Does exercise training improve cardiopulmonary fitness and daily physical activity in children and young adults with corrected tetralogy of Fallot or Fontan circulation? A randomized controlled trial

Duppen, Nienke; Etnel, Jonathan R.G.; Spaans, Laura; Takken, Tim; Berg-Emons, Rita J G van den; Boersma, Eric; Schokking, Michiel; Dulfer, Karolijn; Utens, Elisabeth M. W. J.; Helbing, Willem A.; Hopman, Maria T. E.

doi:10.1016/j.ahj.2015.06.018

Cited by 99 publications

(84 citation statements)

References 34 publications

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“…This high number is comparable with our previously published accelerometer-based study,9 where 76% of the patients met the recommendations of at least 30 min moderate PA per day, which is almost equivalent to the minimally active criteria of the IPAQ. Also the intervention study from Duppen and colleagues19 reported 70% of the participants being actually 60 min or more moderately to vigorously active at baseline.…”

Section: Discussionmentioning

confidence: 99%

“…But because of the variation in the training schemes, type of supervision of training and outcome measures, it was not possible to establish a dose–response and effect size of different training approaches. Indeed the question regarding duration and intensity is crucial as the most recent and largest intervention study showed an increase in exercise capacity after 12 weeks of training only in patients with tetralogy of Fallot but not in Fontan patients 19. However, because Dua and colleagues22 have shown that regular walking already seems to improve exercise capacity and activity sustainably, and is also save, a potential harm of exercise could be ruled out.…”

Section: Discussionmentioning

confidence: 99%

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Physical activity in adults with congenital heart disease and associations with functional outcomes

Müller

Amberger

Berg

et al. 2017

Heart

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Physical activity in adults with congenital heart disease and associations with functional outcomes

Müller

Amberger

Berg

et al. 2017

Heart

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“…It is possible that aerobic training in isolation is less effective at increasing VO2max in Fontans relative to patients with biventricular circulation. While supervised weight training has demonstrated benefits in exercise capacity[8], observed aerobic training programs with demonstrable benefit in biventricular circulation have failed to show a similar benefit in Fontan patients[9]. It may be that dynamic exercise and the accrual of lean muscle mass (especially in the lower extremities) influences exercise performance in Fontan's disproportionately, or that aerobic exercise is ineffective in them.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Habitual Exercise and Performance on Cardiopulmonary Exercise Testing Differs Between Children With Single and Biventricular Circulations

et al. 2016

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Background Increasing habitual exercise has been associated with improved cardiopulmonary exercise testing (CPET) performance, specifically maximal oxygen consumption in children with operatively corrected congenital heart disease. This has not been studied in children following Fontan palliation, a population in whom CPET performance is dramatically diminished. Methods A single-center cross-sectional study with prospective and retrospective data collection was performed that assessed habitual exercise preceding a clinically indicated CPET in children and adolescents with Fontan palliation, transposition of the great arteries following arterial switch operation (TGA), and normal cardiac anatomy without prior operation. Data from contemporaneous clinical reports and imaging studies were collected. The association between percent predicted VO2max and habitual exercise duration adjusted for known covariates was tested. Results A total of 175 subjects (75 post Fontan, 20 with TGA, and 80 with normal cardiac anatomy) were enrolled. VO2max was lower in the Fontan group than patients with normal cardiac anatomy (p<0.0001) or TGA (p<0.0001). In Fontan subjects, both univariate and multivariate analysis failed to demonstrate a significant association between habitual exercise and VO2max (p=0.6), in sharp contrast to cardiac normal subjects. In multivariate analysis, increasing age was the only independent risk factor associated with decreasing VO2max in the Fontan group (p=0.003). Discussion Habitual exercise was not associated with VO2max in subjects with a Fontan as compared to biventricular circulation. Further research is necessary to understand why their habitual exercise is ineffective and/or what aspects of the Fontan circulation disrupt this association.

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“…All six included studies were randomised controlled trials (RCT), conducted in Brazil, The Netherlands, Germany, Switzerland and Germany, Ireland or Australia . Across the included studies, there were 396 participants aged (mean ± standard deviation (SD)) 15 ± 3 years to 45 ± 12 years.…”

Section: Resultsmentioning

confidence: 99%

“…Sample sizes ranged from 37 to143 participants, with 183 (46%) being female. Studies included people with asthma ( n = 2), CF ( n = 2) and congenital heart disease ( n = 2) . Further study characteristics are presented in Appendix S2.…”

Section: Resultsmentioning

confidence: 99%

Behaviour change techniques to optimise participation in physical activity or exercise in adolescents and young adults with chronic cardiorespiratory conditions: a systematic review

Sawyer

Lewthwaite

Gucciardi

et al. 2019

Internal Medicine Journal

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Participation in regular physical activity decreases the risk of developing cardiometabolic disease. However, the proportion of people who participate in the recommended amount of physical activity is low, with common barriers including competing interests and inclement weather. In people with chronic cardiorespiratory conditions, participation in physical activity is reduced further by disease‐specific barriers, time burden of treatment and unpleasant symptoms during physical activity. Addressing these barriers during adolescence and early adulthood may promote greater physical activity participation into older age. The aim of this review was to classify interventions aimed at optimising participation in physical activity as ‘promising’ or ‘not promising’ in people aged 15–45 years with chronic cardiorespiratory conditions and categorise the behaviour change techniques (BCT) within these interventions. Nine databases and registries were searched (October 2017) for studies that reported objective measures of physical activity before and after an intervention period. Interventions were classified as ‘promising’ if a between‐group difference in physical activity was demonstrated. Michie et al.’s (2013) v1 Taxonomy was used to unpack the BCT within interventions. Across the six included studies (n = 396 participants), 19 (20%) of 93 BCT were described. The interventions of three studies were classified as ‘promising’. The most commonly used BCT comprised goal setting, action planning and social support. Five BCT were solely used in ‘promising’ interventions. Our review demonstrated that only 20% of BCT have been utilised, and those BCT that were used only in ‘promising’ physical activity interventions in adolescents and adults with chronic cardiorespiratory conditions were isolated.

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Does exercise training improve cardiopulmonary fitness and daily physical activity in children and young adults with corrected tetralogy of Fallot or Fontan circulation? A randomized controlled trial

Cited by 99 publications

References 34 publications

Physical activity in adults with congenital heart disease and associations with functional outcomes

Physical activity in adults with congenital heart disease and associations with functional outcomes

Relationship Between Habitual Exercise and Performance on Cardiopulmonary Exercise Testing Differs Between Children With Single and Biventricular Circulations

Behaviour change techniques to optimise participation in physical activity or exercise in adolescents and young adults with chronic cardiorespiratory conditions: a systematic review

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