title: Aerobic exercise influences quality of life of children and youngsters with congenital heart disease: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate effects of an exercise program on health-related quality of life (HRQoL) in children and adolescents with tetralogy of Fallot (ToF) or a Fontan circulation.
  
  
  METHODS
  Stratified, randomized, controlled intervention study conducted in five participating centers of pediatric cardiology in The Netherlands. In total, 93 patients, aged 10-25 years, with surgical repair for tetralogy of Fallot or with a Fontan circulation for single-ventricle physiology were included. They were randomly allocated with a ratio of 2:1 to: (1) a 12-week period with an exercise program for 3 times per week or (2) to a control group. Randomization was stratified by age, gender, and cardiac diagnosis. At baseline and follow-up after 12 weeks, all participants completed Web-based age-appropriate HRQoL questionnaires. Primary analyses involved change in HRQoL during follow-up. Secondary analyses concerned influence of cardiac diagnosis and comparison with normative data.
  
  
  RESULTS
  Forty-eight (86%) and 32 (86%) patients in the exercise-group and control-group respectively completed all questionnaires at baseline and follow-up. Compared with the control-group, children, aged 10-15 years, in the exercise-group improved significantly on self-reported cognitive functioning, p < .05, r = .30, and parent-reported social functioning, p < .05, r = .30. Youngsters aged 16-25 years did not change their HRQoL. Cardiac diagnosis had no influence on pre/post changes. Children and youngsters in this study reported comparable or better HRQoL than norm groups.
  
  
  CONCLUSIONS
  Participation in an exercise program improved HRQoL of children with ToF or a Fontan circulation, especially in those with low baseline QoL.
authors: Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors: Karolijn
authors: K
authors: Dulfer
authors: Department of Paediatrics, Division of Cardiology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors: Nienke
authors: N
authors: Duppen
authors: Department of Pediatric Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors: Irene M
authors: IM
authors: Kuipers
authors: Department of Pediatric Cardiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors: Michiel
authors: M
authors: Schokking
authors: Department of Cardiology-Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Ron T
authors: RT
authors: van Domburg
authors: Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors: Frank C
authors: FC
authors: Verhulst
authors: Department of Paediatrics, Division of Cardiology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors: Willem A
authors: WA
authors: Helbing
authors: Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands. Electronic address: e.utens@erasmusmc.nl.
authors: Elisabeth M W J
authors: EM
authors: Utens
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003071:Cognition / Q000502:physiology; D015444:Exercise / Q000502:physiology / Q000523:psychology*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D018729:Fontan Procedure / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009426:Netherlands; D011446:Prospective Studies; D011788:Quality of Life; D012919:Social Behavior; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery; D055815:Young Adult
keywords: Adolescents; Aerobic exercise; Children; Congenital heart disease; Quality of life; Randomized controlled trial; Young adults