Key result
Pediatric cardiac telerehabilitation demonstrates safety with a ~1.5% complication rate across remote exercise sessions.
Why the study?
Management strategies for clinical complications during pediatric cardiac telerehabilitation sessions were not well defined.
Does a pediatric cardiac telerehabilitation program have a manageable safety profile in pediatric patients with cardiac disease?
Observational (n=43)
Does a pediatric cardiac telerehabilitation program have a manageable safety profile in pediatric patients with cardiac disease?
Pediatric cardiac telerehabilitation appears safe with a low complication rate (1.5%) that can be effectively managed through exercise prescription reinforcement and timely recognition.
Pediatric cardiac telerehabilitation may be feasible with remote oversight; leaves open generalizability and safety confirmation in larger randomized trials.
PURPOSE: To determine the management strategies of clinical complications that occurred during remote PCTR sessions. METHODS: Forty-three participants completed the study (25 PCTR, 18 control); Median age 15 years (IQR 13-17); 63% were male; 44% of participants had pulmonary hypertension, 35% had congenital heart disease, and 21% were s/p orthotopic heart transplant. Both groups completed a 12-week program and received an activity monitor (FitBit). Semi-supervised exercise sessions consisting of strength training, stretching, and cardio were performed by the PCTR group, while the control group only engaged in regular daily activities without exercise sessions. RESULTS: Across 260 total exercise sessions, four clinical complications were recorded (1.5%) | Clinical Complication | Cause | Management Strategy | | --- | --- | --- | | Recurrent nosebleeds with or without exercise | Chronic anticoagulation | Team recorded the event, notified the attending, paused the program until anticoagulation was adjusted, and nosebleeds did not re-occur. | | Ventricular Ectopy | Exceeded exercise prescription while weightlifting | Reinforcement of exercise prescription from the team. | | Chest Pain | Exceeded HR range while exercising | Reinforcement of exercise prescription from the team. | | Skin irritation from FitBit | Silicone strap skin irritation | Offered alternative fabric straps. | CONCLUSION: The importance of exercise prescription reinforcement and timely recognition of events allowed our PCTR to have a safety framework which resolved clinical complications our patients experienced.
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Mundo et al. (2026) conducted an observational in Pediatric cardiac conditions (pulmonary hypertension, congenital heart disease, orthotopic heart transplant) (n=43). Pediatric Cardiac Telerehabilitation (PCTR) vs. Regular daily activities without exercise sessions was evaluated on Clinical complications during remote PCTR exercise sessions. Pediatric cardiac telerehabilitation had a complication rate of 1.5% across 260 total exercise sessions, with all events safely recognized and resolved.
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