Physical activity in adolescents and adults with congenital heart defects: individualized exercise prescription

Abstract

Studies in patients with congenital heart disease (CHD) indicate that the majority of individuals participating in such programs achieve significant improvement of their exercise capacity and psychological state.1 The challenge is to ensure safe participation in regular physical activity (PA) in order to avoid the detrimental effects associated with sedentary life style. The improved surgical techniques and clinical care of children with CHD have led to a considerable increase in the population of patients with CHD who reach adulthood, and the number of adults is expected to grow at a rate of 5% per year.2 Cardiac rehabilitation programs in patients with CHD have shown improvements in peak-VO2.3–5 Additionally, regular physical exercise is associated with lower risk of future obesity and ischaemic heart disease.3 Paradoxically, only a minority of CHD patients (19%) receives formal PA advice,4 and are often encouraged towards a sedentary lifestyle as a result of overprotection,5 and uncertainty as to which physical activities and with what intensity should be recommended.1 This is of particular importance when one considers that children with CHD are more likely to be overweight because of physical inactivity compared with children without CHD.6 On the other end of the spectrum, young patients may reject exercise limitations and engage in unsafe sporting practices.