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Current state of home-based exercise interventions in patients with congenital heart disease: a systematic review
  1. Michael Meyer1,2,
  2. Leon Brudy1,2,
  3. Luisa García-Cuenllas3,
  4. Alfred Hager2,
  5. Peter Ewert2,
  6. Renate Oberhoffer1,2,
  7. Jan Müller1,2
  1. 1 Institute for Preventive Pediatrics, Technical University of Munich, Munich, Germany
  2. 2 Department of Pediatric Cardiology, German Heart Centre Munich of the Free State of Bavaria, München, Bayern, Germany
  3. 3 Department of Pediatric Cardiology, Hospital Sant Joan de Déu, Barcelona, Catalunya, Spain
  1. Correspondence to Michael Meyer, Institute for Preventive Pediatrics, Technical University of Munich, Munich, Germany; michael.meyer{at}tum.de

Abstract

Home-based exercise training is a promising alternative to conventional supervised training for patients with congenital heart disease (CHD). Even though the beneficial effect of exercise interventions is well established in patients with CHD, knowledge concerning variety and utility of existing programmes is still lacking. Therefore, the aim of this review is to give an overview about existing home-based exercise interventions in patients with CHD. A systematic search was performed in PubMed, Cochrane, Scopus and PEDro (2008–2018) for relevant clinical trials that provided any kind of home-based exercise with patients with CHD. All articles were identified and assessed by two independent reviewers. Seven articles with 346 paediatric CHD (18 months to 16 years) and five articles with 200 adults with CHD (21–41 years) were included. Most studies performed a supervised home-based exercise intervention with children and adolescents exercising at least three times per week with duration of 45 min for 12 weeks. Reported outcome measurements were health-related quality of life and physical activity, but mostly exercise capacity measured as peak oxygen uptake that improved in four studies (1.2%, 7%, 7.7%, 15%; p<0.05), walking distance in two (3.5%, 19.5%, p<0.05,) or walking time (2 min, p=0.003) in one. The dropout rates were high (15%), and compliance to the training programme was not reported in the majority of the studies (58%). Home-based exercise interventions are safe, feasible and a useful alternative to supervised cardiac rehabilitation for all age groups of patients with CHD. Nevertheless, training compliance represents a major challenge.

  • cardiac rehabilitation
  • congenital heart disease
  • complex congenital heart disease
  • valvular heart disease
  • eHealth/telemedicine/mobile health
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Footnotes

  • Contributors JM was responsible for conception of the review and further monitored the search process and quality assessment of applicable studies. MM and LB screened and assessed the search results. MM also developed the search strategy and drafted the manuscript. LGC was the third reviewer to dissolve in case of disagreement between the first and the second reviewers and further gave important feedback in terms of rehabilitation for patients with CHD. RO, AH and PE gave important input for revising and improving the quality of the manuscript. All authors have read and approved the final version of the manuscript.

  • Funding The study was supported by an unrestricted grant from the ‘Fördergemeinschaft Deutsche kinderherzzentren e.V’.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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