Physical exercise training improves muscle strength and self-esteem in children with intestinal failure.

OBJECTIVES: Pediatric intestinal failure (IF) patients are less physically active compared to healthy peers, exhibit an altered body composition and low bone mineral density, which can be improved through physical activity. We assessed the effects of a tailored exercise intervention on physical fitness, nutritional status, and psychological functioning in children with IF. METHODS: Pediatric IF patients, still on and weaned off parenteral nutrition aged 6-18 years were eligible. Physical fitness ([sub]maximal exercise capacity, amount of physical activity, motor performance, strength, and core stability), nutritional status (body composition, energy expenditure, and laboratory parameters) and psychological functioning (fear, quality of life, fatigue, gastrointestinal symptoms, and self-esteem) were assessed before and after an initial control period and after a 12-week tailored exercise intervention. RESULTS: Sixteen participants (median age 12.2 years [10.5-14.6]) underwent baseline assessments, and eight were weaned off parenteral nutrition. Exercise capacity was normal, but the majority (63%) did not meet physical activity guidelines. Motor skills and muscle strength were impaired. Postintervention, exercise capacity in VO2peak did not improve significantly, but workload in watt (p < 0.01), muscle strength in various muscle groups (p < 0.05), core stability (p < 0.05), and self-esteem (p < 0.05) improved. Nutritional status remained unchanged. Baseline motor skills and change in VO2peak were positively correlated (R = 0.66, p < 0.05). CONCLUSIONS: Our tailored exercise intervention improved muscle strength, core stability, and self-esteem. Most participants do not meet physical activity recommendations and exhibit impaired muscle strength and motor skills, while exercise capacity is normal. Notably, participants with better baseline motor skills showed greater improvements in exercise capacity. CLINICAL TRIAL REGISTRATION: Registration ID: NL8181, https://onderzoekmetmensen.nl/nl/trial/27466.