Practices and Procedures in Clinical Pediatric Exercise Laboratories in North America

Pediatr Exerc Sci. 2022 Nov 1;34(4):202–209. doi: 10.1123/pes.2021-0149. Epub 2022 Apr 7.

Abstract

Interinstitutional differences in clinical pediatric exercise laboratory (CPEL) practices may affect patient care and efficacy of multicenter research.

Purpose: To describe current practices/procedures in CPELs and explore differences in CPELs employing exercise physiologists to those that do not.

Methods: A 40-item survey was distributed to CPELs in North America focusing on (1) staffing; (2) exercise stress testing (EST) volumes, reporting, and interpretation; and (3) EST procedures/protocols.

Results: Of the 55 responses, 89% were in the United States, 85% were children's hospitals with university affiliation, and 58% were cardiology specific. Exercise physiologists were employed in 56% of CPELs, and 78% had master's degrees or higher. Certifications were required in most CPELs (92% emergency life-support, 27% professional, and 21% clinical). Median volume was 201 to 400 ESTs per year, 80% used treadmill, and 10% used cycle ergometer as primary modalities. Ninety-three percent of CPELs offered metabolic ESTs, 87% offered pulmonary function testing, 20% used institution-specific EST protocols, and 72% offered additional services such as cardiac/pulmonary rehabilitation. CPELS staffing exercise physiologists performed higher volumes of ESTs (P = .004), were more likely to perform metabolic ESTs (P = .028), participated in more research (P < .001), and provided services in addition to ESTs (P = .001).

Conclusions: Heterogeneity in CPELs staffing and operation indicates need for standardization.

Keywords: clinical exercise physiologist; clinical exercise testing; pediatric stress testing; pulmonary function testing.

Publication types

  • Multicenter Study

MeSH terms

  • Child
  • Exercise
  • Exercise Test*
  • Humans
  • Laboratories*
  • North America
  • Surveys and Questionnaires
  • United States