Cardiac Rehabilitation and Cardiopulmonary Fitness in Children and Young Adults With Congenital Heart Diseases: A Critically Appraised Topic

Abstract

Public health guidelines and a myriad of studies have proven that exercise is beneficial in the alleviation of various cardio-metabolic diseases. Congenital heart disease (ConHD) is one of the most frequently occurring congenital structural malfunctions in the pediatric population, affecting nine of every 1,000 live births. Only a few studies have established the impact of a structured exercise program on cardiopulmonary fitness in diverse groups of patients with ConHD. It is also alarming to know that a substantial number of these patients and their caregivers often remain very wary of exercise. Anxiety about exercise may increase the risk of developing morbid obesity and other long-term health complications of ConHD. The present review of a critically appraised topic is undertaken to answer the question, “Does structured exercise intervention (cardiac rehabilitation) improve cardiorespiratory fitness in children and young adults with ConHD?” Exercise science and the medical literature were searched for studies that engaged the use of aerobic exercise in patients with different ConHD diagnoses. The search yielded four studies after screening with the inclusion and exclusion criteria, which were further narrowed to three studies after a full-text review. These studies yielded results showing significant increments in peak exercise workload, duration, power output, peak oxygen uptake, or improved tissue oxygenation and muscle strength after an exercise training intervention. It is noteworthy that a group identified as “cyanotic palliated” exhibited the most significant impairment both at baseline and after the exercise intervention. This review provides level 1b medical evidence that a structured exercise program may improve cardiopulmonary fitness in patients with ConHD, which is likely to be beneficial to their overall physical, motor, and psychosocial development. The results of this review may be useful for alleviating the anxiety of patients and their caregivers about participation in structured exercise programs. This review should also motivate future research investigations to develop clinical guidelines for the management of patients with ConHD by adding exercise prescriptions to their daily therapeutic regimens.

Impact of Nocturnal Push-Up on Morning Values of Peripheral Oxygen Saturation and Cardiovascular Indices in Young Males

“…Not only does exercise play important role in maintenance of health wellness, it prevents disease development and progression (Awosika et al, 2022;Uzochukwu et al, 2023). Many studies that reported the roles of exercise in healthy and diseased subjects were conducted in the daytime.…”

“…Blood pressure was measured from the arm, an inch above the elbow using Omron BP7000 Evolve Wireless Upper Arm Sphygmomanometer (Iris Global Care, China). Baseline readings were taken at sitting position as previously reported (Okeke et al, 2023;Adeniyi et al, 2021). Blood pressure measurements were also obtained for each of the legs at the first perception of exertion.…”

“…Physiological processes and mechanisms fluctuate in distinct rhythmical patterns (Awosika et al, 2023;Adeniyi and Agoreyo, 2017). While some require more than 24 hours, others are achieved either in less than 24 hours or at an approximation of 24 hours (Adeniyi et al, 2021;Adeniyi et al, 2020;.…”

“…Morning rise in blood pressure is a predictor of cardiovascular diseases (Hering et al, 2011;Oni and Adeniyi, 2017;. Insufficient blood oxygenation and impaired blood flow are reflected by low peripheral oxygen saturation Awosika et al, 2022).…”

Aldosterone Synthase Inhibitors and Dietary Interventions: A Combined Novel Approach for Prevention and Treatment of Cardiovascular Disease

“…In contrast, the Western diet, which is rich in saturated fats, sucrose, and fructose, together with excessive alcohol consumption, appears to aggravate salt-sensitive fluctuations in BP [37,63]. Identifying the potential mechanisms of salt sensitivity in vulnerable populations and connecting them to protective or beneficial dietary, lifestyle factors, and cardiac rehabilitation exercises can lead to more precise strategies for the prevention of HTN and related complications such as CVD [62,64]. According to current guidelines from the American Heart Association and the American College of Cardiology Foundation, lifestyle modifications are considered a class 1b recommendation for individuals at high to moderate risk for developing CVD [65].…”