Current state of home-based exercise interventions in patients with congenital heart disease: a systematic review

Abstract

<jats:p>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&lt;0.05), walking distance in two (3.5%, 19.5%, p&lt;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.</jats:p>

Cardiopulmonary Rehabilitation Improves Respiratory Muscle Function and Functional Capacity in Children with Congenital Heart Disease. A Prospective Cohort Study

“…In addition to supervised training sessions, children were encouraged to stay active throughout the week, participating in physical education at school and non-competitive games. Regarding respiratory training, as the protocol had to be trained three times a week, two of them were performed during the sessions, while the other one was carried out at home [30]. Patients received a guide and registered session completion and incidents.…”

The impact of the COVID-19 pandemic on application of European Society of Cardiology (ESC) guidelines for exercise in adults with CHD: a data-based questionnaire

“…Healthcare professionals should raise awareness of these online classes to their patients, in order to help them meet and maintain recommended levels of activity despite closure of fitness centers. A systematic review investigating home based exercise programmes for patients with ACHD found these to be a safe and feasible alternative to cardiac rehabilitation, which reaffirms the efficacy of this proposed intervention (10,18) .…”

Exercise training in paediatric congenital heart disease: fit for purpose?

“…The small sample sizes in some studies were probably due to restrictive inclusion criteria, such as only limited to specific CHD cohorts and surgical procedures 30 36 37 39 44 ; furthermore, only four studies included comparisons with a healthy control 35 38 43 Exercise prescription is only as effective as participants' adherence, which was poorly described in most studies. 67 Therefore, acquiring patient and public involvement prior to any intervention could be beneficial in accommodating patients' and parents' expectations and abilities and increase the chances of higher adherence. 67…”