Healthy Hearts via Live Videoconferencing: An Exercise and Diet Intervention in Pediatric Heart Transplant Recipients

Abstract

Background Pediatric heart transplant recipients have high‐risk cardiovascular profiles that can affect their long‐term outcomes; however, promoting exercise and healthy diet has not been a major focus in the field. The objective of this study was to test the feasibility and impact of a supervised exercise and diet intervention delivered via live videoconferencing in this population. Methods and Results Patients 8 to 19 years of age at least 1 year post heart transplantation were enrolled. The 12‐ to 16‐week intervention phase included live video–supervised exercise (×3/week) and nutrition (×1/week) sessions. The 12‐ to 16‐week maintenance phase included ×1/week live video–supervised exercise and nutrition sessions and ×2/week self‐directed exercise sessions. Cardiac, vascular, nutritional, and functional health indices were obtained at baseline, after intervention, and after maintenance. Fourteen patients (median age, 15.2; interquartile range, 14.3–16.7 years) at a median of 3.3 (interquartile range, 1.5–9.7) years after heart transplant completed the intervention. Patients attended 89.6±11% of exercise and 88.4±10% of nutrition sessions during the intervention and 93.4±11% of exercise and 92.3±11% of nutrition sessions during maintenance. After intervention, body mass index percentile (median, −27%; P =0.02), endothelial function (median, +0.29; P =0.04), maximum oxygen consumption (median, +2 mL/kg per minute; P =0.002). Functional Movement Screening total score (median, +2.5; P =0.002) and daily consumption of saturated fat (median, −6 g; P =0.02) improved significantly. After maintenance, improvements in maximum oxygen consumption (median, +3.2 mL/kg per minute; P =0.02) and Functional Movement Screening total score (median, +5; P =0.002) were sustained. Conclusions In pediatric heart transplant recipients, a live video–supervised exercise and diet intervention is feasible. Our results demonstrate excellent adherence with significant improvements in cardiovascular and functional health. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 02519946.

Effectiveness of exercise via telehealth for chronic disease: a systematic review and meta-analysis of exercise interventions delivered via videoconferencing

“…Overall, most trials (n=12, 38%) recruited participants with a pulmonary condition 27–38. Other chronic disease domains included cardiac diseases (n=5, 16%),39–43 metabolic disorders (n=3, 9%),44–46 neurological disorders (n=7, 22%),47–53 cancer (n=3, 9%)54–56 and musculoskeletal conditions (n=1, 3%) 57. One trial recruited participants from multiple disease groups 58.…”

“…Details of the videoconferencing exercise interventions are summarised in table 2. Six trials delivered resistance training45 47–49 52 56; 3 used aerobic training29 30 51; and 23 had a combination of both resistance and aerobic training 27 28 31–44 46 50 53–55 57 58. Eighteen trials used online software with monitoring29 34–37 39–41 46 47 50 51 53–58; 7 had installable systems paired with online monitoring30–32 38 43 44 52 and seven used unspecified systems to facilitate videoconferencing sessions 27 28 33 42 45 48 49.…”

The Impact of Transitioning From In-Person to Virtual Heart Transplantation Selection Committee Meetings: Observational Study

“…This study was unique in focusing on a digital experience among heart transplant professionals, while prior work in the area of telemedicine and heart transplantation focused on patient-facing interventions [ 7 , 8 ]. A prior qualitative study on liver transplant selection committee members found that the main barriers to decision-making included a lack of written policies, difficulty maintaining the balance between advocating for a patient and promoting organ stewardship, inconsistent attendance, and lack of efficiency [ 2 ].…”

Use of active video games with or without videoconferencing on health outcomes in adolescent and young adult cancer survivors: a systematic review

“…Additionally, videoconferencing (Zoom Inc., San Jose, CA) was used by a health educator to lead adolescents with intellectual and developmental disabilities in conventional aerobic exercises [57]. Videoconferencing has also been used to deliver PA interventions for pediatric heart transplant patients [58], older breast and prostate cancer survivor couple dyads [59], and middle-aged adults with obesity [60]. This gap points to the need to explore the use of videoconferencing to deliver PA interventions remotely to address access barriers and maximize intervention participation by AYA cancer survivors.…”