Practices and Procedures in Clinical Pediatric Exercise Laboratories in North America

Abstract

To describe current practices/procedures in CPELs and explore differences in CPELs employing exercise physiologists to those that do not. A 40-item survey was distributed to CPELs in North America focusing on (1)staffing; (2)exercise stress testing (EST) volumes, reporting, and interpretation; and (3)EST procedures/protocols. Of the 55 responses, 89% were in the United States, 85% were children's hospitals with university affiliation, and 58% were cardiology specific. Exercise physiologists were employed in 56% of CPELs, and 78% had master's degrees or higher. Certifications were required in most CPELs (92% emergency life-support, 27% professional, and 21% clinical). Median volume was 201 to 400 ESTs per year, 80% used treadmill, and 10% used cycle ergometer as primary modalities. Ninety-three percent of CPELs offered metabolic ESTs, 87% offered pulmonary function testing, 20% used institution-specific EST protocols, and 72% offered additional services such as cardiac/pulmonary rehabilitation. CPELS staffing exercise physiologists performed higher volumes of ESTs (P = .004), were more likely to perform metabolic ESTs (P = .028), participated in more research (P < .001), and provided services in addition to ESTs (P = .001). Heterogeneity in CPELs staffing and operation indicates need for standardization.