Skip to main content
Erschienen in: Pediatric Cardiology 4/2015

01.04.2015 | Original Article

Children After Fontan have Strength and Body Composition Similar to Healthy Peers and Can Successfully Participate in Daily Moderate-to-Vigorous Physical Activity

verfasst von: Patricia E. Longmuir, M. Corey, G. Faulkner, J. L. Russell, B. W. McCrindle

Erschienen in: Pediatric Cardiology | Ausgabe 4/2015

Einloggen, um Zugang zu erhalten

Abstract

The objective of this study was to evaluate the active lifestyle capacity (daily physical activity, strength, flexibility, body composition) of children after the Fontan procedure; hypothesized to be lower than healthy peers. Participants (n = 64, 25 females) were 9.0 ± 1.7 years of age (range 6.0–11.7 years). Fontan completion occurred at 3.3 ± 1.4 years of age (5.7 ± 2.0 years prior). Canadian Health Measures Survey protocols assessed aerobic endurance (paced walking up/down steps), strength (handgrip), flexibility (sit and reach), body composition (body mass index), and daily moderate-to-vigorous physical activity (7-day accelerometry). Difference scores compared participant data to published norms (t tests). Linear regression evaluated age/gender/demographic factor associations. Children after Fontan had strength scores similar (mean difference 1.1 kg) to their peers were less likely to be obese (mean difference of body mass index = 1.1 ± 2.5, p = 0.001) and performed 50 min of moderate-to-vigorous activity (MVPA) per day (12 ± 17 min/day below healthy peers, p < 0.001). Estimated peak endurance (61 % of expected) and flexibility (64 % of expected) were lower than peers (p < 0.001). Almost all (60/63) participants demonstrated the capacity to perform at least 20 min of MVPA per day. Difference from norms was smaller among children younger at Fontan completion (4 ± 2 min/year) and taking antithrombotic medication (7 ± 18 and 22 ± 17 min/day for taking/not taking, respectively). Children after Fontan demonstrate the capacity for the daily physical activity associated with optimal health. They have similar strength and good body composition. We recommend that children after Fontan be counselled that they can successfully participate in healthy, active lifestyles and physically active peer play.
Literatur
1.
Zurück zum Zitat Banks L, McCrindle BW, Russell JL, Longmuir PE (2013) Optimal physiological response to sub-maximal exercise in children after the Fontan procedure. Med Sci Sports Exerc 45(4):615–621 Banks L, McCrindle BW, Russell JL, Longmuir PE (2013) Optimal physiological response to sub-maximal exercise in children after the Fontan procedure. Med Sci Sports Exerc 45(4):615–621
2.
Zurück zum Zitat Bar-Or O, Rowland TW (2004) Pediatric exercise medicine: from physiologic principles to healthcare application. Human Kinetics, Champaign Bar-Or O, Rowland TW (2004) Pediatric exercise medicine: from physiologic principles to healthcare application. Human Kinetics, Champaign
3.
Zurück zum Zitat Bjarnason-Wehrens B, Dordel S, Schickendantz S, Krumm C, Bott D, Sreeram N, Brockmeier K (2007) Motor development in children with congenital cardiac diseases compared to their healthy peers. Cardiol Young 17:487–498PubMed Bjarnason-Wehrens B, Dordel S, Schickendantz S, Krumm C, Bott D, Sreeram N, Brockmeier K (2007) Motor development in children with congenital cardiac diseases compared to their healthy peers. Cardiol Young 17:487–498PubMed
4.
Zurück zum Zitat Canadian Society for Exercise Physiology (2003) Canadian Physical Activity, Fitness and Lifestyle Approach. Canadian Society for Exercise Physiology, Ottawa Canadian Society for Exercise Physiology (2003) Canadian Physical Activity, Fitness and Lifestyle Approach. Canadian Society for Exercise Physiology, Ottawa
5.
Zurück zum Zitat Cohen J (1988) Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates, Hillsdale Cohen J (1988) Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates, Hillsdale
6.
Zurück zum Zitat Colley RC, Garriguet D, Janssen I, Craig CL, Clarke J, Tremblay MS (2011) Physical activity levels of Canadian children and youth: results from the 2007-2009 Canadian Health Measures Survey. Health Rep 22:15–24PubMed Colley RC, Garriguet D, Janssen I, Craig CL, Clarke J, Tremblay MS (2011) Physical activity levels of Canadian children and youth: results from the 2007-2009 Canadian Health Measures Survey. Health Rep 22:15–24PubMed
7.
Zurück zum Zitat Diller GP, Giardini A, Dimopoulos K, Gargiulo G, Muller J, Derrick G (2010) Predictors of morbidity and mortality in contemporary Fontan patients: results from a multicenter study including cardiopulmonary exercise testing in 321 patients. Eur Heart J 31:3073–3083CrossRefPubMed Diller GP, Giardini A, Dimopoulos K, Gargiulo G, Muller J, Derrick G (2010) Predictors of morbidity and mortality in contemporary Fontan patients: results from a multicenter study including cardiopulmonary exercise testing in 321 patients. Eur Heart J 31:3073–3083CrossRefPubMed
8.
Zurück zum Zitat Donnelly JE, Lambourne K (2011) Classroom-based physical activity, cognition, and academic achievement. Prev Med 52:S36–S42CrossRefPubMed Donnelly JE, Lambourne K (2011) Classroom-based physical activity, cognition, and academic achievement. Prev Med 52:S36–S42CrossRefPubMed
9.
Zurück zum Zitat Feinstein JA, Benson DW, Dubin AM, Cohen MS, Maxey DM, Mahle WT, Pahl E, Villafane J, Bhatt AB, Peng LF, Johnson BA, Marsden AL, Daniels CJ, Rudd NA, Caldarone CA, Mussatto KA, Morales DL, Ivy DD, Gaynor JW, Tweddell JS, Deal BJ, Furck AK, Rosenthal GL, Ohye RG, Ghanayem NS, Cheatham JP, Tworetzky W, Martin GR (2012) Hypoplastic left heart syndrome: current considerations and expectations. J Am Coll Cardiol 59:S1–S42CrossRefPubMed Feinstein JA, Benson DW, Dubin AM, Cohen MS, Maxey DM, Mahle WT, Pahl E, Villafane J, Bhatt AB, Peng LF, Johnson BA, Marsden AL, Daniels CJ, Rudd NA, Caldarone CA, Mussatto KA, Morales DL, Ivy DD, Gaynor JW, Tweddell JS, Deal BJ, Furck AK, Rosenthal GL, Ohye RG, Ghanayem NS, Cheatham JP, Tworetzky W, Martin GR (2012) Hypoplastic left heart syndrome: current considerations and expectations. J Am Coll Cardiol 59:S1–S42CrossRefPubMed
10.
Zurück zum Zitat Fredriksen PM, Ingjer E, Thaulow E (2000) Physical activity in children and adolescents with congenital heart disease. Aspects of measurements with an activity monitor. Cardiol Young 10:98–106PubMed Fredriksen PM, Ingjer E, Thaulow E (2000) Physical activity in children and adolescents with congenital heart disease. Aspects of measurements with an activity monitor. Cardiol Young 10:98–106PubMed
11.
Zurück zum Zitat Ginsburg KR (2007) The importance of play in promoting healthy child development and maintaining strong parent-child bonds. Pediatrics 119:182–191CrossRefPubMed Ginsburg KR (2007) The importance of play in promoting healthy child development and maintaining strong parent-child bonds. Pediatrics 119:182–191CrossRefPubMed
12.
Zurück zum Zitat Graham TP, Driscoll DJ, Gersony WM, Newburger JW, Rocchini A, Towbin JA (2005) Task force 2: congenital heart disease. J Am Coll Cardiol 45(8):1326–1333CrossRefPubMed Graham TP, Driscoll DJ, Gersony WM, Newburger JW, Rocchini A, Towbin JA (2005) Task force 2: congenital heart disease. J Am Coll Cardiol 45(8):1326–1333CrossRefPubMed
13.
Zurück zum Zitat Haskell WL, Leon AS, Caspersen CJ, Froelicher VF, Hagberg JM, Harlan W, Holloszy JO, Regensteiner JG, Thompson PD, Washburn RA, Wilson PW (1992) Cardiovascular benefits and assessment of physical activity and physical fitness in adults. Med Sci Sports 24:S201–S220 Haskell WL, Leon AS, Caspersen CJ, Froelicher VF, Hagberg JM, Harlan W, Holloszy JO, Regensteiner JG, Thompson PD, Washburn RA, Wilson PW (1992) Cardiovascular benefits and assessment of physical activity and physical fitness in adults. Med Sci Sports 24:S201–S220
14.
Zurück zum Zitat Hirth A, Reybrouck T, Bjarnason-Wehrens B, Lawrenz W, Hoffmann A (2006) Recommendations for participation in competitive and leisure sports in patients with congenital heart disease: a consensus document. Eur J Cardiovasc Prev Rehabil 13:293–299PubMed Hirth A, Reybrouck T, Bjarnason-Wehrens B, Lawrenz W, Hoffmann A (2006) Recommendations for participation in competitive and leisure sports in patients with congenital heart disease: a consensus document. Eur J Cardiovasc Prev Rehabil 13:293–299PubMed
15.
Zurück zum Zitat Janssen I, LeBlanc AG (2010) Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act 7:40–56CrossRefPubMedCentralPubMed Janssen I, LeBlanc AG (2010) Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act 7:40–56CrossRefPubMedCentralPubMed
16.
Zurück zum Zitat Kantomaa MT, Purtsi J, Taanila AM, Remes J, Viholainen H, Rintala P, Ahonen T, Tammelin TH (2011) Suspected motor problems and low preference for active play in childhood are associated with physical inactivity and low fitness in adolescence. PLoS One 6(1):e14554CrossRefPubMedCentralPubMed Kantomaa MT, Purtsi J, Taanila AM, Remes J, Viholainen H, Rintala P, Ahonen T, Tammelin TH (2011) Suspected motor problems and low preference for active play in childhood are associated with physical inactivity and low fitness in adolescence. PLoS One 6(1):e14554CrossRefPubMedCentralPubMed
17.
Zurück zum Zitat Karsdorp PA, Everaerd W, Kindt M, Mulder BJM (2007) Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis. J Pediatr Psychol 32:527–541CrossRefPubMed Karsdorp PA, Everaerd W, Kindt M, Mulder BJM (2007) Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis. J Pediatr Psychol 32:527–541CrossRefPubMed
18.
Zurück zum Zitat Longmuir PE, McCrindle BW (2009) Physical activity restrictions for children after the Fontan operation: disagreement between parent, cardiologist, and medical record reports. Am Heart J 157:853–859CrossRefPubMed Longmuir PE, McCrindle BW (2009) Physical activity restrictions for children after the Fontan operation: disagreement between parent, cardiologist, and medical record reports. Am Heart J 157:853–859CrossRefPubMed
19.
Zurück zum Zitat Longmuir PE, Russell JL, Corey M, McCrindle BW (2007) Factors associated with objectively measured activity levels for children after the Fontan procedure. Circulation 116:479–480 Longmuir PE, Russell JL, Corey M, McCrindle BW (2007) Factors associated with objectively measured activity levels for children after the Fontan procedure. Circulation 116:479–480
20.
Zurück zum Zitat Longmuir PE, Russell JL, Corey M, Faulkner G, McCrindle BW (2011) Factors associated with the physical activity level of children who have the Fontan procedure. Am Heart J 161:411–417CrossRefPubMed Longmuir PE, Russell JL, Corey M, Faulkner G, McCrindle BW (2011) Factors associated with the physical activity level of children who have the Fontan procedure. Am Heart J 161:411–417CrossRefPubMed
21.
Zurück zum Zitat Longmuir PE, Brothers JA, de Ferranti SD, Hayman LL, Van Hare GF, Matherne GP, Davis CK, Joy EA, McCrindle BW (2013) Promotion of physical activity for children and adults with congenital heart disease: a scientific statement from the American heart association. Circulation 127:2147–2159CrossRefPubMed Longmuir PE, Brothers JA, de Ferranti SD, Hayman LL, Van Hare GF, Matherne GP, Davis CK, Joy EA, McCrindle BW (2013) Promotion of physical activity for children and adults with congenital heart disease: a scientific statement from the American heart association. Circulation 127:2147–2159CrossRefPubMed
22.
Zurück zum Zitat Malina R (1994) Benefits of activity from a lifetime perspective. In: Toward active living: proceedings of an international conference on physical activity, fitness and health Malina R (1994) Benefits of activity from a lifetime perspective. In: Toward active living: proceedings of an international conference on physical activity, fitness and health
23.
Zurück zum Zitat McCrindle BW, Williams RV, Mital S, Clark BJ, Russell JL, Klein G, Eisenmann JC (2007) 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. Arch Dis Child 92:509–514CrossRefPubMedCentralPubMed McCrindle BW, Williams RV, Mital S, Clark BJ, Russell JL, Klein G, Eisenmann JC (2007) 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. Arch Dis Child 92:509–514CrossRefPubMedCentralPubMed
24.
Zurück zum Zitat Moola F, McCrindle BW, Longmuir PE (2009) Physical activity participation in youth with surgically corrected congenital heart disease: devising guidelines so Johnny can participate. Paediatr Child Health 14:167–170PubMedCentralPubMed Moola F, McCrindle BW, Longmuir PE (2009) Physical activity participation in youth with surgically corrected congenital heart disease: devising guidelines so Johnny can participate. Paediatr Child Health 14:167–170PubMedCentralPubMed
25.
Zurück zum Zitat Muller J, Christov F, Schreiber C, Hess J, Hager A (2009) Exercise capacity, quality of life, and daily activity in the long-term follow-up of patients with univentricular heart and total cavopulmonary connection. Eur Heart J 30:2915–2920CrossRefPubMed Muller J, Christov F, Schreiber C, Hess J, Hager A (2009) Exercise capacity, quality of life, and daily activity in the long-term follow-up of patients with univentricular heart and total cavopulmonary connection. Eur Heart J 30:2915–2920CrossRefPubMed
26.
Zurück zum Zitat Murphy KR, Myors B (2004) Statistical power analysis: a simple and general model for traditional and modern hypothesis tests. Lawrence Erlbaum Associates, Mahwah, NJ Murphy KR, Myors B (2004) Statistical power analysis: a simple and general model for traditional and modern hypothesis tests. Lawrence Erlbaum Associates, Mahwah, NJ
27.
Zurück zum Zitat Paridon SM, Mitchell PD, Colan SD, Williams RV, Blaufox A, Li JS, Margossian R, Mital S, Russell JL, Rhodes J (2008) A cross-sectional study of exercise performance during the first 2 decades of life after the Fontan operation. J Am Coll Cardiol 52:99–107CrossRefPubMed Paridon SM, Mitchell PD, Colan SD, Williams RV, Blaufox A, Li JS, Margossian R, Mital S, Russell JL, Rhodes J (2008) A cross-sectional study of exercise performance during the first 2 decades of life after the Fontan operation. J Am Coll Cardiol 52:99–107CrossRefPubMed
28.
Zurück zum Zitat Puyau MR, Adolph AL, Vohra FA, Zakeri I, Butte NF (2004) Prediction of activity energy expenditure using accelerometers in children. Med Sci Sports Exerc 36:1625–1631PubMed Puyau MR, Adolph AL, Vohra FA, Zakeri I, Butte NF (2004) Prediction of activity energy expenditure using accelerometers in children. Med Sci Sports Exerc 36:1625–1631PubMed
29.
Zurück zum Zitat Reybrouck T, Mertens L (2005) Physical performance and physical activity in grown-up congenital heart disease. Eur J Cardiovasc Prev Rehabil 12:498–502CrossRefPubMed Reybrouck T, Mertens L (2005) Physical performance and physical activity in grown-up congenital heart disease. Eur J Cardiovasc Prev Rehabil 12:498–502CrossRefPubMed
30.
Zurück zum Zitat Shillingford AJ, Glanzman MM, Ittenbach RF, Clancy RR, Gaynor JW, Wernovsky G (2008) Inattention, hyperactivity, and school performance in a population of school-age children with complex congenital heart disease. Pediatrics 121:E759–E767CrossRefPubMed Shillingford AJ, Glanzman MM, Ittenbach RF, Clancy RR, Gaynor JW, Wernovsky G (2008) Inattention, hyperactivity, and school performance in a population of school-age children with complex congenital heart disease. Pediatrics 121:E759–E767CrossRefPubMed
32.
Zurück zum Zitat Statistics Canada(1-11-2010) Canadian Health Measures Survey (CHMS) Data User Guide: Cycle 1. Statistics Canada, Ottawa Statistics Canada(1-11-2010) Canadian Health Measures Survey (CHMS) Data User Guide: Cycle 1. Statistics Canada, Ottawa
33.
Zurück zum Zitat Takken T, Hulzebos HJ, Blank AC, Tacken MHP, Helders PJM, Strengers JLM (2007) Exercise prescription for patients with a Fontan circulation: current evidence and future directions. Neth Heart J 15:142–147CrossRefPubMedCentralPubMed Takken T, Hulzebos HJ, Blank AC, Tacken MHP, Helders PJM, Strengers JLM (2007) Exercise prescription for patients with a Fontan circulation: current evidence and future directions. Neth Heart J 15:142–147CrossRefPubMedCentralPubMed
34.
Zurück zum Zitat Tremblay MS, Shields M, Laviolette M, Craig CL, Janssen I, Gorber SC (2010) Fitness of Canadian children and youth: results from the 2007–2009 Canadian health measures survey. Health Rep 21:7–20PubMed Tremblay MS, Shields M, Laviolette M, Craig CL, Janssen I, Gorber SC (2010) Fitness of Canadian children and youth: results from the 2007–2009 Canadian health measures survey. Health Rep 21:7–20PubMed
35.
Zurück zum Zitat Tremblay MS, Warburton DER, Janssen I, Paterson DH, Latimer AE, Rhodes RE, Kho ME, Hicks A, LeBlanc AG, Zehr L, Murumets K, Duggan M (2011) New Canadian physical activity guidelines. Appl Physiol Nutr Metab 36:36–46CrossRefPubMed Tremblay MS, Warburton DER, Janssen I, Paterson DH, Latimer AE, Rhodes RE, Kho ME, Hicks A, LeBlanc AG, Zehr L, Murumets K, Duggan M (2011) New Canadian physical activity guidelines. Appl Physiol Nutr Metab 36:36–46CrossRefPubMed
36.
Zurück zum Zitat Wolff D, van Melle JP, ebels T, Hillege H, van Slooten YJ, Berger RMF (2014) Trends in mortality (1975-2011) after one- and two-stage Fontan surgery, including bidirectional Glenn through Fontan completion. Eur J Cardiothorac Surg 45:602–609CrossRefPubMed Wolff D, van Melle JP, ebels T, Hillege H, van Slooten YJ, Berger RMF (2014) Trends in mortality (1975-2011) after one- and two-stage Fontan surgery, including bidirectional Glenn through Fontan completion. Eur J Cardiothorac Surg 45:602–609CrossRefPubMed
Metadaten
Titel
Children After Fontan have Strength and Body Composition Similar to Healthy Peers and Can Successfully Participate in Daily Moderate-to-Vigorous Physical Activity
verfasst von
Patricia E. Longmuir
M. Corey
G. Faulkner
J. L. Russell
B. W. McCrindle
Publikationsdatum
01.04.2015
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 4/2015
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-014-1080-6

Weitere Artikel der Ausgabe 4/2015

Pediatric Cardiology 4/2015 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.