Physical activity is an integral part of every child's life. While in former years, children used to participate in a large variety of non-organized games, they nowadays either live a sedentary life or engage in one or two competitive sports. Consequently, physicians have to deal with the effects of low physical activity in a major section of the pediatric population. For young competitive athletes, regular medical guidance is required to avoid the adverse effects of intense sports participation. In this chapter, we will first address some developmental aspects of exercise physiology, since the understanding of basic principles will facilitate the decision process in daily medical practice. This will be followed by discussion of the benefits and risks of exercise at different levels in healthy children and in those with a chronic disease.

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