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Home-based physical exercise improves aerobic capacity in children with chronic diseases like Cerebral PalsyHome exercise improves aerobic capacity in children with chronic diseases

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Key Takeaway
Note that home-based exercise improves aerobic capacity but does not significantly improve functional capacity or quality of life.

This meta-analysis evaluated the impact of home-based physical exercise on children and adolescents with chronic diseases, including Cerebral Palsy and Cystic Fibrosis. The analysis included 81 studies involving a total population of 2923 participants to compare home-based interventions against various control conditions, such as center-based programs or no intervention.

The primary finding indicates that home-based exercise significantly improves aerobic capacity compared to control groups (SMD 0.53; 95% CI 0.32 to 0.74; p<0.0001). In contrast, the meta-analysis found no significant differences in functional capacity or quality of life when comparing home-based interventions to control conditions. Data were insufficient to perform a meta-analysis regarding muscle strength.

Several limitations were noted, including suboptimal reporting quality, risk of bias, and inconsistent data regarding adherence and safety. While most studies reported no adverse events, some reports indicated mild effects such as muscle soreness or fatigue. Clinically, home-based exercise is feasible for improving aerobic capacity in this population, but it may not provide superior outcomes for functional capacity or quality of life compared to other settings.

How this fits prior evidence

This meta-analysis addresses a gap in understanding the feasibility and efficacy of remote interventions for children with chronic conditions. It builds upon evidence regarding Cerebral Palsy, specifically noting that while TMS can improve outcomes in cerebral palsy, home-based exercise provides a distinct pathway for improving aerobic capacity. The findings do not directly relate to the reported risks of OSAHS in Cystic Fibrosis patients or the management of sialorrhea.

For many children living with chronic illnesses, getting to a clinic for physical therapy is not always easy. This study looked at how home-based exercise affects kids with conditions like Cerebral Palsy, Cystic Fibrosis, and Idiopathic Arthritis. By looking at data from nearly 3,000 children across 81 different studies, researchers wanted to see if exercising at home could offer real benefits.

The results show that these home programs significantly improved aerobic capacity, which is the body's ability to use oxygen during physical activity. While this is a clear win for heart and lung health, the study found no significant differences in muscle strength or quality of life when comparing home exercise to other types of care.

Most children tolerated the exercise well, though some reported mild issues like muscle soreness or fatigue. Because the data from different studies was sometimes inconsistent, it is important to view these results carefully. While home programs are a feasible way to build endurance, they may not replace specialized center-based treatments for building specific muscle strength.

What this means for you:
Home-based exercise helps children with chronic diseases improve their aerobic capacity and heart health.

Common questions

Does exercising at home help children with chronic diseases?

Yes, the study found that home-based physical exercise improves aerobic capacity in children and adolescents with chronic diseases. This means it helps their hearts and lungs work better during activity. However, it did not show significant improvements for muscle strength or quality of life compared to other types of care.

Is home-based exercise safe for these children?

Most studies reported no serious problems with home-based exercise. Some reports noted only mild effects, such as muscle soreness, stiffness, and fatigue. Because some data on safety was inconsistent across the 81 studies reviewed, you should talk to a doctor about the best plan for your child.

How does home exercise compare to center-based therapy?

For functional capacity, there were no significant differences between home-based programs and center-based ones. While home exercises are a feasible way to improve aerobic capacity, they do not provide extra benefits for muscle strength or quality of life over other types of intervention.

Study Details

Study typeMeta analysis
Sample sizen = 26
EvidenceLevel 1
PublishedAug 2026
View Original Abstract ↓
OBJECTIVE: (1) To synthesise the available evidence on the clinical effectiveness of home-based physical exercise interventions in improving aerobic capacity, functional capacity, muscle strength and quality of life in children and adolescents with chronic diseases, as well as to evaluate their feasibility; and (2) to assess the reporting quality of these interventions using the Consensus on Exercise Reporting Template, with the aim of identifying gaps in methodological transparency that may limit reproducibility and scalability. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline (via PubMed), Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), SportDiscus and CINAHL database (via EBSCOhost) were searched until 31 December 2025. ELIGIBILITY CRITERIA: Eligible studies included intervention designs (randomised controlled trials (RCTs), non-randomised trials and before-after studies) that evaluated home-based physical exercise interventions in children and adolescents with chronic diseases. Studies were required to include a comparator (eg, centre-based interventions, alternative home-based interventions, such as motor imagery, constraint-induced movement therapy or hand-arm bimanual intensive therapy or no intervention) or to report within-group (baseline-to-follow-up) comparisons. Outcomes of interest were aerobic capacity, functional capacity, muscle strength and quality of life. RESULTS: A total of 81 studies were included, comprising 2923 children and adolescents. The most frequently represented conditions were cerebral palsy (n=26; 32.1%), cystic fibrosis (n=10; 12.3%) and idiopathic arthritis (n=8; 9.8%). Of the 45 RCTs identified, 19 met the criteria for inclusion in the meta-analysis. Home-based physical exercise interventions were effective in increasing aerobic capacity (p<0.0001; standardised mean differences: 0.53; 95% CI 0.32 to 0.74) compared with the control group. No significant differences were observed between home-based interventions and control conditions for functional capacity or quality of life. However, functional capacity gains are similar when comparing centre-based and home-based approaches. A meta-analysis of muscle strength could not be performed due to insufficient data. Adherence to home-based physical exercise interventions was higher than 80% in 27 of the 50 studies that reported this information. Most studies reported no adverse events of home-based physical exercise interventions, with few studies reporting only mild adverse effects (eg, muscle soreness, stiffness and fatigue). CONCLUSIONS: Our meta-analysis of randomised controlled trials comparing home-based interventions with control conditions suggests that home-based physical exercise is feasible and improves aerobic capacity, but does not confer significant benefits for functional capacity, muscle strength or quality of life in children and adolescents with chronic diseases. Suboptimal reporting quality, risk of bias and inconsistent adherence/safety data necessitate cautious interpretation. PROSPERO REGISTRATION NUMBER: CRD42022330567.
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