Systematic review of the effects of physical exercise training programmes in children and young adults with congenital heart disease

Duppen, Nienke; Takken, Tim; Hopman, Maria T. E.; Harkel, Arend D J Ten; Dulfer, Karolijn; Utens, Elisabeth M. W. J.; Helbing, Willem A.

doi:10.1016/j.ijcard.2013.05.086

Cited by 179 publications

(120 citation statements)

References 41 publications

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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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Section: Discussionmentioning

confidence: 99%

Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery

Tikkanen

Nathan

Sleeper

et al. 2018

JAHA

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“…16 A recent review has shown a significant lack of knowledge of alterations of ventricular performance after an exercise training program in patients with ConHD. 8 A total of 29 exercise training studies have been performed in these patients. A total of 621 patients participated in these exercise training studies, which were mostly 12 weeks in duration and consisted of dynamic training 3 times per week.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, only 2 studies reported on the global cardiac status before and after the exercise training program. 8 One included 6 adult Fontan patients in 8 An echocardiographic study was performed before and after the training period. The LV dimensions did not significantly change.…”

Section: Discussionmentioning

confidence: 99%

“…8 Although these studies have shown that patients with ConHD can improve their physical exercise capacity, the effect of exercise training on ventricular performance has hardly been studied. 8 In contrast, the ventricular response to acute stress (physical or pharmacological) has been studied extensively in patients with ToF demonstrating highly abnormal changes for parameters of global ventricular function. 9 Furthermore, right ventricular regional functional abnormalities have been shown to occur during acute exercise in these patients.…”

Section: See Clinical Perspectivementioning

confidence: 99%

“…8 We were only able to study 1 type of exercise training. We therefore did not investigate the effect of strength training or high intensity training, both of which have been advocated as alternatives for dynamic aerobic training in acquired heart disease.…”

Section: Limitationsmentioning

confidence: 99%

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Regional Ventricular Performance and Exercise Training in Children and Young Adults After Repair of Tetralogy of Fallot

Duppen

Geerdink

Kuipers

et al. 2015

Circ: Cardiovascular Imaging

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Background-Public-health guidelines recommend patients with congenital heart disease to exercise. Studies have shown that patients with congenital heart disease can improve physical exercise capacity. The effect of training on regional ventricular performance has hardly been studied. We performed a pilot study to assess whether an exercise training program would result in adverse changes of regional ventricular performance in patients with corrected tetralogy of Fallot. Methods and Results-Multicenter prospective randomized controlled pilot study in patients with tetralogy of Fallot aged 10 to 25 years. A 12-week standardized aerobic dynamic exercise training program (3 one-hour sessions per week) was used. Pre-and post-training cardiopulmonary exercise tests, MRI, and echocardiography, including tissue-Doppler imaging, were performed. Patients were randomized to the exercise group (n=28) or control group (n=20). One patient in the exercise group dropped out. Change in tissue-Doppler imaging parameters was similar in the exercise group and control group (change in right ventricle free wall peak velocity E′ exercise group, 0.8±2.6 cm/s; control group, 0.9±4.1; peak velocity A′ exercise group, 0.4±2.4 m/s; control group 4.6±18.1 cm/s). Conclusions-This randomized controlled pilot study provides preliminary data suggesting that regional ventricular performance is well maintained during 3-month aerobic dynamic exercise training in children and young adults with repaired tetralogy of Fallot. This information might help patients adhere to current public-health guidelines. Clinical Trial Registration-URL: http//:www.trialregister.nl. Unique identifier: NTR2731.

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Interventions to increase physical activity for people with congenital heart disease

Klausen

Buys

Andersen

et al. 2014

Cochrane Database of Systematic Reviews

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Systematic review of the effects of physical exercise training programmes in children and young adults with congenital heart disease

Cited by 179 publications

References 41 publications

Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery

Predictors of Postoperative Rehabilitation Therapy Following Congenital Heart Surgery

Regional Ventricular Performance and Exercise Training in Children and Young Adults After Repair of Tetralogy of Fallot

Interventions to increase physical activity for people with congenital heart disease

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