title: The Utrecht approach to exercise in chronic childhood conditions: the decade in review.
abstract: OBJECTIVE
  To summarize and discuss current evidence and understanding of clinical pediatric exercise physiology focusing on the work the research group at Utrecht and others have performed in the last decade in a variety of chronic childhood conditions as a continuation of the legacy of Dr Bar-Or.
  
  
  CONCLUSIONS
  The report discusses current research findings on the cardiopulmonary exercise performance of children (and adolescents) with juvenile idiopathic arthritis, osteogenesis imperfecta, achondroplasia, hemophilia, cerebral palsy, spina bifida, cystic fibrosis, and childhood cancer. Exercise recommendations and contraindications are provided for each condition. Implications for clinical practice and future research in this area are discussed for each of the chronic conditions presented.
  
  
  CONCLUSIONS
  The authors provide a basic framework for developing an individual and/or disease-specific training program, introduce the physical activity pyramid, and recommend a core set of clinical measures to be used in clinical research.
authors.affiliation: Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. M.vanbrussel@umcutrecht.nl
authors.forename: Marco
authors.initials: M
authors.lastname: van Brussel
authors.forename: Janjaap
authors.initials: J
authors.lastname: van der Net
authors.forename: Erik
authors.initials: E
authors.lastname: Hulzebos
authors.forename: Paul J M
authors.initials: PJ
authors.lastname: Helders
authors.forename: Tim
authors.initials: T
authors.lastname: Takken
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D005081:Exercise Therapy; D006801:Humans; D009139:Musculoskeletal Abnormalities; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D009369:Neoplasms / Q000534:rehabilitation*; D010101:Oxygen Consumption; D010372:Pediatrics; D010809:Physical Fitness; D026741:Physical Therapy Modalities; D013997:Time Factors