TDNet Discover

Background: Congenital heart defects (CHD) impact 0.8-1.2% of deliveries worldwide, with over 40,000 children requiring surgery per year. Historically, clinicians recommended against physical activity in children with CHD due to the risk of sudden cardiac death. Extensive research in the adult population demonstrates the benefits of exercise in reduction of chronic conditions such as heart failure and cardiovascular disease. The American Heart Association recommends activities and weight-lifting for adults but does not specify guidelines in the pediatric population. Exercise in children is determined on a case-by-case basis per clinician and is done so with limited guidelines and references available. Purpose: The research sought to examine the implications of post-operative exercise programs on children with CHD to determine if national guidelines should be established to standardize an approach to care similar to the structured approach seen in other countries or recommendations similar to those provided by the American Heart Association for adults with CHD. Methods: Three independent researchers implemented search and review procedures to locate studies of the highest evidence across 3 databases with specified search terms and phrases. All selections were recorded in a search log, and utilized a criteria checklist. After duplicate quality assessment and deemed “good” quality, data extractions were completed and final studies were selected. An independent panel approved the 3 final studies before beginning data analysis. Results: Gomes-Neto et al found that post-surgical exercise training improves peak VO2 in children with CHD. Van Genuchten et al found that children with CHD have a lower baseline exercise capacity in relation to healthy children, and exercise capacity varies across CHD lesions. Callaghan et al concluded that individualized training programs have been found to increase exercise stress tests output and duration. v Conclusion: There are several studies showcasing the benefit of postoperative exercise programs for children with CHD. These studies are consistent with current research supporting exercise programs in adults. The population of pediatrics with CHD is predisposed to an increased risk of chronic conditions such as heart failure and cardiovascular disease, and it is crucial to implement guidelines to mitigate long-term complications and early mortality