Exercise and training in adults with congenital heart disease (original) (raw)
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Exercise testing and prescription in patients with congenital heart disease
International journal of pediatrics, 2010
The present paper provides a review of the literature regarding exercise testing, exercise capacity, and the role of exercise training in patients with congenital heart disease (CHD). Different measures of exercise capacity are discussed, including both simple and more advanced exercise parameters. Different groups of patients, including shunt lesions, pulmonary valvar stenosis, patients after completion of Fontan circulation, and patients with pulmonary arterial hypertension are discussed separately in more detail. It has been underscored that an active lifestyle, taking exercise limitations and potential risks of exercise into account is of utmost importance. Increased exercise capacity in these patients is furthermore correlated with an improvement of objective and subjective quality of life.
Exercise rehabilitation in congenital cardiac disease
Progress in Pediatric Cardiology, 1993
RJ, et al. An exercise program for pediatric patients with congenital heart disease: organizational and physiologic aspects. J Cardiac Rehabil. 1983;3:467-475. Vaccaro P, Galioto FM, Bradley LM, Hansen DA, Vaccaro J. Development of a cardiac rehabilitation program for children. Sports Med. 1984;1:259-262. Longmuir PE, Turner JA, Rowe RD, Olley PM. Postoperative exercise rehabilitation benefits children with congenital heart disease. Clin Invest Med. 1985; 8~232-238. Calzolari A, Turchetta A, Biondi G, et al. Rehabilitation of children after total correction of tetralogy of Fallot. Int 1 Cardiol. 1990;28:151-158. Peja M, Boros A, Toth A. Effect of physical training on children after reconstructive heart surgery. ON Hetil. 1990;131:2089-2090, Galioto FM. Cardiac rehabilitation for children. In: Garson A, Bricker JT, McNamara DG, eds. The Science and Practice of Pediatric Cardiology. Philadelphia, Pa: Lea and Febiger, 1990:2267-2273. Galioto FM. Exercise rehabilitation programs for children with congenital heart disease: a note of enthusiasm. Pediatr Exert Sci. 1990;2:197-200. Ensing G, Heise C, Driscoll D. Cardiovascular response to exercise after the Mustard operation for simple and complex transposition of the great vessels. Am ] Cardiol. 1988;62:617-622. Paridon SM, Humes RA, Pinsky WM. The role of chronotropic impairment during exercise after the
Exercise training in adults with congenital heart disease: Feasibility and benefits
International Journal of Cardiology, 2010
Background: Regular physical activity is associated with a range of health benefits; however the influence of regular exercise training on exercise capacity and quality of life in adults with congenital heart disease [ACHD] has not been previously reported. Methods: Prospective study of patients attending the ACHD clinic in a supra-regional centre, assessing feasibility and effects of exercise training. There were 3 phases: Phase I: Initial assessment including quality of life and physical activity questionnaires; treadmill exercise test; physical activity assessment with accelerometers [Caltrac ® and Actigraph ® ]; Phase II: Exercise training (home-based walking 5/7 days) for 10 weeks; Phase III: Re-assessment. Results: Sixty-one adults [36 males; mean age 31.7 +/− 10.9 yrs] were divided into 3 groups according to NYHA class. Fifty patients completed the intervention and all pre-post assessments. Group I (n = 21; 13 males), Group II (n = 16; 10 males), Group III (n = 13, 10 males). Median body mass index was 23.8; 12 were overweight (BMI 25-29.9) and 7 obese (BMI N 30).
Exercise training in paediatric congenital heart disease: fit for purpose?
Archives of Disease in Childhood, 2021
Exercise and physical activity (PA) have been shown to be effective, safe and feasible in both healthy children and children with congenital heart disease (CHD). However, implementing exercise training as an intervention is still not routine in children with CHD despite considerable evidence of health benefits and well-being. Understanding how children with CHD can safely participate in exercise can boost participation in PA and subsequently reduce inactivity-related diseases. Home-based exercise intervention, with the use of personal wearable activity trackers, and high-intensity interval training have been beneficial in adults' cardiac rehabilitation programmes. However, these remain underutilised in paediatric care. Therefore, the aims of this narrative review were to synthesise prescribed exercise interventions in children with CHD, identify possible limitation to exercise training prescription and provide an overview on how to best integrate exercise intervention effectively for this population into daily practice.
Effect of physical training in children and adolescents with congenital heart disease
Cardiology in the Young, 2000
In order to test the effect of systematic supervised physical training, we divided a total of 129 children and adolescents with congenital heart disease into a group undergoing intervention and a control group. All patients underwent exercise tests, measurements of physical activity, and a survey of psychosocial factors. An improvement in uptake of peak level of oxygen was observed after intervention. There was also an improvement in physical activity in both groups measured by a monitor, although this was significant only in those with intervention. The psychosocial scales measured by the Child Behavior Checklist showed a decrease in internalizing scores for those subjected to intervention. This was decreased due to decreased withdrawal and somatic complaints. In conclusion, we recommend systematic supervised training, including testing of routine follow-ups, in patients with congenital heart disease.
Cureus Journal of Medical Sciences, 2022
Public health guidelines and a myriad of studies have proven that exercise is beneficial in the alleviation of various cardio-metabolic diseases. Congenital heart disease (ConHD) is one of the most frequently occurring congenital structural malfunctions in the pediatric population, affecting nine of every 1,000 live births. Only a few studies have established the impact of a structured exercise program on cardiopulmonary fitness in diverse groups of patients with ConHD. It is also alarming to know that a substantial number of these patients and their caregivers often remain very wary of exercise. Anxiety about exercise may increase the risk of developing morbid obesity and other long-term health complications of ConHD. The present review of a critically appraised topic is undertaken to answer the question, "Does structured exercise intervention (cardiac rehabilitation) improve cardiorespiratory fitness in children and young adults with ConHD?" Exercise science and the medical literature were searched for studies that engaged the use of aerobic exercise in patients with different ConHD diagnoses. The search yielded four studies after screening with the inclusion and exclusion criteria, which were further narrowed to three studies after a full-text review. These studies yielded results showing significant increments in peak exercise workload, duration, power output, peak oxygen uptake, or improved tissue oxygenation and muscle strength after an exercise training intervention. It is noteworthy that a group identified as "cyanotic palliated" exhibited the most significant impairment both at baseline and after the exercise intervention. This review provides level 1b medical evidence that a structured exercise program may improve cardiopulmonary fitness in patients with ConHD, which is likely to be beneficial to their overall physical, motor, and psychosocial development. The results of this review may be useful for alleviating the anxiety of patients and their caregivers about participation in structured exercise programs. This review should also motivate future research investigations to develop clinical guidelines for the management of patients with ConHD by adding exercise prescriptions to their daily therapeutic regimens.
Exercise Rehabilitation Programs for Children with Congenital Heart Disease: A Note of Enthusiasm
Pediatric Exercise Science, 1990
Cardiac rehabilitation programs are now well established as a routine part of care for adults with heart disease, especially following myocardial infarction and coronary artery surgery (6, 12, 14). There is ample scientific evidence that such programs improve cardiovascular fitness and exercise tolerance (1,7). There is less certain evidence of a reduction in the risk of recurrent myocardial infarction and sudden death after participation in such programs (4). It should be remembered that a primary goal of these programs is to change the lifestyle of individuals with heart disease. Exercise training is only one part of an appropriate cardiac rehabilitation program. Other factors such as dietary measures and reduction of stress are clearly identified as improving the outlook for patients in these adult programs (13). Pediatric cardiac rehabilitation programs have a somewhat different role than the adult programs (10, 11). I believe that these structured, carefully supervised programs for children are not designed for all patients with congenital heart disease. There is no question that the individual who has had successful surgery for lesions such as an atrial septal defect, patent ductus arteriosus, pulmonary stenosis, and even ventricular septal defect without an extensive ventriculotomy can participate in all activities including competitive sports without restriction. These individuals with congenital heart disease are not candidates for a pediatric cardiac rehabilitation program, as they simply do not need it. The role of the pediatric cardiologist for these patients is to approve and even encourage all normal activities of childhood. The normal activities of childhood and adolescence include sports competition, and individuals with successfully repaired congenital heart disease and no residual problems should not be restrained from participation. Cardiac rehabilitation programs for children are designed for individuals with significant residual heart disease. These include, but are not restricted to, individuals with atrial operations for d-transposition of the great arteries, patients with only one functioning ventricle for which they have had a division of their circulations by Fontan's operation, or individuals with lesions such as tetralogy of Fallot whose repair included a significant reconstruction with residual impairment