Sustained effects of cardiac rehabilitation in children with serious congenital heart disease.
OBJECTIVE
Past studies have documented the acute benefits of cardiac rehabilitation in children with congenital heart disease. It is not known whether these benefits persist.


METHODS
Fifteen patients, ages 8 to 17 years, with complex congenital heart disease, whose exercise function immediately after a 12-week cardiac rehabilitation program was superior to that present on a precardiac rehabilitation exercise test, were restudied 6.9 +/- 1.6 months after completion of the cardiac rehabilitation program (approximately 1 year after the precardiac rehabilitation study). Changes in exercise function relative to baseline, precardiac rehabilitation exercise tests were also compared with changes observed in a group of 18 control subjects, with similar diagnoses, who also had 2 exercise tests separated by a year but did not undergo cardiac rehabilitation.


RESULTS
The cardiac rehabilitation patients' exercise function did not change significantly over the 6.9-month period after the completion of the cardiac rehabilitation program; percentage of predicted peak oxygen consumption and peak work rate remained significantly superior to baseline, precardiac rehabilitation values. These changes were also associated with improvements in self-esteem, behavior, and emotional state. In contrast, among the control subjects, small, but statistically insignificant declines in peak oxygen consumption and peak work rate were observed on the final exercise test compared with values obtained at baseline, 1 year earlier. The improvements realized by the cardiac rehabilitation patients differed significantly from the concurrent changes observed among the control subjects and appeared to be a result of an increase in the oxygen pulse at peak exercise; significant changes in peak heart rate were not observed.


CONCLUSIONS
In patients with congenital heart disease, cardiac rehabilitation produces significant, sustained improvements in exercise function, behavior, self-esteem, and emotional state.
Rhodes
Jonathan
J
Department of Cardiology, Children's Hospital, Boston, 300 Longwood Ave, Boston, Massachusetts 02115, USA. jonathan.rhodes@cardio.chboston.org
Curran
Tracy J
TJ
Camil
Laurel
L
Rabideau
Nicole
N
Fulton
David R
DR
Gauthier
Naomi S
NS
Gauvreau
Kimberlee
K
Jenkins
Kathy J
KJ
D000293:Adolescent; D002648:Child; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006330:Heart Defects, Congenital / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010101:Oxygen Consumption; D016896:Treatment Outcome