Exercise in Pediatric COVID-19: A Randomized Controlled Trial.

Autor:	Astley C, Drezner JA; Center of Lifestyle Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, SP, BRAZIL., Sieczkowska SM, Ihara A, Franco T, Gil S, do Prado DML, Longobardi I, Suguita P; Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, BRAZIL., Fink T; Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, BRAZIL., Lindoso L; Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, BRAZIL., Matsuo O; Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, BRAZIL., Martins F; Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, BRAZIL., Bain V; Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, BRAZIL., Leal GN; Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, BRAZIL., Badue MF; Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, BRAZIL., Marques HH; Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, BRAZIL., Silva CA; Chidren and Adolescent Institute, Clinical Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, SP, BRAZIL., Roschel H, Gualano B
Jazyk:	angličtina
Zdroj:	Medicine and science in sports and exercise [Med Sci Sports Exerc] 2024 Nov 06. Date of Electronic Publication: 2024 Nov 06.
DOI:	10.1249/MSS.0000000000003589
Abstrakt:	Abstract: Purpose: This study assessed the impact of a 12-week, home-based exercise training (HBET) program on health-related quality of life (HRQOL, primary outcome), cardiovascular and metabolic parameters in pediatric COVID-19 patients.Methods: In this single-center, randomized controlled trial conducted in Sao Paulo (Brazil) from October 2020 to January 2022, 32 patients (mean age 12 ± 3.3 years; median 4 months [range: 0.7-6.6] between COVID-19 diagnosis [n = 25 mild, n = 4 moderate, n = 3 severe illness] and study entry) from a tertiary hospital were randomly assigned to either HBET or standard of care (CONTROL) in a 2:1 ratio. The HBET group underwent supervised and unsupervised sessions 3 times/week for 12 weeks emphasizing aerobic and bodyweight exercises and the CONTROL group received standard care which included general advice for a healthy lifestyle with no prescribed exercise intervention. HRQOL (Pediatric Quality of Life Inventory [PedsQL], cardiopulmonary exercise test (CPET), brachial flow-mediated dilation (b-FMD) and echocardiography assessments were conducted in both groups. Statistical analysis was performed using an intention-to-treat approach (ITT) for the primary analysis and complete-case (per-protocol) as sensitivity analysis and significance was set at P ≤ 0.05 (P ≤ 0.10 were considered as trend).Results: There was no difference in HRQOL between groups. Intention-to-treat analysis showed a trend toward increased VO2 at anaerobic threshold at post-intervention for the HBET group. Additionally, a sensitivity analysis showed significant changes in peak HR, HRR1min, RER and chronotropic response and tendency towards significance in VE/MVV and chronotropic response for the HBET group. No other between-group differences were detected for CPET, b-FMD and echocardiography variables (all p > 0.05).Conclusions: In this RCT, a 12-week HBET intervention did not impact HRQOL in pediatric COVID-19 patients. However, HBET led to greater improvements in VO2 VAT, heart rate peak and one-minute recovery and in chronotropic response with no changes in other cardiovascular parameters. Further studies are needed to explore the effects of exercise on the recovery of pediatric COVID-19 patients with persistent COVID-19 symptoms. Competing Interests: Conflict of Interest and Funding Source: This study was supported by grants from Fundação de Amparo à Pesquisa do Estado de São Paulo – FAPESP (grants #2021/02742-0, 2022/16147-0 and 2022/16239-1 to C.A., #2019/15231-4 to S.M.S., # 2021/13580-1 to I. L., and #2017/13552-2 to B.G.). The authors declare no competing interests. (Copyright © 2024 by the American College of Sports Medicine.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu