Chest
Volume 140, Issue 2, August 2011, Pages 475-481
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Original Research
Cystic Fibrosis
Bone Health, Daily Physical Activity, and Exercise Tolerance in Patients With Cystic Fibrosis

https://doi.org/10.1378/chest.10-1508Get rights and content

Background

Daily physical activity (PA) may be an excellent tool for the maintenance of bone health in patients with cystic fibrosis (CF). The aim of this study was to analyze the possible association between physical capacity and activity and bone mineral density (BMD) in young adults with CF. A secondary goal was to evaluate vertebral fractures in this population.

Methods

A cross-sectional study was conducted in 50 patients with CF who were clinically stable and aged > 16 years but not lung transplant recipients. PA was quantified with a portable motion monitor (BodyMedia Fit Armband). Cardiopulmonary exercise and 6-min walk tests were used to assess exercise capacity. BMD was obtained from dual-energy x-ray absorptiometry of the lumbar column, hip, and whole body. To analyze vertebral fractures and deformity, we performed the Genant and Cobb methods.

Results

Daily PA time at low (3-4.8 metabolic equivalent tasks [METs]) and moderate (4.8-7.2 METs) intensity, respectively, was correlated with Z score (BMD) of the lumbar column (r = 0.36, P < .01 and r = 0.59, P < .001), the neck of femur (r = 0.51, P < .001 and r = 0.72, P < .001), and the total hip (r = 0.54, P < .001 and r = 0.74, P < .001). PA, BMI, age, and sex were predictors of BMD. Vertebral fractures correlated with kyphosis (r = 0.42, P = .02), but not with BMD. Patients who were mildly and severely affected differed in vertebral fracture rate and kyphosis prevalence (P = .002 and P = .013, respectively).

Conclusions

The most active patients with better exercise capacity had higher BMD. Those with more affected pulmonary function had a greater prevalence of vertebral fractures and dorsal kyphosis.

Section snippets

Population and Study Design

The participants were patients of the Specialized Unit of Cystic Fibrosis of the Virgen del Rocío Hospital (Sevilla, Spain). This study was approved by the ethical committee of the hospital, and written informed consent was obtained from all participants. An observational analytic and cross-sectional study was designed. All patients aged ≥ 16 years of age with CF (two positive sweat tests, compatible clinical and confirmation genetic) were invited to participate and included, provided that they

Results

Fifty patients (46% men) were included in the study. Table 1, Table 2 shows the patient characteristics.

Discussion

When monitoring daily PA, it was noted that the most active patients had the greatest bone mass. The results of the cardiopulmonary exercise test and 6-min walk test confirmed these results. However, no association between BMD and vertebral fracture was found. To our knowledge, no previous study has analyzed the level of PA of patients with CF in real time and the possible relationship of PA to BMD.

Previously, other authors compared the level of PA with BMD using questionnaires and observed a

Acknowledgments

Author contributions: Dr Tejero García had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Dr Tejero García: contributed to the conception and design of the study; data acquisition and analysis; interpretation of information; and preparation, revision, review, and approval of the final manuscript.

Dr Giráldez Sánchez: contributed to the conception and design of the study; data analysis; interpretation of the

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    Funding/Support: This study was developed at the University Hospital Virgen del Rocío de Sevilla, Spain, and supported by a grant (9,000 Euros) from the Association of Pulmonologists of Southern Spain (Neumosur).

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

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