scholarly journals Analysis of exercise capacity, quality of life and leisure sports in patients with a Fontan circulation

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Niemann ◽  
K Rinne ◽  
A Uebing ◽  
I Voges
Keyword(s):  
Quality Of Life ◽  
Oxygen Uptake ◽  
Exercise Capacity ◽  
Fontan Circulation ◽  
Sports Activity ◽  
Large Group ◽  
Oxygen Pulse ◽  
Sporting Activity ◽  
Leisure Sports

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction: Despite the improvement in survival, patients with a Fontan circulation are exposed to numerous complications as well as a reduced exercise capacity and quality of life.  Purpose To assess the influence of the type of single ventricle (right vs. left) and the amount of sporting activity on exercise capacity and health related quality of life (HRQol) in a large group of Fontan patients. Methods Retrospective analysis of standardised cardiopulmonary exercise tests (CPET) performed on a treadmill between 2014 and 2019. Questionnaires to measure HRQol and sporting activity were sent to study participants. Results 79 patients were enrolled in this study (female, n = 31). 56 of them had a systemic right ventricle (SRV), 20 had a systemic left ventricle (SLV) and 3 had diverse anatomies. Median age at CPET was 12.2 years (range 6.2-34.4 years). The results for important exercise parameters were as follows: peak oxygen uptake (VO2max) 30.7 ± 6.2 ml/kg/min, oxygen uptake at anaerobic threshold (VO2-VAT) 24.7 ± 5.8 ml/kg/min, peak oxygen pulse 8.2 ± 3.4 mlO2/beat and VE/VCO2 slope 39.8 ± 9.1. There was no significant difference in VO2max, VO2-VAT, peak oxygen pulse and VE/CO2 slope between SRV and SLV patients: VO2max 30.2 ± 5.6 vs. 32.8 ± 7.5 ml/kg/min, p = 0.14; VO2-AT 24.4 ± 5.3 vs.25.7 ± 7.3 ml/kg/min, p = 0.53; peak oxygen pulse 7.8 ± 3.2 vs. 9.5 ± 3.9 mlO2/beat, p = 0.06; VE/CO2 slope 41.1 ± 9.6 vs. 36.9 ± 6.8, p = 0.10. Analyses of the questionnaires revealed that most of the patients do leisure sports (n = 60, 76%) with nearly half of them more than two hours per week (n = 26, 33%). In a subgroup analysis of patients under 18 years (n = 51, 65%) we found that nearly all of them participate in school sports (n = 50) and have a good subjective healthiness (n = 47). VO2-VAT and VO2max correlated positively with subjective healthiness (VO2-VAT r = 0.32, p < 0.05; VO2max r = 0.35, p < 0.05) as well as with the amount of leisure sports activity (hours/week) (VO2-VAT r = 0.37, p < 0.01; VO2max r = 0.50, p < 0.01). Conclusions By analysing a large group of patients in Fontan circulation we could demonstrate that there is no difference in exercise capacity between SRV and SLV patients. Furthermore, most of the patients participate in leisure sports and have a good subjective healthiness. In a subgroup of paediatric patients, we were able to show that a better exercise capacity is associated with increased leisure sports activity and a better subjective healthiness.

scholarly journals Does allogeneic stem cell transplantation in survivors of pediatric leukemia impact regular physical activity, pulmonary function, and exercise capacity?

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Katharina Ruf ◽  
Alaa Badran ◽  
Céline Siauw ◽  
Imme Haubitz ◽  
Paul-Gerhardt Schlegel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Stem Cell ◽  
Oxygen Uptake ◽  
Stem Cell Transplantation ◽  
Pulmonary Function ◽  
Cell Transplantation ◽  
Exercise Capacity ◽  
Peak Oxygen Uptake

Abstract Background Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has improved survival in high-risk childhood leukemia but is associated with long-term sequelae such as impaired pulmonary function and reduced exercise capacity impacting quality of life. Methods A convenience sample of 17 patients after allo-HSCT (HSCT—12 male, age 15.7±6.7 years, time after HSCT 5.3±2.8 years) underwent pulmonary function testing, echocardiography, and an incremental exercise test on a bike. Physical activity and health-related quality of life were assessed by questionnaires (7-day physical activity recall, PEDS-QL). Seventeen healthy age- and gender-matched controls served as control group (CG) for results of pulmonary function and exercise testing. Results HSCT showed reduced pulmonary function (HSCT vs. CG: FEV1 90.5±14.0 vs. 108.0±8.7%pred; FVC 88.4±19.3 vs. 107.6±6.9%pred, DLCO 75.3±23.6 vs. 104.9±12.8%pred) and exercise capacity (VO2peak 89±30.8%pred, CG 98±17.5%pred; Wmax 84±21.7%pred, CG 115±22.8%pred), but no relevant cardiac dysfunction and a good quality of life (PEDS-QL mean overall score 83.3±10.7). Differences in peak oxygen uptake between groups were mostly explained by 5 adolescent patients who underwent total body irradiation for conditioning. They showed significantly reduced diffusion capacity and reduced peak oxygen uptake. Patients reported a mean time of inactivity of 777±159min/day, moderate activity of 110±107 min/day, hard activity of 35±36 min/day, and very hard activity of 23±22 min/day. A higher amount of inactivity was associated with a lower peak oxygen uptake (correlation coefficient tau −0.48, p=0.023). Conclusions This pilot study shows that although patients after allo-HSCT reported a good quality of life, regular physical activity and exercise capacity are reduced in survivors of stem cell transplantation, especially in adolescents who are treated with total body irradiation for conditioning. Factors hindering regular physical activity need to be identified and exercise counseling should be part of follow-up visits in these patients.

scholarly journals Physical exercise training in patients with a Fontan circulation: A systematic review

2020 ◽  
pp. 204748732094286
Author(s):  
Linda E Scheffers ◽  
Linda EM vd Berg ◽  
Gamida Ismailova ◽  
Karolijn Dulfer ◽  
Johanna JM Takkenberg ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Exercise Training ◽  
Oxygen Uptake ◽  
Cardiac Function ◽  
Exercise Capacity ◽  
Peak Oxygen Uptake ◽  
Training Intervention ◽  
Fontan Patients

Background Patients with a Fontan circulation have a reduced exercise capacity, which is an important prognostic predictor of morbidity and mortality. A way to increase exercise capacity in Fontan patients might be exercise training. This systematic review assesses the effects of exercise training investigated in Fontan patients in order to provide an overview of current insights. Design and methods Studies evaluating an exercise training intervention in Fontan patients published up to February 2020 were included in this systematic review. Results From 3000 potential studies, 16 studies reported in 22 publications met the inclusion criteria. In total, 264 Fontan patients with mean age range 8.7–31 years, were included. Different training types including inspiratory muscle training, resistance training and aerobic training were investigated. Main outcome measures reported were peak oxygen uptake, cardiac function, lung function, physical activity levels and quality of life. Peak oxygen uptake increased significantly in 56% of the studies after training with an overall mean increase of +1.72 ml/kg/min (+6.3%). None of the studies reported negative outcome measures related to the exercise programme. In four studies an adverse event was reported, most likely unrelated to the training intervention. Conclusions Exercise training in Fontan patients is most likely safe and has positive effects on exercise capacity, cardiac function and quality of life. Therefore exercise training in Fontan patients should be encouraged. Further studies are required to assess the optimal training type, intensity, duration and long-term effects.

scholarly journals Peak oxygen uptake and exercise capacity: a reliable predictor of quality of life?

2009 ◽  
Vol 30 (13) ◽  
pp. 1674-1674 ◽  
Author(s):  
S. Glaser ◽  
C. Schaper ◽  
R. Ewert ◽  
B. Koch
Keyword(s):  
Quality Of Life ◽  
Oxygen Uptake ◽  
Exercise Capacity ◽  
Peak Oxygen Uptake ◽  
Reliable Predictor

scholarly journals Study Protocol of the Exercise Study: Unraveling Limitations for Physical Activity in Children With Chronic Diseases Order to Target Them With Tailored Interventions—A Randomized Cross Over Trial

2022 ◽  
Vol 9 ◽  
Author(s):  
Linda E. Scheffers ◽  
Willem A. Helbing ◽  
Elisabeth M. W. J. Utens ◽  
Gwen C. Dieleman ◽  
Karolijn Dulfer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Chronic Diseases ◽  
Exercise Capacity ◽  
Exercise Intervention ◽  
Fontan Circulation ◽  
Dietary Advice ◽  
Activity Levels ◽  
Physical Activity Levels

Introduction: Physical activity is associated with many physiological and psychological health benefits across the lifespan. Children with a chronic disease often have lower levels of daily physical activity, and a decreased exercise capacity compared to healthy peers. In order to learn more about limitations for physical activity, we investigate children with four different chronic diseases: children with a Fontan circulation, children with Broncho Pulmonary Dysplasia (BPD), Pompe disease and inflammatory bowel disease (IBD). Each of these diseases is likely to interfere with physical activity in a different way. Knowing the specific limitations for physical activity would make it possible to target these, and increase physical activity by a personalized intervention. The aim of this study is to first investigate limitations for physical activity in children with various chronic diseases. Secondly, to measure the effects of a tailored exercise intervention, possibly including a personalized dietary advice and/or psychological counseling, on exercise capacity, endurance, quality of life, fatigue, fear for exercise, safety, muscle strength, physical activity levels, energy balance, and body composition.Methods and Analysis: This randomized crossover trial will aim to include 72 children, aged 6–18 years, with one of the following diagnosis: a Fontan circulation, BPD, Pompe disease and IBD. Eligible patients will participate in the 12-week tailored exercise intervention and are either randomized to start with a control period or start with the intervention. The tailored 12-week exercise interventions, possibly including a personalized dietary advice and/or psychological counseling, will be designed based on the found limitations for physical activity in each disease group during baseline measurements by the Rotterdam Exercise Team. Effects of the tailored training interventions will be measured on the following endpoints: exercise capacity (measured by cardiopulmonary exercise test), endurance, physical activity levels, muscle strength, quality of life, fatigue, fear for exercise, disease activity, cardiac function (in children with a Fontan circulation), energy balance, and body composition.Ethics and Dissemination: Conducted according to the Declaration of Helsinki and Good Clinical Practice. Medical-ethical approval was obtained.Trial Registration Number: NL8181, https://www.trialregister.nl/trial/8181.

Exercise Capacity in Chronic Heart Failure

2012 ◽  
Vol 9 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Gina G Mentzer ◽  
Alex J Auseon
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Exercise Training ◽  
Exercise Capacity ◽  
Positive Impact ◽  
Pharmacologic Therapy ◽  
The Past ◽  
Diagnosis And Prognosis ◽  
Future Therapy

Heart failure (HF) affects more than 5 million people and has an increasing incidence and cost burden. Patients note symptoms of dyspnea and fatigue that result in a decreased quality of life, which has not drastically improved over the past decades despite advances in therapies. The assessment of exercise capacity can provide information regarding patient diagnosis and prognosis, while doubling as a potential future therapy. clinically, there is acceptance that exercise is safe in hf and can have a positive impact on morbidity and quality of life, although evidence for improvement in mortality is still lacking. specific prescriptions for exercise training have not been developed because many variables and confounding factors have prevented research trials from demonstrating an ideal regimen. Physicians are becoming more aware of the indices and goals for hf patients in exercise testing and therapy to provide comprehensive cardiac care. it is further postulated that a combination of exercise training and pharmacologic therapy may eventually provide the most benefits to those suffering from hf.

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