The use of cardiopulmonary exercise testing in pediatrics provides critical insights into potential physiological causes of unexplained exercise-related complaints or symptoms, as well as specific pathophysiological patterns based on physiological responses or abnormalities. Clinical interpretation of the results of a cardiopulmonary exercise test in pediatrics requires specific knowledge with regard to pathophysiological responses and interpretative strategies that can be adapted to address concerns specific to the child’s medical condition or disability. In this review, the authors outline the 7-step interpretative approach that they apply in their outpatient clinic for diagnostic, prognostic, and evaluative purposes. This approach allows the pediatric clinician to interpret cardiopulmonary exercise testing results in a systematic order to support their physiological reasoning and clinical decision making.
Marco Van Brussel, Bart C. Bongers, Erik H.J. Hulzebos, Marcella Burghard and Tim Takken
Marcella Burghard, Karlijn Knitel, Iris van Oost, Mark S. Tremblay, Tim Takken and the Dutch Physical Activity Report Card Study Group
The Active Healthy Kids the Netherlands (AHKN) Report Card consolidates and translates research and assesses how the Netherlands is being responsible in providing physical activity (PA) opportunities for children and youth (<18 years). The primary aim of this article is to summarize the results of the 2016 AHKN Report Card.
Nine indicators were graded using the Active Healthy Kids Global Alliance report card development process, which includes a synthesis of the best available research, surveillance, policy and practice findings, and expert consensus.
Grades assigned were: Overall Physical Activity Levels, D; Organized Sport Participation, B; Active Play, B; Active Transportation, A; Sedentary Behaviors, C; Family and Peers, B; School, C; Community and the Built Environment, A; Government Strategies and Investments, INC.
Sedentary behavior and overall PA levels are not meeting current guidelines. However, the Dutch youth behaviors in sports, active transportation, and active play are satisfactory. Several modifiable factors of influence might be enhanced to improve these indicators or at least prevent regression. Although Dutch children accumulate a lot of daily PA through cycling, it is not enough to meet the current national PA guidelines of 60 minutes of moderate-to-vigorous PA per day.