ABSTRACT
The Netherlands; 2Child Development & Exercise Center, Wilhelmina Children’s Hospital, University Medical Center Utrecht, the Netherlands; 3Department of
Rehabilitation Sciences, Catholic University Leuven, Leuven, Belgium
21.1 INTRODUCTION Earlier studies have shown children and young adults with SB to be less active with reduced levels of physical fitness compared to their healthy peers (Steele et al., 1996; van den Berg-Emons et al., 2003; Agre et al., 1987). Based on these results, Van den Berg-Emons et al. (2003) concluded that programs aimed at regular physical exercise and daily physical activity should be started in childhood to prevent further decline in physical fitness and daily functioning. In our SB clinic 23 ambulatory children with SB were seen for sports and lifestyle advice. Results showed low levels of overall muscle strength, exercise capacity and daily physical activity (Schoenmakers et al., 2009). While designing an exercise program aimed at improving both endurance and ambulation in ambulatory children with SB, the question was raised which factors in terms of cardiovascular, pulmonary or muscular were limiting 2peak in these children (De Groot et al., 2008). In this pilot study, we found signs for both deconditioning and -much to our surprisepossible signs of insufficient gas exchange at the pulmonary level as indicated by high ventilatory equivalents for CO2 uptake. We then concluded future exercise testing in ambulatory children with SB should include evaluation of the ventilatory reserve and desaturation to better determine possible ventilatory limitations. The aim of this study was again to look at the limiting factors in exercise testing, but using additional measurements to evaluate the ventilatory limitations.
