Program

Jun 04, 2014

OVERVIEW

The aim of the congenital heart disease (conHD) exercise program is to improve health related quality of life and psychosocial functioning in children, adolescents, and young adults with the cardiac conditions tetralogy of Fallot or Fontan circulation.  The program had statistically significant positive impacts on self-reported cognitive functioning and parent-reported social functioning for children ages 10-15 years.  The program also significantly decreased the time spent in passive leisure time activity. Compared with patients in the exercise group, patients in the control group had statistically significant improvements on measures of withdrawal/depression, somatic complaints, and internalizing.

DESCRIPTION OF PROGRAM

Target population:  children, adolescents, andyouth, ages 10-25 with congenital heart disease (tetralogy of Fallot or Fontan circulation) and who have had corrective or palliative cardiac surgery

The aim of the program is to improve health related quality of life and psychosocial functioning in children, adolescents, and young adults (ages 10-25) with the cardiac conditions tetralogy of Fallot or Fontan circulation.  The program has a particular focus on psychosocial functioning, specifically the subjective, emotional evaluation of congenital heart disease problems and limitations. The program is also intended to improve sports enjoyment and active leisure time.

The exercise program was delivered in 3 hour-long group training sessions per week for twelve weeks.  The exercise program consisted of 10 minutes of warm up, 40 minutes of aerobic dynamic cardiovascular training using heart rate monitors, and 10 minutes of cool down.  The training sessions were supervised by trained and licensed physiotherapists.  Patients in the control group were told to continue their normal daily lives.

EVALUATION OF PROGRAM

 Evaluated Population:

Out of 362 qualifying patients, the study sample consisted of 93 patients.  Seventy percent of the participants were male. Patients with contra-indications for exercise, mental retardation, ventricular outflow obstruction, or MRI were excluded. Fifty-six patients were randomly assigned to the exercise group and 37 to the control group. The program training sessions took place at five pediatric cardiology centers in Amsterdam, Leiden, Nijmegen, and Utrecht.

Approach:

 Patients were assigned to the exercise and control groups in a 2:1 ratio with stratification to ensure representation across age, gender, and cardiac diagnosis. Data were collected from patients and their parents at baseline and at the end of the 12 week exercise period.  The psychological assessment consisted of a web-based questionnaire for the parent and child, and semi-structured telephone interviews.  At baseline, there were no differences between the groups in demographic characteristics, emotional and behavioral problems, cardio-respiratory fitness, or participation in sports activities.  A majority of the participants in both groups did, however, score the highest possible score on the baseline health related quality of life assessment.

Results:

At post-test the program had statistically significant positive impacts on self-reported cognitive functioning and parent-reported social functioning for children and adolescents ages 10-15 years only.  The program also had a statistically significant positive impact on the time spent in passive leisure time activity. Compared with patients in the exercise group, patients in the control group had statistically significant improvements on measures of withdrawal/depression (ES=0.26), somatic complaints (ES=0.28), and internalizing (ES = 0.26).

SOURCES FOR MORE INFORMATION

References

Dulfer, K. (2014). An exercise program in youngsters with complex congenital heart disease: does it improve health related quality of life and psychosocial functioning? Ph.D. dissertation, Erasmus University, Rotterdam, The Netherlands.

KEYWORDS: Children (3-11), Adolescents (12-17), Youth (16+), Young Adults (18-24), Males and Females (Co-ed), Clinic/Provider-based, Depression/Mood Disorders, Health Status/Conditions

 

Program information last updated on 6/4/2014.

 

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