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Original Research: CYSTIC FIBROSIS |

Bone Health, Daily Physical Activity, and Exercise Tolerance in Patients With Cystic FibrosisExercise and Bone Health in Cystic Fibrosis

Sergio Tejero García, MD, PhD; Miguel A. Giráldez Sánchez, MD, PhD; Pilar Cejudo, MD, PhD; Esther Quintana Gallego, MD, PhD; Javier Dapena, MD, PhD; Rosario García Jiménez, MD, PhD; Pedro Cano Luis, MD, PhD; Ignacio Gómez de Terreros, MD, PhD
Author and Funding Information

From the Trauma and Orthopaedic Surgery (Drs Tejero García, Giráldez Sánchez, and Cano Luis), Medical-Surgical Service of Respiratory Diseases (Drs Cejudo and Quintana Gallego), Cystic Fibrosis Unit (Dr Dapena), and Nuclear Medicine (Dr García Jiménez), Virgen del Rocío Hospital, and Faculty of Medicine (Dr Gómez de Terreros), Universidad de Sevilla, Sevilla, Spain.

Correspondence to: Sergio Tejero García, MD, PhD, C/ Narciso Monturiol 17, 41930 Bormujos (Seville), Spain; e-mail: tejerogarciasergio@gmail.com


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).


© 2011 American College of Chest Physicians


Chest. 2011;140(2):475-481. doi:10.1378/chest.10-1508
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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.

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