Effects of an intensive 4-week summer camp on cystic fibrosis: pulmonary function, exercise tolerance, and nutrition.

STUDY OBJECTIVES Cystic fibrosis (CF) patients prefer exercise to most other forms of therapy, although objective improvement remains controversial. Israeli CF patients have attended a summer program in Switzerland for many years with subjective improvement. However, CF camps worldwide have been cancelled recently, due to fears of cross-infection with resistant organisms. Therefore, we evaluated the effect of attending the camp on pulmonary function, exercise tolerance, and nutritional state in CF patients. DESIGN Weight, resting pulmonary function, incremental exercise test results, and sputum culture findings were assessed before and after a 4-week intensive summer camp. SETTING Davos, Switzerland (altitude, 1,500 m). PATIENTS Thirteen Israeli CF patients (seven women and six men) with an age range of 9 to 25 years who had mild-to-moderate lung disease. No patients had Burkholderia cepacia detected in their sputum. INTERVENTIONS The program included a high-calorie diet, chest physiotherapy, daily mountain climbing, and indoor activities. Arterial oxygen saturation (SaO(2)) was maintained at > 88% during exertion. RESULTS Exercise tolerance improved significantly. The peak work capacity increased by 12.7%, the maximal oxygen uptake increased by 10%, and minute ventilation increased by 18.5% (p < 0.0005). Of the calculated parameters, the anaerobic threshold improved by 17%. Ventilation was always the limiting factor during exercise, although it improved. There was no significant change in resting lung function and pulse or in SaO(2) decline at maximal exercise. The mean weight gain was 1 kg. No patient acquired B cepacia. CONCLUSIONS An intensive summer camp improved exercise tolerance and nutrition in CF patients. This may explain improved patient well-being despite unchanged values for resting lung function. The reinstitution of summer camps, with special care to avoid cross-infection, should be considered.