%0 Journal Article
%T Exercise Stress Testing in Children with Metabolic or Neuromuscular Disorders
%A Tim Takken
%A Wim G. Groen
%A Erik H. Hulzebos
%A Cornelia G. Ernsting
%A Peter M. van Hasselt
%A Berthil H. Prinsen
%A Paul J. Helders
%A Gepke Visser
%J International Journal of Pediatrics
%D 2010
%I Hindawi Publishing Corporation
%R 10.1155/2010/254829
%X The role of exercise as a diagnostic or therapeutic tool in patients with a metabolic disease (MD) or neuromuscular disorder (NMD) is relatively underresearched. In this paper we describe the metabolic profiles during exercise in 13 children (9 boys, 4 girls, age 5¨C15 yrs) with a diagnosed MD or NMD. Graded cardiopulmonary exercise tests and/or a 90-min prolonged submaximal exercise test were performed. During exercise, respiratory gas-exchange and heart rate were monitored; blood and urine samples were collected for biochemical analysis at set time points. Several characteristics in our patient group were observed, which reflected the differences in pathophysiology of the various disorders. Metabolic profiles during exercises CPET and PXT seem helpful in the evaluation of patients with a MD or NMD. 1. Introduction Metabolic diseases (MDs) and Neuromuscular disorders (NMDs) comprise a large heterogeneous group of diseases, that directly (via intrinsic muscle pathology or defective metabolic pathways) or indirectly (via nerve pathology), impair muscle function and result in exercise intolerance. Although the value of exercise tests in patients with MD/NMD has been acknowledged for several decades [1¨C3], the role of exercise stress tests as a diagnostic or evaluative tool in children and adults with MD/NMD is relatively underresearched. Moreover, exercise stress tests are not standard for most centers to be performed in clinical care [4¨C7]. In this paper, we provide two standardized exercise tests with preliminary metabolic profiles in children with a diagnosed MD/NMD for this purpose. Exercise stress tests in patients with a metabolic disorder involved in ATP synthesis show a clear specific metabolic profile during exercise [4]. These metabolic profiles can be useful as a reference for identifying patients for a possible MD or NMD. Therefore, the aim of the current study was to describe the metabolic profiles during exercise in children with a diagnosed NMD or MD. This information might be helpful for clinicians in the diagnosis and follow-up of patients with these disorders. 2. Methods 2.1. Subjects In this retrospective chart review, patients with an established diagnosis involving general ATP synthesis or a dystrophinopathy, who were referred for exercise stress testing to the Departments of Metabolic Diseases and Child Development and Exercise Center, University Medical Center Utrecht, the Netherlands, were included. Thirteen patients (9 ¡á, 4 ¡â, age 5¨C15 years) with an established diagnoses were studied in detail. Diagnoses were Glycogen Storage
%U http://www.hindawi.com/journals/ijpedi/2010/254829/