Abstract
The cardiopulmonary exercise test (CPET) is a dynamic examination that encourages the body to draw on its cardiac, respiratory and muscular reserves in order to explore the capacities of adaptation to the effort. The result reflects the oxygen uptake consumption (VO2max), which corresponds to the patient's aerobic physical fitness.The purpose of this functional examination is to promote physical activity, to detect and assess potential future cardiovascular risks. In 2019, American recommendations proposed active management of cardiovascular risk factors associated with the promotion of physical activity for children with chronic illness. These recommendations encourage health professionals in charge of these children to consider physical activity as essential for cardiovascular prevention, and this as early as possible.Despite recommendations that seem clear on the interest of the CPET, we realize that this CPET presents difficulties in being imposed in routine practice in pediatrics. In this PhD manuscript, we propose to present the main levers explored to overcome the difficulties that may have an impact on the generalization of the practice of CPET in pediatrics:-Exploration of CPET parameters to raise awareness of the interpretation of this examination.-Define references values with Z-scores for each of the parameters of the pediatric cardio-respiratory exercise test, which are interpretable for all children (even those with extreme weights), to facilitate and standardize the interpretation of this exam.- Explore specific pediatric chronic diseases to provide these children with adapted physical activity programs.The final goal of this PhD is to communicate and teach around this theme, to generalize the practice of CPET in these children with chronic diseases and to propose to set up preventive strategies centered on rehabilitation to prevent the morbidity/mortality of their chronic pathology in adulthood.