressive T: Progressive to 60 min/session Ty: Aerobic activities (e.g., running, cycling, dance) |
No evidence to support safety. Avoid at this time | F: 2-3x/week, non-consecutive days I: Low to moderate intensity (40–70% of peak workload); progressive T: 1–2 sets of 8–15 repetitions Ty: body-weight exercises; low resistance; supervised use of weights |
F: 2x/week I: Not determined T: 15–20 min Ty: Yoga, stretching |
|
| Obesity & T2D | F: Progressive up to 7x/week I: Moderate to high intensity (70–85% max HR); progressive T: Progressive to 60 min/session Ty: Aerobic activities (e.g., running, cycling, swimming) |
F: 2 x/week I: 70–85% max HR; progressive T: 30 min sessions; ensure adequate rest between work sessions (> 2 min); progressive Ty: Interval training Note: No evidence to support safety in T2D, avoid at this time |
F: 2-3x/week, non-consecutive days I: Moderate intensity (70% of peak workload); progressive T: 1–3 sets of 8–15 repetitions; increase resistance progressively Ty: body-weight exercises; supervised use of weights |
F: 2x/week I: Not determined T: 15–20 min Ty: Yoga, stretching |
|
| JIA | F: 2–3 x/week I: Moderate to high intensity (65–85% max HR); progressive T: 45–60 min/session; progressive Ty: Aerobic activities (e.g., running, cycling, swimming) |
No evidence to support safety. Avoid at this time | F: 2-3x/week, non-consecutive days I: Low to moderate intensity (40–70% peak workload); progressive T: 1–3 sets of 8–15 repetitions; increase resistance progressively Ty: body-weight exercises; use of resistance bands; supervised use of weights |
F: 2x/week I: Not determined T: 15–20 min Ty: Yoga, stretching |
|
| Cancer | F: 2–4 x/week; progressive up to 3–5 x/week I: Start low, mild intensity (40% max HR); progressive up to moderate intensity (70% max HR) T: 30–45 min/session; progressive (can break into shorter 10 min blocks) Ty: Aerobic activities (e.g., running, cycling, swimming) |
No evidence to support safety. Avoid at this time | F: 1-3x/week, non-consecutive days I: Low-moderate intensity (40–60% of peak workload); progressive T: 1–3 sets of 8–15 repetitions; increase resistance progressively Ty: body-weight exercises; use of resistance bands; supervised use of weights |
F: 2x/week I: Not determined T: 15–20 min Ty: Yoga, stretching, balancing |
CF Cystic Fibrosis
CHD Congenital Heart Disease
T2D Type 2 Diabetes
JIA Juvenile Idiopathic Arthritis
F Frequency of exercise
I Intensity of exercise
T Time, i.e., amount of exercise
Ty Type of exercise
HR Heart rate