Exercise for Preschoolers and Elementary School Children With CF
FIRST, THE FACTS
First of all, if there is ever an easier time to get kids to move…this is it. Just as before, encourage the notion that exercise is fun. Being active is fun. Playing with your family and friends outdoors (or indoors) vigorously is fun! The neural pathways you help your child establish now will be with them into adulthood. They can be health promoting pathways, making an active lifestyle easy to maintain…or , they can be sedentary living pathways, which will be difficult to overcome. Your power to promote long lasting behaviors at this stage is enormous.
While the target goal is to have your child accumulate at least 30 minutes of moderate to vigorous activity each day, remember that this does not have to happen in one session. In fact, kids are wired to be active in short bursts, so go with that, and break up activity sessions into 5-10 minute chunks. Go out and play hide and seek with them…or tag…or whatever makes their (and your) hearts pump and lungs work hard. The “active time” can include swimming, soccer, basketball, biking, jumping rope, rollerblading, running/walking, jumping on a pogo stick (one of my favorites), or rebounder, or safely enclosed trampoline. Really, you are limited only by your and your child’s imaginations.
Preschool and elementary school aged children can also build strength. They aren’t ready to pump iron at the gym with you, but with a little creativity, you can help them strengthen their back extensors and other core musculature. In a soon to be revealed video, I will demonstrate some easy ways to do this.
Habits are being formed now, as I said before, and this also applies to posture. Why is posture so important to think about in cystic fibrosis? Several reasons come to mind. One, optimizing posture optimizes usable lung tissue. Think about what ends up happening as we age (unless we work hard to avoid it). Our upper backs tend to bend forward, as our shoulders roll forward from years of typing, driving, working at a bench, or whatever. At the same time, our lower backs tend to become more “swaybacked” as the pelvis rolls anteriorly from years of sitting and subsequent tightening and shortening of hip flexors. The result is that the upper areas of our lungs get, to use a technical term, scrunched, and we get chronic low back pain. Both of these are bad. Compressed lung tissue is bad in CF, because compressed tissue collapses and, 1) isn’t used to exchange gases and, 2) is a set up for mucus plugging and infection. Back pain is bad in CF for the same reasons it is bad in anyone…it hurts and leads to inactivity. It is also bad because with low back pain and weakness comes abdominal muscle weakness, and inefficient and weak cough mechanics.
So you are probably wondering how to avoid all of this. Start strengthing back extensor muscles early, as well as all of the core muscles that surround the trunk! I have come up with several examples of these in the aforementioned video (coming to your computer screen soon). Many of these are exercises that adults do, but have been slightly modified and given cute names.
HOW DO I CONVINCE THE LITTLE BUGGER
Finally, a word about motivation during these fun, but sometimes difficult years. Let’s be clear here…sometimes it’s more about motivating yourself to be consistent and unwavering about establishing exercise as a “family value” more than it is about motivating your child to do it. Parenting is hard (tell me about it) and can be draining. Convincing a young child to do what you want can be like herding cats. Sometimes “motivating” them really means “bribing” them. Clearly, you have to pick your battles, and exercise may not be the most important thing to focus on every time. The point is, at this age, you are aiming a moving target. Just because a trick works one day doesn’t mean it will work the next. You need to have a Plan B and C ready.
COMMON TRICKS, I MEAN STATEGIES
Enticement is a wonderful tool. Giving a “reward” for doing their exercise can be extremely effective. Pre-school kids will do the most amazing things for a sticker or a small bouncy ball. A 5, 6 or 7 year old can be told to get 5000 steps on their pedometer (that you gave them as a reward for exercising) before they get to watch their favorite cartoon. (I discovered the hard way that after this age, the kids quickly learn to just shake the pedometer when you aren’t looking). An older 4th or 5th grader may gladly do their exercise if they are told that there will be no screen time until they do.
Calling exercise by a different name is sometimes effective. Personally, I think it is a lovely word, but many people hate exercise and like to say so. Kids overhear this and can easily associate “exercise” with pain and discomfort. So, “Let’s go play on the trampoline!” sounds better than, “Go exercise on your trampoline.” “Let’s pretend you are a wheelbarrow!” sounds fun! “Let’s make your muscles stronger!” sounds like work. “Let’s make an obstacle course!” sounds much more exciting than “Let’s do interval training!”
Competition works well for some kids and completely turns off others. One of my kids hates it and refuses to play. The other will do anything if I tell him I’m going to time him. You know your own child and if this will work. If it does, you can have races or see who can jump the farthest or the most without missing (jumping rope).
Finally, video games that encourage movement are available and fun! The Wii has several active games, both the games that come with the Wii as well as Wii Fit and others that really get you moving! Dance, Dance Revolution is another great example of this and more are being created every day. Video games are here to stay. I think of this with the Aikido mentality of “using the opponent’s force to get what you want.” If you can, get a Wii or other console system, and allow the games that encourage movement. Play them with your kid! Not as a substitute for other exercise, but as a complement. After all, they are fun!