Lifestyle Intervention Improves Physical Fitness and Quality of Life in Children with Bronchopulmonary Dysplasia

Abstract

Abstract Background: Exercise capacity in children with bronchopulmonary dysplasia (BPD) is lower compared to healthy peers. We aimed to improve maximal exercise capacity using a combined lifestyle intervention in children with BPD. Methods: This semi-cross-over randomized controlled trial investigated the effects of a combined intervention of high-intensity interval training, healthy diet recommendations, and psychological support in children with BPD. Effects were measured on (sub) maximal exercise capacity, lung function, muscle strength, core stability, physical activity levels, quality of life, fatigue, fear of exercise, caloric intake, energy balance, and body composition using a generalized estimation approach. Results: Fourteen children with BPD, median age 8.0 years (interquartile range: 7.7–8.9), 8 males, participated. At baseline, all patients had peak oxygen (VO2)/kg, forced vital capacity (FVC), and forced expiratory volume in 1 s (FEV1) within normal limits. These parameters did not increase significantly after the intervention compared to the control period (effect size peak VO2/Kg + 3.1 ml/kg/min [95% confidence interval (CI) −0.4–6.7], P = 0.076, FVC z-score + 0.67 [95% CI − 0.1–1.4] P = 0.082, and FEV1 z-score + 0.53 [95% CI − 0.13–1.19] P = 0.117). Peak load and peak ventilation on the maximal cardiopulmonary exercise test and walked distance on the 6-min walking test increased significantly compared to the control period (respectively, +14 watt [95% CI 10–18], P < 0.001, +7 L/min [95% CI 2–12], P = 0.009 and + 45 m [95% CI 1–90], P = 0.046). Both self-reported and parent-reported quality of life improved significantly in five domains (including the physical functioning domain). Conclusion: A 12-week combined lifestyle intervention improved peak load and peak ventilation, walk distance, and quality of life in children with BPD.