Children with intestinal failure—a serious digestive condition—often struggle with weak muscles and low confidence. Researchers tested whether a 12-week exercise program could help. The study found that kids who did tailored exercises got stronger muscles, better core stability (the muscles that support your spine), and improved self-esteem. While their overall exercise capacity didn’t change much, the improvements in strength and confidence suggest that customized exercise programs can really help these children feel better physically and emotionally.

The Quick Take

  • What they studied: Whether a specially designed 12-week exercise program could help children with intestinal failure (a condition where the digestive system doesn’t work properly) improve their muscle strength, fitness, and emotional well-being.
  • Who participated: Sixteen children ages 6-18 with intestinal failure, including some still receiving nutrition through IV tubes and others who had stopped. The average age was about 12 years old.
  • Key finding: After 12 weeks of tailored exercise, children showed significant improvements in muscle strength and core stability (muscles supporting the spine), plus better self-esteem. Interestingly, kids who started with better motor skills (coordination and movement control) showed the most improvement in exercise capacity.
  • What it means for you: If you have a child with intestinal failure, a customized exercise program may help them build stronger muscles and feel more confident about themselves. However, this is a small study, so talk with your child’s doctor about what exercises are safe and appropriate for their specific situation.

The Research Details

This was a carefully controlled study where researchers measured children with intestinal failure before exercise training started, during a waiting period (control period), and then after 12 weeks of customized exercise. The exercise program was tailored to each child’s abilities and needs. Researchers tested multiple things: how much exercise the kids could do, their muscle strength, how their bodies were composed (muscle versus fat), and their emotional health including self-esteem, fear, and quality of life.

The study included children ages 6-18, some who were still receiving nutrition through IV tubes (parenteral nutrition) and others who had stopped this treatment. Sixteen children started the study, with eight having already stopped IV nutrition. This design allowed researchers to see if exercise helped children at different stages of their condition.

Researchers measured everything carefully before and after the exercise program, including fitness tests, blood work, body composition scans, and questionnaires about how the children felt emotionally and physically.

Children with intestinal failure face unique challenges—their digestive systems don’t work normally, so they often can’t eat regular food and need special nutrition support. This can lead to weak muscles, poor bone health, and emotional struggles like low confidence. Understanding whether exercise can help is important because it could improve both their physical health and mental well-being. A tailored approach (customized to each child) is especially important because these children have different abilities and limitations than healthy kids.

This study has both strengths and limitations. Strengths include careful measurement of multiple health areas (fitness, nutrition, emotions), a control period to establish a baseline, and a published protocol registered before the study started (which increases transparency). The main limitation is the small sample size (only 16 children), which means results may not apply to all children with intestinal failure. The study was published in a respected pediatric journal, suggesting it met scientific standards. However, the small size means we should be cautious about drawing firm conclusions.

What the Results Show

The most important finding was that muscle strength and core stability improved significantly after the 12-week exercise program. Children could do more work (measured in watts) during exercise tests, and this improvement was linked to how well they could coordinate their movements at the start. Interestingly, their maximum exercise capacity (VO2peak) didn’t improve much, but the amount of work they could do did improve.

Self-esteem—how good children felt about themselves—also improved noticeably after the exercise program. This is important because children with chronic digestive conditions often struggle emotionally. The improvement in self-esteem suggests that exercise helped them feel more confident and positive.

Before the exercise program, most children (63%) weren’t getting enough physical activity compared to health guidelines. Many also had weak muscles and poor motor skills (coordination and movement control), even though their basic exercise capacity was normal. This suggests that these children weren’t moving enough in their daily lives, which led to weakness and poor coordination.

The study also looked at other important outcomes. Children’s core stability (the strength of muscles supporting the spine) improved, which is important for posture and preventing back problems. The researchers found that children who started with better motor skills showed greater improvements in exercise capacity during the program, suggesting that coordination and movement control are important for fitness gains. While the study measured body composition and energy expenditure, these didn’t show major changes, possibly because 12 weeks wasn’t long enough or the sample was too small to detect differences.

Previous research showed that children with intestinal failure are less active than healthy children and have weaker muscles and bones. This study confirms those findings and adds new information: a tailored exercise program can actually improve muscle strength and self-esteem. The finding that exercise capacity was normal (despite weak muscles) is interesting and suggests these children have the basic ability to exercise but lack the strength and coordination to do it well. This fits with the idea that these children need specific, targeted exercise training rather than just general activity.

The study had several important limitations. First, only 16 children participated, which is a small number. This means results might not apply to all children with intestinal failure. Second, there was no comparison group of children who didn’t exercise, so we can’t be completely sure the improvements came from exercise rather than other factors (though the control period helps with this). Third, the study only lasted 12 weeks, so we don’t know if improvements lasted longer or if more benefits would appear with longer training. Fourth, the study didn’t measure whether children actually increased their daily physical activity outside the program. Finally, the children in this study had relatively normal exercise capacity, so results might differ for children with more severe limitations.

The Bottom Line

If your child has intestinal failure, talk with their medical team about starting a tailored exercise program. The evidence suggests moderate confidence that customized exercise can improve muscle strength and self-esteem. Start slowly and work with professionals who understand your child’s condition. Aim for regular exercise sessions (the study used 12 weeks as a timeframe). Combine exercise with other treatments your child is already receiving. Don’t expect dramatic changes in overall fitness capacity, but do expect improvements in strength and how your child feels about themselves.

This research is most relevant for children with intestinal failure and their families. It’s also important for doctors, physical therapists, and nutritionists who work with these children. Children with intestinal failure who are not meeting physical activity guidelines should especially consider this. However, this study is too small to apply to all children with intestinal failure—your child’s specific situation may be different. Children with very severe limitations or other serious health conditions should get personalized advice from their medical team.

Based on this study, you might expect to see improvements in muscle strength within 12 weeks of regular, tailored exercise. Improvements in self-esteem and confidence may also appear within this timeframe. However, these are initial findings from a small study, so individual results will vary. Some children may see benefits sooner, while others may need longer. Consistency matters—regular exercise is more important than occasional activity.

Want to Apply This Research?

  • Track weekly exercise sessions completed and rate muscle strength on a simple 1-10 scale before and after exercise. Also track self-esteem or mood using a daily emoji rating (happy, neutral, sad) to see if exercise correlates with better emotional well-being.
  • Set a goal to complete 2-3 tailored exercise sessions per week, starting with exercises recommended by your child’s physical therapist. Log each session in the app and note which exercises felt easiest or hardest. Celebrate weekly consistency rather than perfection.
  • Use the app to track exercise consistency over 12 weeks (matching the study timeline), measuring muscle strength improvements through simple tests (like how many push-ups or how long a plank hold), and monitoring self-esteem through weekly mood check-ins. Compare measurements at 4 weeks, 8 weeks, and 12 weeks to see progress.

This research describes findings from a small study of 16 children with intestinal failure. While the results are promising, they should not replace personalized medical advice from your child’s healthcare team. Before starting any new exercise program, especially for a child with intestinal failure or other chronic conditions, consult with your pediatrician, gastroenterologist, or physical therapist. Exercise recommendations should be tailored to your child’s specific medical situation, current nutrition status, and abilities. This summary is for educational purposes and does not constitute medical advice.