Prevalence and Correlates of Sleep-Disordered Breathing in Congenital Heart Disease

Abstract

METHODS:We recruited children 10-18 years of age with CHD. Baseline testing included cardiopulmonary exercise testing and measurement of activity using an accelerometer (GT3X+ Acti-Graph LLC; 15s epoch). Physical activity was assessed using the FITT (frequency, intensity, time and type) principle. Participants were randomised; those in the intervention group were given an exercise prescription and activity tracker (MOVband, Cleveland, OH) for 16 weeks. The control group did not receive exercise prescription or activity trackers. Exercise physiologists monitored the intervention group's physical activity online and provided support on a bi-weekly basis. MVPA was assessed with an accelerometer after 16 weeks. We included those who met usual wear time criteria (!2 days with !600 minutes wear time/day, allowing non-wear of 60 minutes of zeros, 2 minutes spike allowance <100 counts per minute (cpm)). Vertical acceleration counts were categorised into sedentary (<100cpm) and MVPA (! 2296cpm) reported as mean daily minutes of MVPA and % sedentary time (sedentary minutes relative to wear time). RESULTS: Eight children (age 13-16 years) participated in the study with 4 randomly allocated to the intervention group. Two were excluded due to wear time <2 days with the accelerometers; both in the control group. Three of four children in the intervention group increased MVPA (2.5 to 24.8 minutes) and decreased %sedentary time (2.3% to 6.1%), while the two control children decreased MVPA (6.9 and 9.6 minutes) and sedentary behaviour was unchanged (0%) or increased (4.0%). CONCLUSION: The use of exercise prescription with an activity tracker is feasible and associated with increases in MVPA and decreases in sedentary time in children with CHD. This new technology provides unique opportunities to promote and remotely monitor activity levels in this population. There is good compliance and tolerability of this device in children with CHD. A larger scale randomised trial is warranted to confirm the results of this pilot study and determine the impact of changes in activity levels on exercise capacity in children with CHD.