Endurance training may improve exercise capacity, lung function and quality of life in Fontan patients

Abstract

Univentricular heart is a complex and rare heart malformation. The incidence has been reported to be 0.39 per 1000 births. 1 The survival of children born with complex heart malformations has improved and, today, most will survive to adult age. 2,3 Children with univentricular hearts go through repeated surgical interventions, resulting in a Fontan circulation. [4][5][6][7] There is growing concern about these patients' physical performance but also about their quality of life. Deterioration of heart function, oxygen uptake, physical capacity and quality of life have all been shown to be predictive of hospital admissions and death in adult Fontan patients. 2,[8][9][10][11] Since most Fontan patients will experience a gradual deterioration of these health parameters as adults, it is important for the growing young Fontan subjects to be encouraged to develop a healthy life style including physical activities. Skeletal and respiratory muscle work may augment cardiac output in Fontan patients. In this review, we accordingly focus on physical capacity, lung function and healthrelated quality of life and the effects of training in the young Fontan patient. | ME THODThe PubMed database was searched for publications using relevant search terms on univentricular heart, single ventricle, Fontan, Fontan circulation, outcome, mortality, survival, morbidity, quality of life, physical capacity, physical performance, physical exercise, activity, training, lung function and combinations thereof. Publications on review articles and meta-analyses were focused on as well as

Physical Activity in Fontan Patients Relates to Quality of Life and Sleep Quality

“…Few other authors also reported a positive correlation between PA levels and the self-reported psychosocial functioning and general health ( 4 , 5 ). In contrast other studies did not observe any association between PA levels and parent-reported HRQoL ( 32 , 33 ). Even though data are not completely consistent, our results suggests that specific interventions targeted to increase PA levels may have some beneficial effects not only on physical aspects but also on peer and family socialization and patients cognitive development ( 8 , 9 ).…”

Exercise Capacity and Training Programs in Paediatric Fontan Patients: A Systematic Review

“…It has been suggested that exercise training may enhance submaximal, rather than maximal, exercise capacity. 65 In our review, 3 training programs reported improved submaximal exercise parameters without significant increases in peak or maximal VO 2 consumption (Table 3 and Supplemental Figure S1). However, one of these studies focused exclusively on inspiratory muscle training without aerobic training, 46 and it is possible that isolated respiratory muscle training may not improve VO 2peak as substantially as aerobic training.…”

Influences of Gymnastics on Body Composition and Cardiopulmonary Function of Athletes

“…This lowers blood pressure. 12 The athlete's heart rate increases by 150 beats after doing aerobics, in which case the strength of the respiratory muscles can be increased, and the maximum oxygen intake can be increased. Increasing the hemoglobin level in the process also increases the speed of aerobic exercise.…”