Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
Department of Paediatrics, Division of Cardiology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
J Adolesc Health. 2014 Jul;55(1):65-72. doi: 10.1016/j.jadohealth.2013.12.010. Epub 2014 Feb 8.
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.
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.
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.
Participation in an exercise program improved HRQoL of children with ToF or a Fontan circulation, especially in those with low baseline QoL.
评估运动方案对法洛四联症（ToF）或单心室生理 Fontan 循环患儿健康相关生活质量（HRQoL）的影响。
在荷兰五家儿科心脏病学参与中心开展分层、随机、对照干预研究。共纳入 93 例年龄 10-25 岁、接受过 ToF 外科修复或单心室生理 Fontan 循环手术的患者。按照 2:1 的比例随机分配到运动方案组（每周 3 次，共 12 周）或对照组。随机分配按年龄、性别和心脏诊断分层。在基线和 12 周后随访时，所有参与者都通过网络完成了适合年龄的 HRQoL 问卷。主要分析包括随访期间 HRQoL 的变化。次要分析涉及心脏诊断的影响以及与参考数据的比较。
运动组和对照组分别有 48（86%）和 32（86%）例患者完成了所有基线和随访时的问卷。与对照组相比，年龄在 10-15 岁的运动组患儿在自我报告的认知功能（p <.05，r =.30）和父母报告的社会功能（p <.05，r =.30）方面有显著改善。年龄在 16-25 岁的青少年在 HRQoL 方面没有变化。心脏诊断对预/后变化没有影响。与参考组相比，本研究中的儿童和青少年报告的 HRQoL 相当或更好。
参加运动方案可提高 ToF 或 Fontan 循环患儿的 HRQoL，尤其是那些基线 QoL 较低的患儿。
