# Transforming Exercise Testing and Physical Activity Assessment in Children: New Approaches to Advance Clinical Translational Research in Child Health

> **NIH NIH U01** · UNIVERSITY OF CALIFORNIA-IRVINE · 2022 · $1,313,811

## Abstract

Children are the most naturally physically active human beings; reduced physical activity is a cardinal sign of
childhood disease, and exercise testing provides mechanistic insights into health and disease that are often
hidden when the child is at rest. Despite this, and because data analytics and testing protocols have failed to
keep pace with enabling technologies and computing capacity, biomarkers of fitness and physical activity have
yet to be widely incorporated into translational research and clinical practice in child health. The goal of this
project is to address the obstacles that have impeded optimal use of cardiopulmonary exercise testing (CPET)
in children. Aim 1 is to rethink and transform current clinical research applications of typical CPET in children
by novel implementation of breath-by-breath technologies and data analytic approaches. Aim 2 is to develop
new exercise testing protocols (multiple brief exercise bouts) that more closely mimic real-life patterns of
physical activity and, in so doing, better assess relevant pathophysiology. Aim 3 is to identify and overcome
logistical issues that have limited multicenter studies involving exercise biomarkers. Our use-cases, sickle cell
disease and cystic fibrosis, highlight how very different diseases can impair exercise and physical activity. The
value of the new CPET approaches will be analyzed in a variety of ways, including by: 1) established indexes
of health (e.g., body composition), 2) habitual physical activity, an emerging metric of overall health, and 3)
novel exercise-responsive gene expression signals in the circulating blood. In combination with healthy
children as comparisons, our project will delineate the use of CPET biomarkers across a broad spectrum of
pediatric health and disease. We will take advantage of the grant cycle and study cohorts prospectively as our
participants grow and mature from Tanner 2–3 to 5, roughly a 3-year interval. This provides the unique
opportunity to study CPET longitudinally in health and disease over a critical period of growth. Our team
represents the diverse and challenging array of academic health centers and affiliated stand-alone children’s
hospitals often involved in multicenter pediatric translational research: 1) University of California at Irvine
Institute for Clinical and Translational Science, 2) Northwestern University Clinical and Translational Sciences
Institute, and 3) the Southern California Clinical and Translational Science Institute, Children’s Hospital of Los
Angeles, University of Southern California. Each of these centers is committed to underserved populations. In
addition, we will collaborate with the North American Society of Pediatric Exercise Medicine and the American
College of Sports Medicine, each dedicated to advancing exercise-as-medicine in children. Through our
proposed: 1) innovations in data analytics of commonly used CPET, 2) developing new testing paradigms, 3)
providing the research community with...

## Key facts

- **NIH application ID:** 10450177
- **Project number:** 5U01TR002004-05
- **Recipient organization:** UNIVERSITY OF CALIFORNIA-IRVINE
- **Principal Investigator:** DAN M COOPER
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1,313,811
- **Award type:** 5
- **Project period:** 2018-07-17 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10450177

## Citation

> US National Institutes of Health, RePORTER application 10450177, Transforming Exercise Testing and Physical Activity Assessment in Children: New Approaches to Advance Clinical Translational Research in Child Health (5U01TR002004-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10450177. Licensed CC0.

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