title: Systematic review of the effects of physical exercise training programmes in children and young adults with congenital heart disease.
abstract: BACKGROUND
  Most patients with congenital heart disease (ConHD) do not perform regular physical exercise. Consensus reports have stated that exercise should be encouraged and regularly performed in these patients, but this is not common practise. We reviewed the literature on actual evidence for either negative or positive effects of physical exercise training programmes in children and young adults with ConHD.
  
  
  METHODS
  Using the Medline database, we systematically searched for articles on physical exercise training programmes in ConHD.
  
  
  RESULTS
  A total of 31 articles met all inclusion criteria; in total, 621 subjects (age range 4 to 45 years) were included. Most studies used training programmes with a duration of 12 weeks. On average, the number of training sessions was 3 times per week. In 12 studies, training intensity was set at a percentage of peak heart rate. Outcome measures reported were PeakVO2, activity levels and muscle strength. Twenty-three studies (72%) found a significant positive change in the main outcome measure after the physical exercise training period. None of the studies reported negative findings related to physical exercise training in ConHD. Cardiac effects have hardly been studied.
  
  
  CONCLUSIONS
  In most studies, participation in a physical exercise training programme was safe and improved fitness in children and young adults with ConHD. We recommend that patients with ConHD participate in physical exercise training. Cardiac effects need to be studied more extensively.
authors.affiliation: Department of Paediatrics, Division of Cardiology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Duppen
authors.forename: T
authors.initials: T
authors.lastname: Takken
authors.forename: M T E
authors.initials: MT
authors.lastname: Hopman
authors.forename: A D J
authors.initials: AD
authors.lastname: ten Harkel
authors.forename: K
authors.initials: K
authors.lastname: Dulfer
authors.forename: E M W J
authors.initials: EM
authors.lastname: Utens
authors.forename: W A
authors.initials: WA
authors.lastname: Helbing
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D010809:Physical Fitness / Q000502:physiology*; D015397:Program Evaluation; D055815:Young Adult
keywords: Congenital heart disease; Fontan circulation; Obstructive lesions; Physical exercise training programme; Tetralogy of Fallot; Transposition of great arteries