Impact of a paediatric cardiac rehabilitation programme upon patient quality of life.

Introduction: Cardiac rehabilitation programmes for paediatric patients with congenital heart disease (CHD) have been shown to promote emotional and physical health without any associated adverse events. While prior studies have demonstrated the effectiveness of these types of interventions, there has been limited research into how the inclusion of psychological interventions as part of the programme impacts parent-reported and patient-reported quality of life.

Materials And Methods: Patients between the ages of 7 and 24 years with CHD completed a cardiac rehabilitation programme that followed a flexible structure of four in person-visits with various multidisciplinary team members, including paediatric psychologists.

Quantifying Activity Levels After Sport-Related Concussion Using Actigraph and Mobile (mHealth) Technologies.

Context: Interest in identifying the effects of physical and mental activity on recovery after sport-related concussion is growing. Clinical studies of concussed athletes' activities require well-validated methods for tracking their intensity and timing.

Objective: To develop and validate a novel multimodal approach to monitoring activity postconcussion using mobile (mHealth) technologies.

Intrauterine growth restriction is not associated with decreased exercise capacity in adolescents with congenital heart disease.

Objective: Multiple studies demonstrate the association of intrauterine growth restriction (IUGR) with impaired aerobic fitness in adolescents and adults. To our knowledge, there are no studies including individuals with the history of both IUGR and congenital heart disease (CHD). Thus, we sought to evaluate the impact of IUGR on exercise capacity in adolescents with CHD.

Cardiopulmonary Exercise Testing in Fontan Patients With and Without Isomerism (Heterotaxy) as Compared to Patients With Primary Ciliary Dyskinesia and Subjects With Structurally Normal Hearts.

Isomerism, also known as heterotaxy, is a clinical entity that impacts multiple organ systems both anatomically and functionally. The airways and lungs are involved in a great number of these patients, leading to increased sinopulmonary symptoms, increased need for oxygenation, and increased postoperative ventilatory support. Additionally, these patients often have congenital heart disease requiring Fontan palliation.

Toward translating near-infrared spectroscopy oxygen saturation data for the non-invasive prediction of spatial and temporal hemodynamics during exercise.

Image-based computational fluid dynamics (CFD) studies conducted at rest have shown that atherosclerotic plaque in the thoracic aorta (TA) correlates with adverse wall shear stress (WSS), but there is a paucity of such data under elevated flow conditions. We developed a pedaling exercise protocol to obtain phase contrast magnetic resonance imaging (PC-MRI) blood flow measurements in the TA and brachiocephalic arteries during three-tiered supine pedaling at 130, 150, and 170 % of resting heart rate (HR), and relate these measurements to non-invasive tissue oxygen saturation [Formula: see text] acquired by near-infrared spectroscopy (NIRS) while conducting the same protocol. Local quantification of WSS indices by CFD revealed low time-averaged WSS on the outer curvature of the ascending aorta and the inner curvature of the descending aorta (dAo) that progressively increased with exercise, but that remained low on the anterior surface of brachiocephalic arteries.

Can a Home-based Cardiac Physical Activity Program Improve the Physical Function Quality of Life in Children with Fontan Circulation?

Objective: Patients after Fontan operation for complex congenital heart disease (CHD) have decreased exercise capacity and report reduced health-related quality of life (HRQOL). Studies suggest hospital-based cardiac physical activity programs can improve HRQOL and exercise capacity in patients with CHD; however, these programs have variable adherence rates. The impact of a home-based cardiac physical activity program in Fontan survivors is unclear.

Pain Response after Maximal Aerobic Exercise in Adolescents across Weight Status.

Introduction: Pain reports are greater with increasing weight status, and exercise can reduce pain perception. It is unknown, however, whether exercise can relieve pain in adolescents of varying weight status. The purpose of this study was to determine whether adolescents across weight status report pain relief after high-intensity aerobic exercise (exercise-induced hypoalgesia (EIH)).

Effect of Fontan fenestration on regional venous oxygen saturation during exercise: further insights into Fontan fenestration closure.

Fontan fenestration closure is a topic of great debate. The body of data regarding the risks and benefits of fenestration closure is limited yet growing. Previous studies have demonstrated that Fontan patients have less exercise capacity than those with normal cardiovascular anatomy.

Restrictive versus nonrestrictive physiology following repair of tetralogy of Fallot: is there a difference?

Background: Long-term outcome in repaired tetralogy of Fallot (TOF) is related to chronic pulmonary insufficiency (PI), right ventricular (RV) dilation, and deterioration of RV function. The aim of this study was to characterize clinical differences between restrictive and nonrestrictive RV physiology in young patients with repaired TOF.

Methods: Patients were prospectively enrolled from February 2008 to August 2009.

Restrictive lung disease is an independent predictor of exercise intolerance in the adult with congenital heart disease.

Background/objectives: Following repair of congenital heart disease (CHD), adult patients are at risk for reduced exercise capacity. Restrictive lung disease (RLD) may contribute to reduced exercise capacity in this population. The aim of this study was to determine the prevalence of RLD and its impact on exercise tolerance in the adult with CHD.

Near-infrared spectroscopic monitoring during cardiopulmonary exercise testing detects anaerobic threshold.

Cardiopulmonary exercise testing (CPET) provides assessment of the integrative responses involving the pulmonary, cardiovascular, and skeletal muscle systems. Application of exercise testing remains limited to children who are able to understand and cooperate with the exercise protocol. Near-infrared spectroscopy (NIRS) provides a noninvasive, continuous method to monitor regional tissue oxygenation (rSO2).

Near infrared spectroscopy describes physiologic payback associated with excess postexercise oxygen consumption in healthy controls and children with complex congenital heart disease.

Exercise creates a physiologic burden with recovery from such effort crucial to adaptation. Excess postexercise oxygen consumption (EPOC) refers to the body's increased metabolic need after work. This investigation was designed to determine the role of near infrared spectroscopy (NIRS) in the description of exercise recovery in healthy controls (NL) and children with congenital heart disease (CHD).

Objectively assessed physical activity and sedentary behaviour does not differ between children and adolescents with and without a congenital heart defect: a pilot examination.

Objectives: To objectively evaluate and describe physical activity levels in children with a stable congenital heart defect and compare those levels with children who do not have a congenital heart defect.

Methods: We matched 21 pairs of children for gender and grade in school and gave them an accelerometer-based motion sensor to wear for 7 consecutive days.

Results: Physical activity levels did not differ between children with and without a congenital heart defect.

Near infrared spectroscopy: guided tilt table testing for syncope.

Syncope is transient loss of consciousness. Neurocardiogenic syncope (NCS) is the most common cause of syncope. Head-up tilt-table test (HUTT) has been used to demonstrate physiologic events during graded orthostatic challenge in individuals with significant handicap from NCS.

Cerebral hemodynamics in the presence of decreased systemic venous compliance in patients with Fontan physiology may limit anaerobic exercise capacity.

Patients who have had the Fontan procedure report poor exercise performance. Fontan subjects can tolerate a higher level of sub maximal activity than might be anticipated from VO2, suggesting a different mechanism of exercise limitation. Near-infrared spectroscopy (NIRS) provides a non-invasive, continuous method to monitor regional tissue oxygenation (rSO2) and thereby a window into regional oxygen supply-demand relationships.

Evaluation of Cooper 12-minute walk/run test as a marker of cardiorespiratory fitness in young urban children with persistent asthma.

Objective: To evaluate Cooper 12-minute run/walk test (CT12) as a one-time estimate of cardiorespiratory fitness and marker of fitness change compared with treadmill fitness testing in young children with persistent asthma.

Design: A cohort of urban children with asthma participated in the asthma and exercise program and a subset completed pre- and postintervention fitness testing.

Setting: Treadmill fitness testing was conducted by an exercise physiologist in the fitness laboratory at an academic children's hospital.

Measurement of regional tissue bed venous weighted oximetric trends during exercise by near infrared spectroscopy.

Background: Cardiopulmonary exercise testing (CPET) is limited to children able to tolerate the equipment. Modification of instrumentation to reduce invasiveness will open CPET to a wider population. Near Infrared Spectroscopy (NIRS) devices measure regional oxyhemoglobin saturation (rSO2).

Moderate and vigorous exercise programs in children with asthma: safety, parental satisfaction, and asthma outcomes.

Background: Previous research suggests that physical activity programs may improve fitness and reduce symptoms in children with asthma, but few studies have included severe asthmatics and focused on safety and parental satisfaction with the programs.

Objective: To examine safety, parental satisfaction, and pre- to post-intervention changes in symptoms and quality of life (QOL) in a pilot study of the impact of vigorous physical activity (swimming) and moderate-intensity activity (golf) on inner-city children with asthma.

Design/methods: Children with asthma (7-14 years old) residing in Milwaukee's highest asthma prevalence zip codes were randomized to a 9-week swimming or golf program.

Chest pain: characteristics of children/adolescents.

Chest pain (CP) in children/adolescents is a common referral for the pediatric cardiologist. A group of 263 patients (141 males/122 females, mean age = 13.4 years, range = 5-22 years) with the primary complaint of CP underwent evaluation in the cardiac stress lab at Children's Hospital of Wisconsin.

Exercise recommendations and risk factors for sudden cardiac death.

This article reviews the risk factors that are associated with exercise that can lead to sudden cardiac death and what can be done to identify those who are at risk. Additionally, exercise recommendations to reduce the chance of sudden cardiac death and comments about restrictions and quality of life issues are addressed.