Randomized Control Trial Of Pediatric Cardiac Telerehabilitation In Congenital Heart Disease On Clinical Outcomes

PURPOSE: Virtual pediatric cardiac rehabilitation programs or pediatric cardiac telerehabilitation (PCTR) can expand access to care. However, there are limited data on the effectiveness of these programs. The purpose of this study was to determine the effectiveness of PCTR on exercise capacity, quality of life (QoL) and mood in children with congenital heart disease (CHD). METHODS: This was a prospective randomized control design (RCT) study. Patients performed cardiopulmonary exercise testing (CPET), questionnaires and had activity data (Fitbit) collected at the time of enrollment and 3 months ± 1 month post enrollment. PCTR group performed 12-weeks of semi-supervised PCTR consisting of 3 exercise sessions per week (1 to 2 supervised and 1 to 2 independent). The PCTR group received remote single lead electrocardiogram monitors, Fitbit exercise prescription, and stationary bikes, weights, and bands. The control group performed regular daily activities and received a Fitbit. RESULTS: We recruited 23 patients for the study. Twenty patients completed the study (10 PCTR, 10 control), mean age 15 years ± 2; 40% were female; BMI 21.8 ± 5.5. Two participants are still on study. Data was normally distributed, and a repeated measures ANOVA was performed to test within and between effects of the intervention. The PCTR group had significant improvements in exercise associated anxiety (p=0.029), quality of life scores (p=0.011), depression (p=0.024), watts at the anaerobic threshold (AT) (p=0.005), peak watts (p=0.016), peak O 2 pulse (p<0.001) and peak VO 2 ml/kg/min (p=0.007). No significant improvements were seen within the control group in any metric. The PCTR group demonstrated a significantly greater increased in O 2 pulse at AT (p=0.015), peak VO 2 ml/kg/min (p=0.042), and peak O 2 pulse (p=0.017) from the control group. CONCLUSION: Using an RCT study design, we conclude that PCTR significantly improves exercise capacity, QoL and mood in children with CHD.