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Buchanan M, Spence C, Keir M, Khoury M. Physical Activity Promotion Among Individuals With Tetralogy of Fallot. CJC PEDIATRIC AND CONGENITAL HEART DISEASE 2023; 2:322-334. [PMID: 38161681 PMCID: PMC10755793 DOI: 10.1016/j.cjcpc.2023.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/11/2023] [Indexed: 01/03/2024]
Abstract
In the general population, the most cited barriers to physical activity (PA) are time, energy, and motivation. Consequently, despite the significant contribution of PA to health and well-being, many individuals are insufficiently active. Physical inactivity and sedentary lifestyles increase the risk of acquired cardiometabolic disease, a risk that may complicate and is compounded by the anatomic and physiologic features inherent in the patient with repaired tetralogy of Fallot (ToF). Individuals with ToF commonly present with reduced exercise capacity and PA levels. In light of historically PA restrictive management of their heart disease, known reductions in exercise capacity among individuals with ToF are combined with psychosocial barriers to their participation, potentially establishing a cycle of further detraining, inactivity, and disease progression/health decline. To this end, children and young adults with ToF are known to have reduced self-efficacy towards PA, defined as their confidence in their ability to participate. In this review, we apply self-efficacy as an overarching mediator of PA participation and explore trends and determinants of PA participation among individuals with ToF and its subsequent impact on exercise capacity, disease risk, and health-related quality of life. We outline the rationale and strategies aimed at improving PA in children and adults with ToF and highlight current knowledge gaps and future directions in the promotion of PA in the population with ToF.
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Affiliation(s)
- Mackenzie Buchanan
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Christopher Spence
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Keir
- Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michael Khoury
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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Kean KA, Fitzgerald DJ, Ayers MD, Kean AC. The Effects of Cardiac Implantable Electronic Device Personal Protective Equipment Use in Patients with Pediatric and Adult Congenital Heart Disease. Pediatr Cardiol 2023; 44:1721-1725. [PMID: 37573512 DOI: 10.1007/s00246-023-03264-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 08/03/2023] [Indexed: 08/15/2023]
Abstract
Pediatric and adult congenital heart disease (ACHD) patients encounter physical and emotional barriers. Cardiac implantable electronic devices (CIEDs), including pacemakers and implantable cardiac defibrillators (ICD) often compound these issues. Patient fear associated with damaging the CIED system can lead to avoidance of physical activity and reduced quality of life (QOL). CIED personal protective equipment (PPE) is a potential treatment for decreasing this fear. We sought to determine the effects of CIED PPE use in the pediatric and ACHD population. Patients 5 years or older with a CIED at a single pediatric and ACHD heart rhythm center received a CIED protector and customized athletic shirt. QOL was assessed using the PedsQL TM 4.0 SF15 prior to and after 6-12 months. Of the 77 patients enrolled, 26 completed repeat assessment. The mean age at enrollment was 15.6 years (range 5-36) with a mean device age of 2.2 years (< 1-10 years). Pacemakers were present in 77% and 23% had ICDs. The PPE was used in 92% with no PPE malfunction. Fear associated with physical activity was reduced, z = - 4, p < 0.001, with a large effect size (r = 0.55). There was a trend toward increased physical activity. Total QOL scores improved, z = - 2.771, P < 0.05, with a medium effect size (r = 0.4). This first study of CIED PPE in children shows that providing CIED PPE to pediatric and ACHD patients may decrease their fear of damaging their device system, increasing physical activity levels, and improving quality of life.
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Affiliation(s)
- Kelly A Kean
- School of Nursing, Purdue University College of Health and Human Science, West Lafayette, IN, USA
| | - Donna J Fitzgerald
- Division of Pediatric Cardiology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Mark D Ayers
- Division of Pediatric Cardiology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Adam C Kean
- Division of Pediatric Cardiology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
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Effects of Sports, Exercise Training, and Physical Activity in Children with Congenital Heart Disease-A Review of the Published Evidence. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020296. [PMID: 36832425 PMCID: PMC9955038 DOI: 10.3390/children10020296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/21/2023] [Accepted: 01/25/2023] [Indexed: 02/05/2023]
Abstract
Children and adolescents with congenital heart disease (CHD) should be encouraged to adopt a physically active lifestyle, ideally by participating in sports activities at school and sports clubs. Children with complex CHD or other risk factors (for example, pacemakers, cardioverter-defibrillators, channelopathies) may, however, need specific individualized training programs. This review article summarizes the current knowledge regarding the clinical effects of sports and exercise training on CHD and its pathophysiologic mechanisms. An evidence-based approach based on a literature search, using PubMed, Medline, CINHAL, Embase, and the Cochrane Library was conducted, last completed on 30 December 2021. In studies with 3256 CHD patients in total, including 10 randomized controlled trials, 14 prospective interventional trials, 9 observational trials, and 2 surveys, exercise training has been shown to improve exercise capacity and physical activity, motoric skills, muscular function, and quality of life. Sports and exercise training appears to be effective and safe in CHD patients. Despite being cost-efficient, training programs are currently scarcely reimbursed; therefore, support from healthcare institutions, commissioners of healthcare, and research-funding institutions is desirable. There is a strong need to establish specialized rehabilitation programs for complex CHD patients to enhance these patients' access to this treatment intervention. Further studies may be desirable to confirm these data to investigate the impact on risk profiles and to identify the most advantageous training methodology and underlying pathophysiological mechanisms.
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Zhang Y, Hasibagen, Zhang C. The influence of social support on the physical exercise behavior of college students: The mediating role of self-efficacy. Front Psychol 2022; 13:1037518. [PMID: 36532973 PMCID: PMC9756807 DOI: 10.3389/fpsyg.2022.1037518] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/14/2022] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVES To study the influencing factors on college students' physical exercise behavior and the mediating relationship of self-efficacy based on the theory of social support and self-efficacy; to provide theoretical support and practical guidance for college students engaging independently in physical exercise. METHODS A total of 1,440 college students from six universities in the Inner Mongolia Autonomous Region of China were selected as the research objects, and three scales (Self-Efficacy Scale, Social Support Scale, and Physical Exercise Rating Scale) were used to construct a structural equation model. RESULTS (1) A comprehensive sports facility environment is conducive to college students' physical activities and the emotional support of friends and family and the campus cultural atmosphere cannot be ignored. (2) Peer support has a direct impact on physical exercise behavior, family support and school support indirectly affect college students' physical exercise behavior, based on the intermediary role of self-efficacy. (3) According to the total effect, social support was ranked as school support (0.444), peer support (0.312), and family support (0.145). CONCLUSION Social support not only directly affects physical exercise behavior but also indirectly affects physical exercise behavior based on the mediating effect of self-efficacy.
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Affiliation(s)
- Yan Zhang
- School of Resource and Environmental Economy, Inner Mongolia University of Finance and Economics, Hohhot, China
| | - Hasibagen
- School of Resource and Environmental Economy, Inner Mongolia University of Finance and Economics, Hohhot, China
| | - Chang Zhang
- School of Business, Central South University, Changsha, China
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Brudy L, Meyer M, Oberhoffer R, Ewert P, Müller J. Move more - be happier? physical activity and health-related quality of life in children with congenital heart disease. Am Heart J 2021; 241:68-73. [PMID: 34289343 DOI: 10.1016/j.ahj.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/13/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This cross-sectional study aimed to determine whether there is an association between objectively assessed physical activity (PA) and health-related quality of life (HRQoL) in children with CHD. PATIENTS AND METHODS From September 2017 to January 2021, 343 children with CHD (12.1 ± 3.3 years, 135 girls) provided valid PA data after a 7-day objective PA assessment. PA was evaluated as average daily steps and moderate-to-vigorous physical activity (MVPA) minutes assessed via wearable bracelet Garmin vivofit Jr. These children also completed the KINDL - a 24 Likert-scaled item questionnaires assessing HRQoL in the six dimensions physical well-being, emotional well-being, self-esteem, family, friends and everyday functioning. RESULTS Daily Steps (r = 0.166, P = .003) and daily MVPA minutes (r = 0.134, P = .017,) were both correlated to total KINDL score. Furthermore, both steps and MVPA were associated with the subscales physical well-being (steps: r = 0.165 p=.003; MVPA: r = 0.129, P = .022), friends (steps: r = 0.210, P < .001, MVPA: r = 0.179, P = .001), steps, and to everyday functioning (r = 0.142, P = .012). Logistic regression showed each MVPA minute increase conferred to a 1% increase in reporting better HRQoL (OR: 1.009 [95% CI: 1.002 - 1.017], P = .019). CONCLUSIONS PA was positively associated with HRQoL in children with CHD. Patients who move more are more likely to report better HRQoL. While the magnitude of this association needs to be further understood, continuous encouragement towards more PA seems to be crucial in a holistic approach to medical aftercare in children with CHD.
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E-Health Exercise Intervention for Pediatric Patients with Congenital Heart Disease: A Randomized Controlled Trial. J Pediatr 2021; 233:163-168. [PMID: 33516681 DOI: 10.1016/j.jpeds.2021.01.058] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/21/2021] [Accepted: 01/23/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To improve health-related physical fitness (HRPF) (primary outcome) and health-related quality of life (HRQoL) with a web-based motor intervention program in pediatric patients with congenital heart disease (CHD). STUDY DESIGN Overall, 70 patients (13.0 ± 2.6 years; 34% girls) aged 10-18 years with moderate or complex CHD severity were randomly allocated 1:1 to an intervention or control group. The intervention group trained 3 times per week for 20 minutes in a web-based exercise program over a period of 24 weeks. The control group followed lifestyle per usual. At baseline and follow-up HRPF was assessed via 5 tasks of the FITNESSGRAM and converted to a HRPF z score. HRQoL was assessed with KINDL self-report questionnaire. RESULTS In total, 61 patients completed the follow-up. There was no change in total HRPF z score (intervention group: 0.14 ± 0.38 vs control group: 0.09 ± 0.38, P = .560) and total HRQoL (intervention group: -1.73 ± 8.33 vs control group: 1.31 ± 7.85, P = .160) after the 24-week web-based exercise intervention. This was true for all subcategories of HRPF and HRQoL. There were no adverse events associated with the web-based exercise intervention. CONCLUSIONS We found that 24 weeks of web-based exercise intervention with an aimed volume of 60 minutes of exercise per week was safe but did not improve HRPF and HRQoL in children with moderate or complex CHD. TRIAL REGISTRATION Clinicaltrials.gov: NCT03488797.
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van Deutekom AW, Lewandowski AJ. Physical activity modification in youth with congenital heart disease: a comprehensive narrative review. Pediatr Res 2021; 89:1650-1658. [PMID: 33049756 PMCID: PMC8249230 DOI: 10.1038/s41390-020-01194-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/25/2020] [Accepted: 09/18/2020] [Indexed: 11/08/2022]
Abstract
Congenital heart disease (CHD) affects nearly 1% of births. As survival rates have dramatically improved, the majority of individuals with CHD now live into adulthood. As these patients age, they become prone to a large range of complications, such as chronic heart failure and acquired cardiovascular disease. Promotion of a healthy and active lifestyle from childhood onwards has been suggested as a sustainable and effective strategy to enhance cardiovascular health, improve quality of life and reduce immediate and long-term risk in people with CHD. Well-established physical activity consensus statements for youth with CHD have now been published. In this article, we review how increasing physical activity in youth with CHD may offer immediate and long-term cardiovascular benefits, what is known about physical activity in children with CHD, describe the unique factors that contribute to achieving sufficient and insufficient physical activity levels and summarize the evidence of trials on physical activity promotion in youth with CHD. Furthermore, we discuss some of the challenges that need to be addressed by further research regarding the optimal strategy, timing and format of physical activity intervention programmes in children and adolescents with CHD. IMPACT: Congenital heart disease (CHD) affects nearly 1% of births, with the majority of individuals with CHD now living into adulthood due to improved survival. As CHD patients age, they become prone to a large range of cardiovascular complications. This article discusses how and why increasing physical activity in youth with CHD may offer immediate and long-term cardiovascular benefits, the barriers to achieving sufficient physical activity levels and the evidence from trials on physical activity promotion in youth with CHD. The optimal strategy, timing and format of physical activity intervention programmes in children and adolescents with CHD are discussed.
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Affiliation(s)
- Arend W van Deutekom
- Division of Pediatric Cardiology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
| | - Adam J Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
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Physical activity in children and adolescents with CHD: review from a measurement methodological perspective. Cardiol Young 2021; 31:518-531. [PMID: 33722326 DOI: 10.1017/s1047951121000627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AIM To compile a literature overview of physical activity in children with CHD and to critically evaluate the methodology used for physical activity assessment. METHODS A review of the literature was performed using PubMed to identify studies examining accelerometer and subjectively assessed physical activity in children and adolescents with CHD. RESULT A total of 15 studies were included (6 studies using subjective measures and 9 articles using accelerometers for the assessment of physical activity). The patients generally failed to meet the recommendations of physical activity. When compared to healthy controls, the results were widely divergent in the subjectively assessed measures and the accelerometer-based studies showed a tendency of no difference in physical activity. Neither subjective methods nor accelerometer-based studies reported any difference in physical activity in general, in relation to the severity of the heart disease. CONCLUSION Methodological variation and limitations in the assessment of physical activity largely explain the divergent results and the inability to establish differences in physical activity between children with CHD of different severity and compared to healthy controls. Methodological knowledge and guidelines are provided for improved assessment of physical activity using accelerometers in clinical research.
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Acosta‐Dighero R, Torres‐Castro R, Rodríguez‐Núñez I, Rosales‐Fuentes J, Vilaró J, Fregonezi G, Lopetegui B. Physical activity assessments in children with congenital heart disease: A systematic review. Acta Paediatr 2020; 109:2479-2490. [PMID: 32654285 DOI: 10.1111/apa.15478] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/19/2020] [Accepted: 07/08/2020] [Indexed: 11/29/2022]
Abstract
AIM To describe the physical activity (PA) of children with congenital heart disease (CHD) according to different assessment methods and compare their results with the World Health Organization (WHO) recommendations. METHODS A systematic review was conducted using five databases. We included cross-sectional, longitudinal, observational studies and clinical trials in a paediatric population with CHD. In publications with indirect measurement, the score in each dimension was considered. Similarly, moderate-to-vigorous PA (MVPA) was considered as the main outcome in articles with direct measurement. RESULTS A total of 1103 articles were found, and 16 primary articles were considered. Eight articles evaluated PA with indirect methods, six with direct methods and two used both methods, representing 1649 subjects evaluated. It was found that 46% of children with CHD do not exceed WHO recommendations for MVPA, with no differences depending on the severity of CHD. CONCLUSION There are a variety of ways to measure PA in children with CHD. In the articles that objectively evaluated PA, the most measured outcome was the MVPA, which shows that the MVPA time was shorter in about half of the children with CHD than what is recommended by WHO.
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Affiliation(s)
| | | | | | | | - Jordi Vilaró
- Blanquerna School of Health Sciences Global Research on Wellbeing (GRoW) Ramon Llull University Barcelona Spain
| | - Guilherme Fregonezi
- PneumoCardioVascular Lab Department of Physiotherapy & Hospital Universitário Onofre Lopes ‐ Empresa Brasileira de Serviços Hospitalares (EBSERH) Federal University of Rio Grande do Norte (UFRN) Natal Brazil
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Physical Activity Patterns in Children and Adolescents With Heart Disease. Pediatr Exerc Sci 2020; 32:233-240. [PMID: 32963120 DOI: 10.1123/pes.2020-0073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/17/2020] [Accepted: 07/26/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To quantify the differences in daily physical activity (PA) patterns, intensity-specific volumes, and PA bouts in youth with and without heart disease (HD). METHODS Seven-day PA was measured on children/adolescents with HD (n = 34; median age 12.4 y; 61.8% male; 70.6% single ventricle, 17.7% heart failure, and 11.8% pulmonary hypertension) and controls without HD (n = 22; median age 12.3 y; 59.1% male). Mean counts per minute were classified as sedentary, light, and moderate to vigorous PA (MVPA), and bouts of MVPA were calculated. PA was calculated separately for each hour of wear time from 8:00 to 22:00. Multilevel linear mixed modeling compared the outcomes, stratifying by group, time of day, and day part (presented as median percentage of valid wear time [interquartile range]). RESULTS Compared with the controls, the HD group had more light PA (33.9% [15%] vs 29.6% [9.5%]), less MVPA (1.7% [2.5%] vs 3.2% [3.3%]), and more sporadic bouts (97.4% [5.7%] vs 89.9% [9.2%]), but fewer short (2.0% [3.9%] vs 7.1% [5.7%]) and medium-to-long bouts (0.0% [1.9%] vs 1.6% [4.6%]) of MVPA. The HD group was less active in the late afternoon, between 15:00 and 17:00 (P < .03). There were no differences between groups in sedentary time. CONCLUSION Children/adolescents with HD exhibit differences in intensity-specific volumes, PA bouts, and daily PA patterns compared with controls.
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Physical Activity Promotion in Pediatric Congenital Heart Disease: Are We Running Late? Can J Cardiol 2020; 36:1406-1416. [DOI: 10.1016/j.cjca.2020.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 12/15/2022] Open
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A classroom-based physical activity intervention for adolescents: Is there an effect on self-efficacy, physical activity, and on-task behavior? HEALTH PSYCHOLOGY REPORT 2020. [DOI: 10.5114/hpr.2020.99002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kwon SJ, Choi EK, Lee KH, Im YM. Factors Influencing Physical Activity in Adolescents with Complex Congenital Heart Disease. CHILD HEALTH NURSING RESEARCH 2019; 25:262-272. [PMID: 35004419 PMCID: PMC8650962 DOI: 10.4094/chnr.2019.25.3.262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/20/2019] [Accepted: 03/23/2019] [Indexed: 11/27/2022] Open
Abstract
Purpose We aimed to identify factors influencing physical activity in adolescents with complex congenital heart disease. Methods We recruited 92 adolescents with complex congenital heart disease from a tertiary medical center in Seoul, measured their levels of physical activity, and identified factors that influenced their physical activity levels using the Global Physical Activity Questionnaire, the New York Heart Association classification, congenital heart disease complexity, the Self-Efficacy Scale, and the Parental Bonding Instrument scale. Stepwise multiple linear regression was used to determine factors influencing physical activity. Results Total physical activity was higher in males than in females (t=4.46, p<.001). Adolescents who participated in school physical education classes engaged in more physical activity than those who did not (t=6.77, p<.001). Higher self-efficacy (β=.41, p<.001), male gender (β=.37, p<.001) and participation in school physical education classes (β=.19, p=.042) were associated with a higher likelihood of engagement in physical activity. Conclusion It is necessary to develop nursing interventions that enhance self-efficacy in order to promote physical activity in adolescents with complex congenital heart disease. Physical activity should also be promoted in an individualized manner, taking into account gender, disease severity, and parental attitude.
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Affiliation(s)
- Su Jin Kwon
- Advanced Practice Nurse, Congenital Heart Disease Center, Asan Medical Center, Seoul, Korea
| | - Eun Kyoung Choi
- Assistant Professor, College of Nursing · Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - Kyung Hee Lee
- Assistant Professor, College of Nursing · Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - Yu-Mi Im
- Assistant Professor, Seoul Women's College of Nursing, Seoul, Korea
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Physical activity levels and self-efficacy of Greek children with congenital heart disease compared to their healthy peers. Hellenic J Cardiol 2019; 61:180-186. [PMID: 30639356 DOI: 10.1016/j.hjc.2019.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/21/2018] [Accepted: 01/03/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE It remains a challenge for children with congenital heart disease (CHD) to develop healthy lifestyle behaviors. This study investigates the interrelationship of physical activity and self-efficacy levels in Greek children with corrected CHD and compares them with those of healthy controls. METHODS A prospective cross-sectional study of 76 patients with operated CHD and 78 healthy volunteers (n = 154) was conducted. The Self Efficacy Scale and Previous Day Physical Activity Recall self-reporting questionnaires were used to assess self-efficacy and physical activity, respectively. Calculated metabolic equivalent of task (MET) provided an indication of participation in moderate and vigorous physical activities. RESULTS Mean physical self-efficacy in children with CHD was 29.01 ± 7.28, while that in healthy volunteers was 29.04 ± 6.60 (p = 0.076). Average physical activity levels-METs in children with CHD (2.38 ± 0.85) were significantly lower than those in controls (3.1 ± 0.95). Physical self-efficacy and physical activity were positively correlated (r = 0.515, p = 0.001), thus indicating that children with higher self-efficacy engaged in more vigorous physical activities. In children with CHD, self-efficacy was quite important in predicting physical activity, thus explaining almost ¼ of the variability in observed activities. CONCLUSION The low physical activity levels exhibited by Greek children with corrected CHD can lead to a sedentary adult lifestyle. Improving physical self-efficacy may help encourage them and consequently increase their physical activity levels. School-based education initiatives and athletic programs can play an important role in improving this.
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Motor Proficiency and Generalized Self-Efficacy Toward Physical Activity in Children With Intestinal Failure. J Pediatr Gastroenterol Nutr 2019; 68:7-12. [PMID: 30052565 DOI: 10.1097/mpg.0000000000002107] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Survival rates of children with intestinal failure have increased; however, associated co-morbidities may affect long-term motor developmental outcomes. This study evaluates motor proficiency and generalized self-efficacy toward physical activity (PA) in children ages 6 to 12 years with intestinal failure. METHODS This is an observational, cross-sectional study of children followed in a multidisciplinary intestinal rehabilitation program. Motor proficiency was assessed using the Bruininks-Oseretsky Test of Motor Proficiency-2 Short Form (BOT-2 SF) and the Scales of Independent Behavior (parent-proxy report). Children completed the Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity (CSAPPA) and a PA questionnaire. Relevant demographic and medical variables were correlated with assessment results. RESULTS Participants include 30 children (18 males), median age 7 years (interquartile range [IQR] 6-9) with gestational age 35 weeks (IQR 32-39) and birth weight 2.13 kg (IQR 1.68-2.77). Thirteen (43%) were dependent on parenteral nutrition. Fifteen (50%) scored below average on the BOT-2 SF. Lower BOT-2 SF scores were significantly associated with lower CSAPPA scores (r = 0.480, P = 0.01), with a common barrier to PA being the presence of a central line or enterostomy tube. Gestational age, height z scores, length of hospital admissions, and number of septic events were all significantly correlated with lower scores in motor proficiency. Number of septic events and total parenteral nutrition days were significant predictors of lower BOT-2 SF scores, when adjusting for birth weight. CONCLUSIONS Multiple medical variables related to intestinal failure may affect motor proficiency and PA self-efficacy. Developmental follow-up is important to optimize motor skill development and promote PA participation.
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Geographical variation and predictors of physical activity level in adults with congenital heart disease. IJC HEART & VASCULATURE 2018; 22:20-25. [PMID: 30511012 PMCID: PMC6257939 DOI: 10.1016/j.ijcha.2018.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 10/12/2018] [Accepted: 11/07/2018] [Indexed: 11/20/2022]
Abstract
Background Physical activity is important to maintain and promote health. This is of particular interest in patients with congenital heart disease (CHD) where acquired heart disease should be prevented. The World Health Organization (WHO) recommends a minimum of 2.5 h/week of physical activity exceeding 3 metabolic equivalents (METS) to achieve positive health effects. It is unknown whether physical activity levels (PAL) in adult CHD patients differ by country of origin. Methods 3896 adults with CHD recruited from 15 countries over 5 continents completed self-reported instruments, including the Health Behaviour Scale (HBS-CHD), within the APPROACH-IS project. For each patient, we calculated whether WHO recommendations were achieved or not. Associated factors were investigated using Generalized Linear Mixed Models. Results On average, 31% reached the WHO recommendations but with a great variation between geographical areas (India: 10%–Norway: 53%). Predictors for physical activity level in line with the WHO recommendations, with country of residence as random effect, were male sex (OR 1.78, 95%CI 1.52–2.08), NYHA-class I (OR 3.10, 95%CI 1.71–5.62) and less complex disease (OR 1.46, 95%CI 1.16–1.83). In contrast, older age (OR 0.97, 95%CI 0.96–0.98), lower educational level (OR 0.41, 95%CI 0.26–0.64) and being unemployed (OR 0.57, 95%CI 0.42–0.77) were negatively associated with reaching WHO recommendations. Conclusions A significant proportion of patients with CHD did not reach the WHO physical activity recommendations. There was a large variation in physical activity level by country of origin. Based on identified predictors, vulnerable patients may be identified and offered specific behavioral interventions.
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Key Words
- APPROACH-IS, assessment of patterns of patient-reported outcomes in adults with congenital heart disease — international study
- Adult congenital heart disease
- CHD, congenital heart disease
- CI, confidence interval
- HBS-CHD, health behaviour scale
- Health-behaviour scale
- METS, metabolic equivalents
- Metabolic equivalent
- NYHA, New York Heart Association (class)
- OR, odds ratio
- PAL, physical activity level
- PRO, patient-reported outcomes
- Patient-reported outcome
- Physical activity level
- Physical activity recommendation
- WHO, World Health Organization
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17
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Ko JM, White KS, Kovacs AH, Tecson KM, Apers S, Luyckx K, Thomet C, Budts W, Enomoto J, Sluman MA, Wang JK, Jackson JL, Khairy P, Cook SC, Subramanyan R, Alday L, Eriksen K, Dellborg M, Berghammer M, Johansson B, Mackie AS, Menahem S, Caruana M, Veldtman G, Soufi A, Fernandes SM, Callus E, Kutty S, Gandhi A, Moons P, Cedars AM. Physical Activity-Related Drivers of Perceived Health Status in Adults With Congenital Heart Disease. Am J Cardiol 2018; 122:1437-1442. [PMID: 30139525 DOI: 10.1016/j.amjcard.2018.06.056] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 06/19/2018] [Accepted: 06/26/2018] [Indexed: 11/24/2022]
Abstract
Data on the differential impact of physical activity on perceived health status (PHS) in a large adult congenital heart disease (ACHD) patient population are lacking. We conducted a cross-sectional assessment of 4,028 ACHD patients recruited from 24 ACHD-specialized centers in 15 countries across 5 continents to examine the association between physical activity and PHS in a large international cohort of ACHD patients. A linear analog scale of the EuroQol-5D 3 level version and the 12-item Short Form Health Survey-version 2 were used to assess self-reported health status and the Health-Behavior Scale-Congenital Heart Disease was used as a subjective measurement of physical activity type, participation, and level. Correlation analyses and Wilcoxon Rank Sum tests examined bivariate relations between sample characteristics and PHS scores. Then, multivariable models were constructed to understand the impact of physical activity on PHS. Only 30% of our sample achieved recommended physical activity levels. Physically active patients reported better PHS than sedentary patients; however, the amount of physical activity was not associated with PHS. Further statistical analyses demonstrated that specifically sport participation regardless of physical activity level was a predictor of PHS. In conclusion, the majority of ACHD patients across the world are physically inactive. Sport participation appears to be the primary physical activity-related driver of PHS. By promoting sport-related exercise ACHD specialists thus may improve PHS in ACHD patients.
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18
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Adapted Motivational Interviewing to Promote Exercise in Adolescents With Congenital Heart Disease: A Pilot Trial. Pediatr Phys Ther 2018; 30:326-334. [PMID: 30199516 DOI: 10.1097/pep.0000000000000534] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess a motivational interviewing (MI) intervention to improve moderate-to-vigorous physical activity (MVPA) in adolescents with congenital heart disease. METHODS Intervention participants received one-on-one telephone-based adapted MI sessions over 3 months. Outcomes were acceptability, change mechanisms (stage of change and self-efficacy), and limited efficacy (physical activity, fitness, and quality of life). RESULTS Thirty-six participants were randomized. Intervention participants completed 4.2 ± 1.2/6 MI sessions, with no improvements in the high self-efficacy or stage of change observed. Participants accumulated 47.24 ± 16.36 minutes of MVPA/day, and had comparable outcomes to peers without heart disease (except for functional capacity). There was no significant difference in change in any outcome by group. CONCLUSIONS The intervention was acceptable, but effectiveness could not be determined due to the nature and size of sample. CLINICAL RELEVANCE Pediatric cardiac rehabilitation remains the sole effective intervention to increase MVPA in this population.
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19
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Bay A, Lämås K, Berghammer M, Sandberg C, Johansson B. It’s like balancing on a slackline-A description of how adults with congenital heart disease describe themselves in relation to physical activity. J Clin Nurs 2018; 27:3131-3138. [DOI: 10.1111/jocn.14507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Annika Bay
- Department of Public Health and Clinical Medicine; Umeå University; Umeå Sweden
- Department of Nursing; Umeå University; Umeå Sweden
| | | | - Malin Berghammer
- Department of Health Science; University West; Trollhättan Sweden
- Department of Pediatrics; The Queen Silvia Children's Hospital; Gothenburg Sweden
| | - Camilla Sandberg
- Department of Public Health and Clinical Medicine; Umeå University; Umeå Sweden
- Department of Community Medicine and Rehabilitation, Physiotherapy; Umeå University; Umeå Sweden
| | - Bengt Johansson
- Department of Public Health and Clinical Medicine; Umeå University; Umeå Sweden
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20
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Thomet C, Moons P, Schwerzmann M, Apers S, Luyckx K, Oechslin EN, Kovacs AH. Self-efficacy as a predictor of patient-reported outcomes in adults with congenital heart disease. Eur J Cardiovasc Nurs 2018; 17:619-626. [DOI: 10.1177/1474515118771017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: Self-efficacy is a known predictor of patient-reported outcomes in individuals with acquired diseases. With an overall objective of better understanding patient-reported outcomes in adults with congenital heart disease, this study aimed to: (i) assess self-efficacy in adults with congenital heart disease, (ii) explore potential demographic and medical correlates of self-efficacy and (iii) determine whether self-efficacy explains additional variance in patient-reported outcomes above and beyond known predictors. Methods: As part of a large cross-sectional international multi-site study (APPROACH-IS), we enrolled 454 adults (median age 32 years, range: 18–81) with congenital heart disease in two tertiary care centres in Canada and Switzerland. Self-efficacy was measured using the General Self-Efficacy (GSE) scale, which produces a total score ranging from 10 to 40. Variance in the following patient-reported outcomes was assessed: perceived health status, psychological functioning, health behaviours and quality of life. Hierarchical multivariable linear regression analysis was performed. Results: Patients’ mean GSE score was 30.1 ± 3.3 (range: 10–40). Lower GSE was associated with female sex ( p = 0.025), not having a job ( p = 0.001) and poorer functional class ( p = 0.048). GSE positively predicted health status and quality of life, and negatively predicted symptoms of anxiety and depression, with an additional explained variance up to 13.6%. No associations between self-efficacy and health behaviours were found. Conclusions: GSE adds considerably to our understanding of patient-reported outcomes in adults with congenital heart disease. Given that self-efficacy is a modifiable psychosocial factor, it may be an important focus for interventions targeting congenital heart disease patients’ well-being.
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Affiliation(s)
- Corina Thomet
- Center for Congenital Heart Disease, Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
| | - Philip Moons
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Sweden
| | - Markus Schwerzmann
- Center for Congenital Heart Disease, Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Silke Apers
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
| | - Koen Luyckx
- School Psychology and Development in Context, KU Leuven – University of Leuven, Belgium
| | - Erwin N Oechslin
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network and University of Toronto, Canada
| | - Adrienne H Kovacs
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network and University of Toronto, Canada
- The Knight Cardiovascular Institute, Oregon Health & Science University, Portland, USA
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21
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The use of bicycle desks to increase physical activity in two special education classrooms. HEALTH PSYCHOLOGY REPORT 2018. [DOI: 10.5114/hpr.2018.76783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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22
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Bay A, Dellborg M, Berghammer M, Sandberg C, Engström G, Moons P, Johansson B. Patient reported outcomes are associated with physical activity level in adults with congenital heart disease. Int J Cardiol 2017; 243:174-179. [DOI: 10.1016/j.ijcard.2017.03.137] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 03/08/2017] [Accepted: 03/29/2017] [Indexed: 11/17/2022]
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23
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Banks L, Rosenthal S, Manlhiot C, Fan CPS, McKillop A, Longmuir PE, McCrindle BW. Exercise Capacity and Self-Efficacy are Associated with Moderate-to-Vigorous Intensity Physical Activity in Children with Congenital Heart Disease. Pediatr Cardiol 2017; 38:1206-1214. [PMID: 28608149 DOI: 10.1007/s00246-017-1645-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/29/2017] [Indexed: 01/02/2023]
Abstract
This study sought to determine whether exercise capacity, self-efficacy, and gross motor skills are associated with moderate-to-vigorous physical activity (MVPA) levels in children, and if these associations differ by congenital heart disease (CHD) type. Medical history was abstracted from chart review. We assessed MVPA levels (via accelerometry), percent-predicted peak oxygen consumption ([Formula: see text] cardiopulmonary exercise test), gross motor skill percentiles (test of gross motor development version-2), and self-efficacy [children's self-perceptions of adequacy and predilection for physical activity scale (CSAPPA scale)]. CHD patients (n = 137, range 4-12 years) included children with a repaired atrial septal defect (n = 31, mean ± standard deviation MVPA = 454 ± 246 min/week), transposition of the great arteries after the arterial switch operation (n = 34, MVPA = 423 ± 196 min/week), tetralogy of Fallot after primary repair (n = 37, MVPA = 389 ± 211 min/week), or single ventricle after the Fontan procedure (n = 35, MVPA = 405 ± 256 min/week). MVPA did not differ significantly between CHD groups (p = 0.68). Higher MVPA was associated with a higher percent-predicted [Formula: see text] (EST[95% CI] = 16.9[-0.2, 34] MVPA min/week per 10% increase in percent-predicted [Formula: see text] p = 0.05) and higher self-efficacy (EST[95% CI] = 5.2[1.0, 9.3] MVPA min/week per 1-unit increase in CSAPPA score, p = 0.02), after adjustment for age, sex, and testing seasonality, with no association with CHD type. Higher MVPA was not associated with gross motor skill percentile (p = 0.92). There were no significant interactions between CHD type and percent-predicted [Formula: see text] self-efficacy scores, and gross motor skill percentiles regarding their association with MVPA (p > 0.05 for all). Greater MVPA was associated with higher exercise capacity and self-efficacy, but not gross motor skills.
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Affiliation(s)
- Laura Banks
- Labatt Family Heart Centre, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Shelly Rosenthal
- Labatt Family Heart Centre, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Cedric Manlhiot
- Labatt Family Heart Centre, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Chun-Po Steve Fan
- Labatt Family Heart Centre, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Adam McKillop
- Labatt Family Heart Centre, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Patricia E Longmuir
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Brian W McCrindle
- Labatt Family Heart Centre, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. .,Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
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24
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Patterson C, So S, Schneiderman JE, Stephens D, Stephens S. Physical activity and its correlates in children and adolescents post-liver transplant. Pediatr Transplant 2016; 20:227-34. [PMID: 26893138 DOI: 10.1111/petr.12662] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/24/2015] [Indexed: 11/28/2022]
Abstract
The health benefits of PA are well established for healthy and chronically ill children. This study objectively measures physical fitness and PA levels in children PLT and explores potential correlates and perceived barriers impacting their PA. A total of 23 children (16 females, mean 14.01 ± 2.49 yrs) >1 yr PLT were assessed for peak oxygen consumption (VO2 peak), muscle strength, endurance, and flexibility. MVPA and steps/day were determined with accelerometry. Additionally, SE, perceived fatigue, and barriers and benefits of PA were examined. VO2 peak (mean 33. 2 ± 7.61 mL/kg/min; 77.0 ± 15.6% predicted) and PA (average 6841 ± 2299 steps/day) were below healthy norms. MVPA (31.6 ± 16.1 min/day) was lower than national guidelines. Six participants (30%) attained criterion standards for abdominal strength and one participant (5%) for push-ups. Fatigue and SE were lower than reported levels in healthy children. A commonly perceived barrier to PA was "I am tired." A positive correlation was shown between SE and MVPA (r = 0.57, p = 0.007), SE and fatigue (r = 0.54, p = 0.01), and PELD score and fatigue (r = 0.66, p = 0.007). Children PLT demonstrate below normal levels of PA and aerobic capacity. SE is a modifiable correlate of their PA. Further investigation of the impact of PA correlates can guide the development of future innovative PA intervention strategies in children PLT.
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Affiliation(s)
- Catherine Patterson
- Rehabilitation Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Stephanie So
- Rehabilitation Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jane E Schneiderman
- Physiology and Experimental Medicine, The Hospital for Sick Children, Toronto, ON, Canada.,Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Derek Stephens
- Clinical Research Services, The Hospital for Sick Children, Toronto, ON, Canada
| | - Samantha Stephens
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.,Institute of Health Policy and Evaluation, University of Toronto, Toronto, ON, Canada
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25
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Moola FJ, Faulkner GEJ, White L, Kirsh JA. The psychological and social impact of camp for children with chronic illnesses: a systematic review update. Child Care Health Dev 2014; 40:615-31. [PMID: 25250399 DOI: 10.1111/cch.12114] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Advances in medicine have reduced mortality among children with complex medical conditions, resulting in a growing number of young patients living with chronic illnesses. Despite an improved prognosis, these children experience significant psychosocial morbidity, such as depression and anxiety. Therapeutic summer recreation camps have been proposed as an intervention to enhance quality of life among these children. The purpose of this systematic review was to assess the psychosocial impact of camp for children with chronic illnesses. A systematic review of central databases was undertaken using key words, and a rating tool – the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies – was employed to rate methodological quality. 21 studies were included in this systematic review. Although overall methodological quality was weak, camp participation appeared to offer short-term psychosocial benefits on some parameters in children with a variety of chronic illnesses. There was some consistency in improved social outcomes, such as social interaction and acceptance. Based on the available evidence, it is premature to make robust claims regarding the psychosocial impact of camp as a therapeutic intervention. Theoretically informed camp programs, long-term follow-up, and incorporating camp-based messaging into routine hospital care,may enhance the utility of camp as a potential psychosocial intervention in paediatrics.
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Affiliation(s)
- F. J. Moola
- Faculty of Kinesiology and Recreation Management; The University of Manitoba; Winnipeg MB Canada
- The Manitoba Institute for Child Health; Winnipeg MB Canada
| | - G. E. J. Faulkner
- Faculty of Kinesiology and Physical Education; The University of Toronto; Toronto ON Canada
| | - L. White
- Faculty of Kinesiology and Physical Education; The University of Toronto; Toronto ON Canada
| | - J. A. Kirsh
- Department of Paediatrics; Hospital for Sick Children and the Faculty of Medicine, University of Toronto
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Dulfer K, Helbing WA, Duppen N, Utens EMWJ. Associations between exercise capacity, physical activity, and psychosocial functioning in children with congenital heart disease: a systematic review. Eur J Prev Cardiol 2013; 21:1200-15. [PMID: 23787793 DOI: 10.1177/2047487313494030] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Children and adolescents operated upon for congenital heart disease (ConHD) may show reduced exercise capacity and physical activity, possibly associated with lowered self-esteem and quality of life (QoL). The studies into associations between these parameters have not been reviewed before. OBJECTIVE Review of studies into associations between exercise capacity, physical activity, respectively exercise training, and psychosocial functioning of ConHD youngsters. DATA SOURCES PubMed, Embase and reference lists of related articles. STUDY SELECTION Articles published between January 2000 and December 2012 into exercise capacity and/or physical activity, and a measure of psychosocial functioning in children with ConHD. DATA EXTRACTION Two investigators independently reviewed the identified articles for eligibility, and one author extracted the data. RESULTS Although exercise capacity was strongly related to physical domains of parent-reported and self-reported QoL, it was almost never associated with psychosocial domains of QoL. Physical activity was rarely associated with physical or psychosocial domains of QoL. Remarkably, self-reported depressive symptoms were associated with both physical and psychosocial QoL. The few studies into exercise-training programmes showed promising results in QoL and emotional and behavioral problems, but they contained methodological flaws. CONCLUSIONS No clear relationships were found between exercise capacity, physical activity, and QoL in children and adolescents with ConHD. Therefore we recommend assessing QoL separately, preferably both self-reported and parent-reported. Since depressive symptoms were associated with reduced physical and psychosocial QoL, screening on these symptoms is also recommended.
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Affiliation(s)
- Karolijn Dulfer
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Willem A Helbing
- Department of Paediatrics, Division of Cardiology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Nienke Duppen
- Department of Paediatrics, Division of Cardiology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Elisabeth M W J Utens
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
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