NEW YORK (Reuters Health) - Children with chronic illnesses or disability can often benefit from the right exercise program, showing improved quality of life, greater aerobic capacity and better function, according to a report published this month.

But chronically ill or disabled children and teens who aren't active can get out of shape and too fat, just like their peers who aren't challenged by illness or disability, warns Dr. Patrick J. Morris of the University of Minnesota in Minneapolis.

Morris notes that children with cerebral palsy often have movement problems that make it difficult to walk, let alone exercise. But he points to a study in seven teens with the disease that showed three months of training improved their aerobic capacity and their ability to stand, walk, jump and run.

Physical activity is also beneficial to individuals with spinal cord injuries, Morris adds. And while the jury is still out on whether exercise can help people with cystic fibrosis get stronger and breathe more easily, he notes, the studies to date show no evidence that physical activity is harmful for these patients.

Even children with the bleeding disease hemophilia can engage in physical activity, according to Morris, if they choose a sport that's appropriate for their fitness and coordination level.

Aerobic workouts can clearly help children with asthma get stronger and more fit, although the evidence is not as clear on whether training affects symptoms like breathlessness or the amount of medication a patient needs.

Exercise is also crucial for helping children with type 2 diabetes manage their illness, according to Morris, but a study out last year showed that adolescents found the hardest thing about following an exercise program was "lack of motivation."

Just because exercise can benefit young people with disease "doesn't mean it's easier to get these kids to sign on to physical activity," Morris concedes. To help motivate them, he suggests emphasizing "fun approaches with variety and freedom that are supported by peers, that have the option of family participation, and that foster success."

Morris points to the offerings of Courage St. Croix, a rehab and resource center for disabled individuals near his home, as examples of activities that fit the bill: "power wheelchair soccer, hockey, softball or rugby; ...handcycling, SCUBA, rock climbing, kayaking, downhill skiing, water skiing, golf, archery, and bicycling; ... and yoga, tai chi and horseback riding."

"Physical activity," he concludes, "is a positive intervention for children growing up with the challenge of a chronic disease or disability. When physical activity becomes a lifestyle for these children, they're supported on their way to becoming happier, healthier adults who are up to any challenge."

SOURCE: Current Sports Medicine Reports, November/December 2008.

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