Sports practice predicts better functional capacity in children and adults with Fontan circulation

Rato, João; Cordeiro, Susana Arruda; Mendes, Miguel; Anjos, Rui

doi:10.1016/j.ijcard.2019.11.116

Cited by 10 publications

(10 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fontan surgery aims at producing hemodynamic conditions that provide the child with competence for natural daily life activities at the expense of limited reserves of cardiac output. However, when the Fontan circulation works well, it allows in active young subjects a better maximal oxygen uptake [17], and in some offers almost equal performance compared to their healthy peers [18]. Consistently, our data on exercise intervention are encouraging and suggest that the patients were able to gain an improved capacity for the daily grind.…”

Section: Discussionsupporting

confidence: 81%

Exercise Prescription Enhances Maximal Oxygen Uptake and Anaerobic Threshold in Young Single Ventricle Patients with Fontan Circulation

et al. 2022

View full text Add to dashboard Cite

A modified Fontan procedure is performed to palliate single ventricle malformations. This hemodynamic arrangement sets systemic venous pressure unphysiologically high which predisposes the patient to severe long-term complications. As a means of self-care, exercise may ease transpulmonary flow. We investigated the effects of 6-month exercise prescription on pediatric Fontan patients. Eighteen stable Fontan patients (14 ± 2.6 years, 160.4 ± 11.3 cm, and 51.4 ± 14.4 kg) were recruited. Baseline fitness was assessed by physical activity questionnaire, body composition, cardiorespiratory performance, and muscle fitness tests. Exercise prescription was individually tailored for a 6-month training period at home. At entrance to the study, Fontan patients had lower than normal maximal oxygen uptake (VO2max) of 28. ± 5.9 ml/kg/min (61 ± 11% of normal). VO2max significantly correlated with weekly amount of habitual exercise and muscle mass of the lower limbs (p < 0.001 for both). After 6 months of training, the patients had improved their anaerobic threshold of 18 ± 3.5 vs 20 ± 4.8 ml/kg/min, p = 0.007, and workload tolerance of 119 ± 39 vs 132.4 ± 44 W, p = 0.001. At EUROFIT tests, the patient muscle fitness was below age-matched reference, but correlations existed between VO2max and lower limb muscle tests. Our patients with Fontan hemodynamics were able to positively respond to an exercise program by enhancing submaximal performance which should be beneficial for getting through daily activities. Future studies should correlate whether hemodynamic findings at Fontan completion influence physical activity and exercise reserves, and whether these predict predisposition to chronic complications.

show abstract

Section: Discussionsupporting

confidence: 81%

Exercise Prescription Enhances Maximal Oxygen Uptake and Anaerobic Threshold in Young Single Ventricle Patients with Fontan Circulation

et al. 2022

View full text Add to dashboard Cite

show abstract

“…A common characteristic of a person with a Fontan circulation who has “normal” aerobic exercise capacity is regular participation in moderate-to-vigorous intensity physical activity from a young age ( 54 , 121 , 122 ). Some possible mechanisms for this observation may include superior development of the pulmonary vasculature (e.g., increased pulmonary artery size), increased lower limb lean mass, higher lung volumes due to stronger respiratory muscles, and adaptive remodeling of the single ventricle due to better preload ( 97 , 98 , 106 ).…”

Section: Addressing the Unanswered Questions: Rationale For The Fontan Fitness Intervention Trial—therapies And Future Directionmentioning

confidence: 99%

Exercise Intolerance, Benefits, and Prescription for People Living With a Fontan Circulation: The Fontan Fitness Intervention Trial (F-FIT)—Rationale and Design

et al. 2022

View full text Add to dashboard Cite

Background: Despite developments in surgical techniques and medical care, people with a Fontan circulation still experience long-term complications; non-invasive therapies to optimize the circulation have not been established. Exercise intolerance affects the majority of the population and is associated with worse prognosis. Historically, people living with a Fontan circulation were advised to avoid physical activity, but a small number of heterogenous, predominantly uncontrolled studies have shown that exercise training is safe—and for unique reasons, may even be of heightened importance in the setting of Fontan physiology. The mechanisms underlying improvements in aerobic exercise capacity and the effects of exercise training on circulatory and end-organ function remain incompletely understood. Furthermore, the optimal methods of exercise prescription are poorly characterized. This highlights the need for large, well-designed, multi-center, randomized, controlled trials.Aims and Methods: The Fontan Fitness Intervention Trial (F-FIT)—a phase III clinical trial—aims to optimize exercise prescription and delivery in people with a Fontan circulation. In this multi-center, randomized, controlled study, eligible Fontan participants will be randomized to either a 4-month supervised aerobic and resistance exercise training program of moderate-to-vigorous intensity followed by an 8-month maintenance phase; or usual care (control group). Adolescent and adult (≥16 years) Fontan participants will be randomized to either traditional face-to-face exercise training, telehealth exercise training, or usual care in a three-arm trial with an allocation of 2:2:1 (traditional:telehealth:control). Children (<16 years) will be randomized to either a physical activity and exercise program of moderate-to-vigorous intensity or usual care in a two-arm trial with a 1:1 allocation. The primary outcome is a change in aerobic exercise capacity (peak oxygen uptake) at 4-months. Secondary outcomes include safety, and changes in cardiopulmonary exercise testing measures, peripheral venous pressure, respiratory muscle and lung function, body composition, liver stiffness, neuropsychological and neurocognitive function, physical activity levels, dietary and nutritional status, vascular function, neurohormonal activation, metabolites, cardiac function, quality of life, musculoskeletal fitness, and health care utilization. Outcome measures will be assessed at baseline, 4-months, and 12-months. This manuscript will describe the pathophysiology of exercise intolerance in the Fontan circulation and the rationale and protocol for the F-FIT.

show abstract

“…Cold, fever, cough, vomiting, and diarrhea are infants' most common health issues, which are needed to predict. The infant health prediction process improves the health condition of infants by increasing the accuracy rate in the prediction process [ 8 ]. The gestational age (GA) prediction process is an important health prediction method for the infant that predicts accurate details about the health condition.…”

Section: Introductionmentioning

confidence: 99%

Health Information Prediction System of Infant Sports Based on Deep Learning Network

Zhang

2022

BioMed Research International

View full text Add to dashboard Cite

The sensed data from infant sports and training programs are useful in analyzing their health conditions and forecasting any disorders or abnormalities. The sensed information is processed for providing errorless predictions for infant diseases/disorders, coupled with artificial intelligence and sophisticated healthcare technologies. The problem of noncongruent sensed data impacting the forecast occurs due to errors between consecutive training iterations. This problem is addressed using the deep learning (PEST-DL) proposed perceptible error segregation technique. The training process is halted between two consecutive iterations generating errors until a similarity verification based on infant history is performed. The similarity output determines the errors due to mismatching data observations, and therefore, the data augmentation is performed. The first perceptible error is mitigated by training the learning paradigm with all possible infant history data in the learning process. This prevents prediction lag and data omissions due to discrete availability. The learning is trained from the identified error with the precise detected disorder/abnormality data previously detected. Therefore, the first and consecutive training data segregate error instances from the actual training iterations. This improves the prediction accuracy and precision with controlled error and time complexity.

show abstract

Sports practice predicts better functional capacity in children and adults with Fontan circulation

Cited by 10 publications

References 39 publications

Exercise Prescription Enhances Maximal Oxygen Uptake and Anaerobic Threshold in Young Single Ventricle Patients with Fontan Circulation

Exercise Prescription Enhances Maximal Oxygen Uptake and Anaerobic Threshold in Young Single Ventricle Patients with Fontan Circulation

Exercise Intolerance, Benefits, and Prescription for People Living With a Fontan Circulation: The Fontan Fitness Intervention Trial (F-FIT)—Rationale and Design

Health Information Prediction System of Infant Sports Based on Deep Learning Network

Contact Info

Product

Resources

About