The most common medical conditions that impact exercise are congenital heart defects, overweight, type 1 diabetes, cerebral palsy and other neuromuscular conditions, and pulmonary conditions, such as asthma and cystic fibrosis. This article contains just introductory information. Parents should always consult their child's pediatrician or another qualified health-care professional if their child has a particular condition.
Congenital heart defects
Certain conditions, such as pulmonary hypertension, arrhythmias, stenosis, and myocardial dysfunction, may decrease cardiovascular ability.
Overweight and obesity
Overweight is considered at the 85th to 94th percentile in growth charts, and obesity is considered at >95th percentile. Children facing obesity may not stay regularly active and may have trouble becoming consistently active because of a number of factors, such as becoming fatigued sooner during aerobic activity, competing priorities, and fearing judgment from their peers.
Strength training is often a great starting point for these kids, because they tend to have more strength than their lower weight counterparts. It will also help them feel confident to participate in a wider variety of activities or sports. The American College of Sports Medicine's commentary on this subject is available at http://www.acsm.org/docs/current-comments/childhoodobesitytemp.pdf.
Type 1 diabetes
Blood glucose control is of the utmost concern in this population. Periods of higher intensity activity may require adjustments to insulin dosages. It is also necessary to have an adequate supply of carbohydrates available in order to deal with hypoglycemia. Wounds and injury are of larger concern in this population because of the influence of inflammation and recovery on blood glucose. In addition, high-intensity interval training is associated with sustained hyperglycemia.
Cerebral palsy and other neuromuscular conditions
Movement and physical activity are sometimes more challenging in these populations because of contractures, spasticity, or impaired balance. Daily chores can cause fatigue. Regular physical activity early in the rehabilitation process could play a key role in maintaining function. It is important to perform exercise testing to track the effects of training.
Pulmonary conditions: asthma and cystic fibrosis
Lung-related issues typically impact the body's ability to receive oxygen, which thereby reduces aerobic ability. With cystic fibrosis, it is necessary to address additional fluid and electrolyte issues, especially in the heat or at high altitudes. The American College of Sports Medicine's commentary on exercising with allergies and asthma is available at http://www.acsm.org/docs/current-comments/allergiesandasthmatemp.pdf.
References and recommended readings
Riner WF, Sabath RJ. Physical activity for children and adolescents. In: Durstine JL, Moore GE, Painter PL, Roberts SO, eds. ACSM's Exercise Management for Persons with Chronic Diseases and Disabilities . 3rd ed. Champaign, IL: Human Kinetics; 2009.