Sports and CF

Question

Which sports are not uniformly good for patients with cystic fibrosis?

Answer

Hello.
At first glance, there unfortunately is no simple answer to your question. It would be better to resolve the benefits of a specific sport for a specific patient, because completely general recommendations cannot practically be made.
Considering that CF has a very diverse set of clinical expressions, there will be different recommendations for people with CF with major lung difficulties, for those with diabetes and for those who have osteoporosis.
People with CF have higher energy needs and a high concentration of salt in their sweat. Generally, then, it is necessary to replace energy expended during physical activity more than for the average population and at the same time to replace salt lost through sweating. If there are any problems in this area, then any sport that leads to these is not appropriate. In the same way, sports where major changes in pressure occur (such as diving), or decreased amounts of atmospheric oxygen (such as mountainclimbing), are not appropriate.
It is very beneficial for the individual to get regular exercise. No regular recreational sport is generally counterindicated for an individual with CF, but it is important to make sure they do not hold their breath during movement. It is also important to drink regularly and to take more frequent breaks during exercise.
Advanced lung disease limits the individual's physical performance and brings the risk of pneumothorax in sudden changes of barometric pressure. Every patient can check their level of tolerance to physical exertion themselves and adapt their efforts (running, bicycle riding or swimming can be done from recreational to top levels). Considering the risk of lung exacerbation, activities with a risk of chest injury are not appropriate, such as boxing and other contact sports; the pain leads to worsened coughing up of sputum. Considering the risk of pneumothorax, sports such as diving, skydiving, and skiing - if major changes in altitude are made – are not recommended. Stays at higher elevations (in sports such as mountainclimbing) are connected with an increased risk of exposure to lower partial oxygen pressure and therefore to a lack of oxygen in the body.
Those with being treated with insulin for diabetes are at risk of hypoglycemia, especially in physical activity and a lack of food intake. This could occur with every sport connected with physical exertion, but the riskiest are those where a possible loss of consciousness could threaten one's life, such as cycling or motor sports.
For people with osteoporosis, the threat is from broken bones and a shattering of the vertebrae. In this case, sports with risks of injury, such as weightlifting, jumping from heights and rotational movements (such as tennis) are inappropriate.

In summary, patients without serious organ/system involvement are most
probably at the same risk as healthy individuals, while patients with a problem are at increased rsik for a number of activities. Therefore, it is advisable to
perform an exercise test before starting a sports program. The recommendation when such a test is necessary varies from country to country,
in Germany for example it is recommended to perform a test in all patients
with an FEV below 70%. In Great Britian, for example, such a test is
recommended in all patients, in order to unmask risks arsing when doing
exercise.

The most important recommendation about sports for CF therefore is: Always follow your doctor's advice about the optimal amount of physical exertion in sports.

Best regards Libor Fila and Jitka Brazova

09.03.2009