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Determinants of Physical Fitness in Children with Repaired Congenital Heart Disease

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Abstract

The aim of this study was to determine factors associated with physical fitness (PF) in children who underwent surgery for congenital heart disease (CHD). Sixty-six children (7–14 years) who underwent surgery for ventricular septal defect (n = 19), transposition of great arteries (n = 22), coarctation of aorta (n = 10), and tetralogy of Fallot (n = 15) were included. All children performed PF tests: cardiorespiratory fitness, upper- and lower-limb muscle strength, speed, balance, and flexibility. Cardiac evaluation was done via echocardiography and cardiopulmonary exercise test. Factors related to child’s characteristics, child’s lifestyle, physical activity motivators/barriers, and parental factors were assessed. Linear regression analyses were conducted. The results showed no significant differences in physical activity (PA) level by CHD type. Boys had better cardiorespiratory fitness (difference = 1.86 ml/kg/min [0.51;3.22]) and were more physically active (difference = 19.40 min/day [8.14;30.66]), while girls had better flexibility (difference = − 3.60 cm [− 7.07;− 0.14]). Physical activity motivators showed an association with four out of six PF components: cardiorespiratory fitness, coefficient = 0.063 [0.01;0.11]; upper-limb muscle strength, coefficient = 0.076 [0.01;0.14]; lower-limb muscle strength, coefficient = 0.598 [0.07;1.13]; and speed, coefficient = 0.03 [0.01;0.05]. Age, sex, and motivators together reached a maximum adjusted R2 = 0.707 for upper-limb strength. Adding other possible determinants did not significantly increase the explained variance. Apart from age and sex as non-modifiable determinants, the main target which might improve fitness would be the introduction of an intervention which increases the motivation to be active.

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Acknowledgements

We would like to express our gratitude to Ilse Coomans from the Pediatric cardiology department for supervising cardiopulmonary exercise test and Lisa Vynckier from the Public health department for field work assistance.

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The authors received no specific funding for this work.

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Authors and Affiliations

  1. Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium

    Mahmoud Zaqout

  2. Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium

    Mahmoud Zaqout, Stefaan De Henauw & Nathalie Michels

  3. Department of Pediatric Cardiology, Ghent University Hospital, Ghent, Belgium

    Kristof Vandekerckhove, Daniel De Wolf & Joseph Panzer

  4. Department of Cardiac Surgery, Ghent University Hospital, Ghent, Belgium

    Thierry Bové & Katrien François

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  1. Mahmoud Zaqout
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Contributions

MZ conceptualized and designed the study, analyzed and interpreted the data, and drafted the initial manuscript; NM and DDW contributed to study conception and design, acquisition of data, interpretation of data, and review and revision of the manuscript. KV, JP, KF, TB, and SDH contributed to study conception and design, interpretation of data, and detailed review and revision of the manuscript, and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Mahmoud Zaqout.

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Zaqout, M., Vandekerckhove, K., De Wolf, D. et al. Determinants of Physical Fitness in Children with Repaired Congenital Heart Disease. Pediatr Cardiol 42, 857–865 (2021). https://doi.org/10.1007/s00246-021-02551-y

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