title: Physical exercise recommendations improve postural changes found in children and adolescents with cystic fibrosis: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate postural changes and the distribution of plantar pressures in patients with cystic fibrosis (CF). We also sought to evaluate the effects of an educational guideline for physical activity on body posture in children and adolescents with CF.
  
  
  METHODS
  This was a 2-phase study of individuals between age 7 and 20 years. Phase I was a cross-sectional study in which healthy subjects were selected for postural evaluation and baropodometry, aiming to perform a later comparison with patients with CF. In phase II, we performed a randomized controlled clinical trial to assess the influence of the exercise guideline on the postural changes. Patients were assigned to 2 groups: control and intervention. The intervention consisted of a handbook with instructions for aerobic exercise and stretching. Main outcomes were postural abnormalities, plantar pressure distribution, and lung function.
  
  
  RESULTS
  In phase I, 34 patients with CF and 34 healthy matched individuals were included. No significant baseline differences were identified. Children with CF presented more postural deviations compared with healthy subjects (P < .05), as to alignment of the head, shoulder girdle, and pelvis, increased cervical lordosis, and lateral chest distance. In phase II (n = 34), there were no baseline differences between groups. The intervention caused (P < .05) a decrease in cervical lordosis, thoracic kyphosis, lumbar lordosis, lateral chest distance, and abdominal protrusion, as well as in the baropodometric mean pressure and contact area.
  
  
  CONCLUSIONS
  Children and adolescents with CF present postural changes when compared with healthy individuals. The educational guideline for exercise practice helped to improve posture, preventing the progression of some postural disorders.
authors.affiliation: Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Cláudia S
authors.initials: CS
authors.lastname: Schindel
authors.affiliation: Centro Universitário Franciscano, UNIFRA, Santa Maria, Brazil.
authors.forename: Patrícia X
authors.initials: PX
authors.lastname: Hommerding
authors.affiliation: Nursing School, Nutrição e Fisioterapia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Denizar A S
authors.initials: DA
authors.lastname: Melo
authors.affiliation: School of Physical Education, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Rafael R
authors.initials: RR
authors.lastname: Baptista
authors.affiliation: Department of Pediatrics, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Paulo J C
authors.initials: PJ
authors.lastname: Marostica
authors.affiliation: Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; Nursing School, Nutrição e Fisioterapia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil. Electronic address: mdonadio@pucrs.br.
authors.forename: Márcio V F
authors.initials: MV
authors.lastname: Donadio
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000503:physiopathology / Q000534:rehabilitation*; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D011187:Posture / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult