The effect of exercise training on exercise capacity, physical activity, and health-related quality of life in children after repair of congenital heart defect
Date Issued
2008
Date
2008
Author(s)
Tsai, Yun-Ping
Abstract
Background and Purpose: Many studies have shown that children with congenital heart disease (CHD) had lower values in exercise capacity, physical activity (PA), and health-related quality of life (HRQoL) even years after the correction of their defects than their healthy counterparts. The purpose of this study was to investigate the effects of exercise training on exercise capacity, PA, HRQoL, and the psychosocial factors affecting PA in sedentary CHD children and healthy sedentary children. The degree of improvement after exercise training were compared between CHD children and healthy sedentary children. Method: Thirty-three children with CHD who ever accepted correction and had sedentary life style were recruited from the pediatric outpatient departments. Additional 27 healthy children with matched age and puberty stage were recruited for comparisons. They were assigned to exercise or control group by stratified randomization according to their gender and puberty stage. Both exercise groups took 12-week exercise training, twice in hospital and once at home, using a video game so-called Dance Dance Revolution (DDR), while the control group kept their daily routines. Each subject took a maximal treadmill exercise test, 7-day PA measurement by pedometer, and questionnaires for HRQoL and psychosocial influences on children’s PA before and after 12 weeks. Independent t test and Chi-square test were used to compare the baseline data between CHD group and healthy group. Two by two repeated measure ANOVA was utilized to compare the difference of all variables between groups and within groups (pre-and post-test). A 2 x 2 ANCOVA was used if significant baseline differences were found, the baseline value was used as the covariate. Independent t test was used to compare the percentage change in exercise capacity, daily inactivity time and daily steps took between the CHD and healthy exercise groups. The percentage change of VO2max, daily inactivity time and daily steps walked were analyzed by using Pearson’s correlation coefficients. Results: The VCO2, VE, VT, O2 pulse, physical complaints, and cognitive function were significant different between CHD and healthy groups. After DDR exercise training, the children with CHD were significantly improved in VO2max, HRmax, VCO2, 3-min HR recovery, daily steps taken in the weekend. The within group difference was only observed in O2 pulse, VE, daily steps in weekdays and average daily steps taken. The sedentary healthy children improved in VO2max, VCO2, and O2 pulse after training, the within group difference was observed in VE, 1-min HR recovery, and inactivity time in the weekend. In addition, CHD children in exercise group had greater improvement in the percentage change of daily steps in the weekend than the healthy children of exercise group. The correlation analysis results demonstrated significant correlation between in the percentage change of VO2max and inactivity time in weekdays only for healthy children. Conclusion: Exercise training using DDR proved to improve the exercise capacity of sedentary children with CHD after the corrective procedures and healthy children and to enhance their habitual PA and decrease their daily inactivity time.
Subjects
Congenital heart disease
Children
Exercise capacity
Physical activity
Quality of life
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