Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium.
Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
Pediatr Cardiol. 2021 Apr;42(4):857-865. doi: 10.1007/s00246-021-02551-y. Epub 2021 Jan 23.
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 R = 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.
本研究旨在确定与接受先天性心脏病（CHD）手术的儿童体能相关的因素。共纳入 66 名接受室间隔缺损（n=19）、大动脉转位（n=22）、主动脉缩窄（n=10）和法洛四联症（n=15）手术的儿童。所有儿童均进行了体能测试：心肺适能、上下肢肌肉力量、速度、平衡和灵活性。通过超声心动图和心肺运动试验进行心脏评估。评估与儿童特征、儿童生活方式、体力活动促进因素/障碍以及父母因素相关的因素。进行线性回归分析。结果显示，不同 CHD 类型之间的体力活动（PA）水平无显著差异。男孩心肺适能较好（差值=1.86ml/kg/min[0.51;3.22]），体力活动更活跃（差值=19.40min/天[8.14;30.66]），而女孩灵活性更好（差值=-3.60cm[-7.07;-0.14]）。体力活动促进因素与六项体能成分中的四项相关：心肺适能，系数=0.063[0.01;0.11]；上肢肌肉力量，系数=0.076[0.01;0.14]；下肢肌肉力量，系数=0.598[0.07;1.13]；速度，系数=0.03[0.01;0.05]。年龄、性别和促进因素共同达到上肢力量最大调整 R²=0.707。添加其他可能的决定因素并不能显著增加解释的方差。除年龄和性别作为不可变决定因素外，提高适应性的主要目标可能是引入一项增加活动积极性的干预措施。
