Beyond the Lungs: Social and Parental Factors Associated With Exercise Capacity and Respiratory Muscle Strength in Children With Cystic Fibrosis

ABSTRACT Introduction Children with cystic fibrosis (CF) receive essential parental support, and parental attitudes and social support may affect functional outcomes. This retrospective cross‐sectional study investigated associations between parental attitudes, physical activity (PA)‐related perceived social support, exercise capacity, pulmonary function, and respiratory muscle strength. Methods Thirty‐five children with CF (19 females, 16 males, 10.62 ± 3.29 years) were included. They underwent the Modified Shuttle Walk Test (MSWT), spirometry, respiratory muscle strength tests [maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP)], the Perceived Social Support Scale (PSSS), and the Parenting Style Scale (PSS). Pearson correlation analyses and multivariable linear regression analyses were performed. The Benjamini–Hochberg procedure adjusted for multiple comparisons. Results Correlations between PA‐related perceived social support and functional outcomes did not remain significant after Benjamini–Hochberg correction. In contrast, parental strictness/supervision remained negatively correlated with absolute PEF, MIP, and MEP values ( r = −0.627 to −0.728, all p < 0.001), but not with percentage‐predicted values. In adjusted regression analyses, total perceived social support was positively associated with MSWT% ( β = 0.439, p = 0.014), although the overall model was not statistically significant ( p = 0.059). Parental strictness/supervision was independently associated with lower MIP% ( β = −0.767, p = 0.003; adjusted R 2 = 0.368), whereas neither variable was independently associated with FEV 1 % (both p > 0.05). Conclusion In children with CF, parental strictness/supervision was independently and negatively associated with inspiratory muscle strength. These findings highlight the potential relevance of parenting styles to comprehensive CF management, and warrant further investigation in larger samples.