February 17, 2007Open Access
Physical activity levels in children and adolescents are reduced after the Fontan procedure, independent of exercise capacity, and are associated with lower perceived general health
Key Result
Children and adolescents after the Fontan procedure had markedly reduced physical activity levels, with only 38% meeting current recommendations, which was associated with lower perceived general health.
Study Design
Type
Cross-Sectional (n=147)
Multicenter
Yes
Structured PICO
Are physical activity levels reduced in children and adolescents after the Fontan procedure, and are they associated with functional status and exercise capacity?
P
Population
147 children and adolescents (median age 11.6 years, 38% female) assessed at a median of 8.1 years after the Fontan procedure.
O
Outcome
Physical activity levels measured by accelerometry (MTI Actigraph) and their relationship to functional status and exercise capacitysurrogate
Physical activity levels are markedly reduced in children and adolescents after the Fontan procedure, independent of exercise capacity, and correlate with lower perceived general health.
Limitations
- Potential selection bias as there was no formal comparison between enrolled and non-enrolled patients.
- Normal values for exercise capacity were derived in the 1980s.
- Physician and parent-imposed activity restrictions were not reliably recorded.
- Unknown amount of monitor tampering or degree of non-compliance.
Abstract
OBJECTIVES: To determine physical activity levels in paediatric patients who underwent the Fontan procedure, and their relationship to functional status and exercise capacity. STUDY DESIGN: We studied 147 patients (ages 7-18 years) at a median of 8.1 years after Fontan, as part of the Pediatric Heart Network cross-sectional study of Fontan survivors. Assessment included medical history, self-reported physical activity, parent-completed Child Health Questionnaire (CHQ), cardiopulmonary exercise testing and physical activity level measured by accelerometry (MTI Actigraph). RESULTS: Measured time spent in moderate and vigorous activity was markedly below normal at all ages, particularly in females, and was not significantly related to self-reported activity levels, or to maximum Vo2, Vo2 at anaerobic threshold or maximum work rate on exercise testing. Lower measured activity levels were significantly related to lower perceived general health but not to self-esteem, physical functioning, social impact of physical limitations or overall physical or psychosocial health summary scores. Reduced exercise capacity was more strongly related than measured activity levels to lower scores in general health, self-esteem and physical functioning. CONCLUSIONS: Physical activity levels are reduced after Fontan, independent of exercise capacity, and are associated with lower perceived general health but not other aspects of functional status.