Practices and Procedures in Clinical Pediatric Exercise Laboratories in North America

in Pediatric Exercise Science

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Kelli M. TesonPediatric Physical Activity and Cardiac Exercise Science Program, Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, MO, USA
School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA

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Jessica S. WatsonPediatric Physical Activity and Cardiac Exercise Science Program, Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, MO, USA

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Wayne A. MaysThe Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

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Sandy KnechtThe Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

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Tracy CurranDepartment of Cardiology, Boston Children’s Hospital, Boston, MA, USA

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Paul RebovichPulmonology Department, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

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David D. WilliamsDivision of Health Services and Outcomes Research, Children’s Mercy Kansas City, Kansas City, MO, USA

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Stephen M. ParidonDivision of Cardiology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

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David A. WhitePediatric Physical Activity and Cardiac Exercise Science Program, Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, MO, USA
School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA

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Interinstitutional differences in clinical pediatric exercise laboratory (CPEL) practices may affect patient care and efficacy of multicenter research. Purpose: To describe current practices/procedures in CPELs and explore differences in CPELs employing exercise physiologists to those that do not. Methods: 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. Results: 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). Conclusions: Heterogeneity in CPELs staffing and operation indicates need for standardization.

White (dawhite@cmh.edu) is corresponding author.

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