scholarly journals Rehabilitating Case of Tetralogy of Fallot Undergone Surgical Repair with Comprehensive Exercise Program: A Case Report

Author(s):  
Sidra Ahmad Siraj ◽  
Vaishnavi Dilip Yadav ◽  
Moli Jai Jain ◽  
Om C. Wadhokar

Tetralogy of Fallot (TOF) is one of the most common cyanotic congenital heart disorders (CHDs). The children with CHD lead relatively sedentary lifestyles, on account of the restriction imposed by treating doctors, parents, and society and by themselves due to fear. The disability related to CHD results in an additional adverse impact on quality of life and physical activity level due to deconditioning. The cardiovascular effects of deconditioning are a decrease in cardiac output, increase resting heart rate with activity, decreased blood pressure in upright positions (orthostatic hypotension), and decreased exercise capacity. These effects would be more pronounced and disabling in an already compromised heart. The operative procedure for the correction of TOF is not curative rather a palliative one. After the correction of the TOF defects, the patient has reduced activity level and exercise capacity. Cardiac rehabilitation including Interval and continuous exercise training modalities were proven to be safe and efficient in improving exercise capacity and functioning of the heart.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. TPS11636-TPS11636
Author(s):  
Nicole Brenna Quenelle ◽  
Kathryn Blount Bollin

TPS11636 Background: Studies show physical activity has a positive impact on fatigue and quality of life both during cancer treatment with chemotherapy and radiation and post-treatment (1, 2). There may also be a survival benefit to increasing physical activity both during and after treatment (3). To date there is no published research on the role of exercise in ameliorating the fatigue patients can experience during treatment with immune therapy. Our study proposes to use the existing framework of the LIVESTRONG at the YMCA program to objectively measure improvement in activity level and objective quality of life measurements. Methods: Randomized controlled prospective study evaluating patient participation in LIVESTRONG at YMCA program during active cancer treatment to assess change in minutes per week of self-reported physical activity over 12 weeks. Assessments will be done based on attendance of 12 week program, activity log, functional assessments of physical activity pre- and post- program (6 min walk test, % change in weight, % change in max weight lifted and flexibility), and questionnaires evaluating fatigue (PROMIS 13a FACIT-F), pain (PROMIS pain intensity scale, ASCQ-Me short form), quality of life (FACT-G), Godin Leisure Time Activity Questionnaire, and inflammatory markers (ESR, CRP). Data will be analyzed on an intention-to-treat analysis. A sample size of 100 participants per group will achieve 80% power to detect a 60 minute difference with a standard deviation of 150 minutes 1 and with a significance level (alpha) of 0.050 using a two-sided two-sample t-test. Enrollment is targeted at 108 participants per arm to allow for 8% attrition, 216 total. Secondary endpoints will be assessed at a baseline functional assessment session for all participants and a follow up session after 12 weeks, including administration of questionnaires at both sessions. For physical activity measurements and survey completions, percent change in baseline and completion measurements will be calculated for each patient, then comparison using a chi-square test will be done to determine statistical significance.(Tomlinson et al. Effect of exercise on cancer-related fatigue: a meta-analysis. Am J Phys Med Rehabil. 2014;93:675-686; Irwin et al. Effect of the LIVESTRONG at the YMCA Exercise Program on Physical Activity, Fitness, Quality of Life, and Fatigue in Cancer Survivors. 2016 (published online October 28, 2016); Li T et al. The dose–response effect of physical activity on cancer mortality: findings from 71 prospective cohort studies . Br J Sports Med. 2016;50:339-345).


Open Heart ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. e000932 ◽  
Author(s):  
Anette Sandtröm ◽  
Camilla Sandberg ◽  
Daniel Rinnström ◽  
Gunnar Engström ◽  
Mikael Dellborg ◽  
...  

BackgroundDue to improved care, the numbers of patients with tetralogy of Fallot (ToF) are increasing. However, long-term morbidity and need for reinterventions are concerns and also address issues of quality of life (QoL).MethodsPatients with ToF and valid EuroQol-5 dimensions questionnaire (EQ-5D) were identified in the national Swedish register on congenital heart disease. EQ-5Dindex was calculated and dichotomised into best possible health-related QoL (EQ-5Dindex=1) or differed from 1.Results288 patients met the criteria and were analysed. Univariate logistic regression showed a positive association between New York Heart Association (NYHA) class I (OR 8.32, 95% CI 3.80 to 18.21), physical activity >3 h/week (OR 3.34, 95% CI 1.67 to 6.66) and a better right ventricular function (OR 2.56, 95% CI 1.09 to 6.02). A negative association between symptoms (OR 0.23, 95% CI 0.13 to 0.42), cardiovascular medication (OR 0.31, 95% CI 0.18 to 0.53), age (OR 0.97, 95% CI 0.96 to 0.99) and EQ-5Dindex was observed. In multivariate logistic regression, NYHA I (OR 7.28, 95% CI 3.29 to 16.12) and physical activity >3 h/week (OR 2.27, 95% CI 1.07 to 4.84) remained associated with best possible health-related QoL. Replacing NYHA with symptoms in the model yielded similar results.ConclusionIn this registry study, self-reported physical activity, staff-reported NYHA class and absence of symptoms were strongly associated with best possible health-related QoL measured by EQ-5D. Physical activity level is a potential target for intervention to improve QoL in this population but randomised trials are needed to test such a hypothesis.


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