Paediatric cardiac rehabilitation in congenital heart disease: a systematic review

Tikkanen, Ana Úbeda; Oyaga, Ainhoa Rodriguez; Riaño, María Olga Arroyo; Álvaro, E. Maroto; Rhodes, Jonathan

doi:10.1017/s1047951111002010

Cited by 90 publications

(67 citation statements)

References 51 publications

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“…Another systematic review in pediatric cardiac rehabilitation [32] describes that aerobic and resistance training were the core component of most studies, what is in accordance with our review. As well as in the review by Dupenn et al [14], the authors included uncontrolled trials, making difficult a recommendation more accurate about exercise training in children and adolescents after CHD surgery.…”

Section: Discussionsupporting

confidence: 90%

Impact of Exercise Training in Aerobic Capacity and Pulmonary Function in Children and Adolescents After Congenital Heart Disease Surgery: A Systematic Review with Meta-analysis

et al. 2015

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The aim of the study was to examine the effects of exercise training on aerobic capacity and pulmonary function in children and adolescents after congenital heart disease surgery. We searched MEDLINE, Cochrane Controlled Trials Register, EMBASE, (from the earliest date available to January 2015) for controlled trials that evaluated the effects of exercise training on aerobic capacity and pulmonary function (forced expiratory volume in 1 s and forced vital capacity) in children and adolescents after congenital heart disease surgery. Weighted mean differences and 95 % confidence intervals (CIs) were calculated,, and heterogeneity was assessed using the I (2) test. Eight trials (n = 292) met the study criteria. The results suggested that exercise training compared with control had a positive impact on peak VO2. Exercise training resulted in improvement in peak VO2 weighted mean difference (3.68 mL kg(-1) min(-1), 95 % CI 1.58-5.78). The improvement in forced expiratory volume in 1 s and forced vital capacity after exercise training was not significant. Exercise training may improve peak VO2 in children and adolescents after congenital heart disease surgery and should be considered for inclusion in cardiac rehabilitation. Further larger randomized controlled trials are urgently needed to investigate different types of exercise and its effects on the quality of life.

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Section: Discussionsupporting

confidence: 90%

Impact of Exercise Training in Aerobic Capacity and Pulmonary Function in Children and Adolescents After Congenital Heart Disease Surgery: A Systematic Review with Meta-analysis

et al. 2015

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“…While several studies have explored late neurodevelopmental outcomes2, 3, 4, 5 and exercise training on older patients with CHD after surgery,10, 11, 12, 13, 14, 15 little has been published on the acute impact on functional status following CHD surgery, and the associated RT use in the immediate postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery

Tikkanen

Nathan

Sleeper

et al. 2018

JAHA

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BackgroundPatients with congenital heart disease are at risk of motor, cognitive, speech, and feeding difficulties after cardiac surgery. Rehabilitation therapy could improve functional outcomes in this population if applied in the acute postcardiac surgical in‐hospital stay. However, information on the types of acute postcardiac surgery therapy needs in children is scarce. Our goal was to describe rehabilitation therapy following congenital heart surgery and pre/intraoperative factors associated with need for therapy.Methods and ResultsThis is a retrospective cohort study of patients <18 years undergoing heart surgery at our center from January 1, 2013 to January 31, 2015. Demographic, and pre‐, intra‐, and postoperative clinical and rehabilitation therapy (physical, occupational, speech, feeding therapy, and neurodevelopment intervention) data were collected. Need for rehabilitation therapy in the acute postoperative period, particularly following palliative repair, was the outcome variable in a multivariable logistic regression model to identify independent pre‐ and intraoperative factors associated with therapy. A total of 586 out of 1415 (41%) subjects received rehabilitation therapy postsurgery. Certain subgroups had increased rehabilitation therapy use such as neonates (80%). On multivariable analysis, palliative repair, prematurity, genetic syndrome, presurgical hospital stay of more than 1 day, and prolonged cardiopulmonary bypass time were independently associated with rehabilitation therapy.ConclusionsNearly half of patients who underwent post–congenital heart surgery received rehabilitation therapy. Frequency of use and types of therapy vary according to patient characteristics; however, certain pre‐ and intraoperative factors are associated with need for rehabilitation therapy, and may aid decision‐making for appropriate resource allocation.

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“…Together with the absence of easily available exercise training programmes, this can represent a significant hurdle 34. Despite level 3 treatment benefit evidence, only 10% of all adult candidates with CHD receive structured exercise training and the number is estimated to be even lower in the paediatric population 24. The recently published document from the European Association for Cardiovascular Prevention and Rehabilitation on PA and exercise prescription for adolescents and adults with CHD is a first step towards an evidenced-based approach 35…”

Section: Exercise Training In Specific Conditionsmentioning

confidence: 99%

“…Exercise training in the context of medical treatment or rehabilitation is underused at present in most healthcare systems despite widespread evidence of health benefit in children 23 24. Although preliminary knowledge of exercise limitations exists for many paediatric disease groups, the few available generic training programmes which exist address overall body systems and their use needs to be tailored to specific diseases and disease-specific targets.…”

Section: Introductionmentioning

confidence: 99%

Paediatric exercise training in prevention and treatment

Pieles

Horn

Williams

et al. 2013

Archives of Disease in Childhood

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Exercise training is an underused intervention in paediatric healthcare. This is surprising, since initial evidence demonstrates its effectiveness and safety; furthermore it confers socioeconomic benefits for healthcare systems. Pilot studies have assessed and confirmed the feasibility of exercise training in many paediatric disease settings. However, more research is needed to understand the pathophysiology, quantify treatment effects and monitor outcomes. A concerted effort from researchers, health professionals and police makers will be necessary to make exercise training an evidence-based and cost-effective intervention in paediatric care.

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Paediatric cardiac rehabilitation in congenital heart disease: a systematic review

Cited by 90 publications

References 51 publications

Impact of Exercise Training in Aerobic Capacity and Pulmonary Function in Children and Adolescents After Congenital Heart Disease Surgery: A Systematic Review with Meta-analysis

Impact of Exercise Training in Aerobic Capacity and Pulmonary Function in Children and Adolescents After Congenital Heart Disease Surgery: A Systematic Review with Meta-analysis

Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery

Paediatric exercise training in prevention and treatment

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