Structured intervention increases peak exercise capacity

While physical activity levels in most young children with congenital heart disease (CHD) are well preserved, a structured intervention programme can raise peak exercise capacity and improve attitude towards positive lifestyle changes, as shown in a study.

The study randomly assigned 163 paediatric CHD patients (mean age 8.4 years, 61.3 percent boys) to the intervention group or the control group. The intervention involved a 1-day education session and an individual written exercise plan to be performed over a 4-month period. The control group continued with their usual level of care.

All participants completed a biophysical assessment, including a formal exercise stress test and daily activity monitoring using an accelerometer, at baseline and after 4 months.

At baseline, the majority of the children were active with good exercise tolerance. As indicated by the schoolteachers, most of the children participated in physical activities at the same level as their classmates, if not better. Only 1.5 percent opted out of physical education at all.

In the subgroup of cyanotic palliated children, exercise duration was shorter (p=0.001) and power output at peak exercise was lower (p=0.002) than in the acyanotic and cyanotic corrected subgroups.

The intervention led to a substantial improvement in peak exercise capacity, with exercise duration increasing by 43 seconds or 11 percent from baseline. There was also a trend toward increased daily activity levels.

The improvements in exercise tolerance and daily activities in young children with CHD may have important clinical implications for long-term physical and psychosocial outcomes in these patients.