Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.
Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia; Queensland Paediatric Cardiac Service, Queensland Children's Hospital, Brisbane, Queensland, Australia.
Am Heart J. 2022 Nov;253:1-19. doi: 10.1016/j.ahj.2022.06.006. Epub 2022 Jun 26.
While exercise training is beneficial in the prevention and management of many chronic diseases, the role of exercise training in children and adolescents with congenital heart disease is less understood. We sought to determine the safety and efficacy of exercise training in children and adolescents with congenital heart disease.
We conducted a systematic search of the following databases: PubMed, CINAHL, EMBASE, Web of Science and SportDiscus. We included randomised controlled trials that incorporated an exercise intervention compared with a non-exercising comparator group and examined safety and efficacy in children and adolescents with congenital heart disease. A descriptive analysis of the included trials was then conducted.
A total of 9 articles from 6 trials (642 participants with varying conditions and disease severity) were included. Significant variability of study participants and outcomes were observed across the trials. No adverse events linked to the exercise interventions were stated. The articles reported numerous positive changes to clinically relevant fitness measures. Exercise capacity improved with exercise training in 3 of 4 trials in which it was measured. Cardiorespiratory fitness showed improvements in 3 of 4 trials. Neuromuscular fitness increased in 1 of 2 trials. Physiological and metabolic parameters were improved, and negative changes were not observed to several clinically important measures (e.g. muscular oxygenation, cardiac measures) in 2 of 2 trials. Physical activity increased in 1 of 3 trials. No articles reported on changes in measures of body composition. Outcomes are varied with little consensus on measurements or assessment methods.
Exercise training appears to be safe and efficacious for improving physical fitness in children and adolescents with congenital heart disease who have been appropriately screened by their medical team. However, the certainty of the evidence for these findings is low to moderate.
尽管运动训练有益于预防和管理许多慢性疾病，但运动训练在先天性心脏病儿童和青少年中的作用却知之甚少。我们旨在确定运动训练在先天性心脏病儿童和青少年中的安全性和有效性。
我们对以下数据库进行了系统检索：PubMed、CINAHL、EMBASE、Web of Science 和 SportDiscus。我们纳入了将运动干预与非运动对照组进行比较，并检查了先天性心脏病儿童和青少年安全性和有效性的随机对照试验。然后对纳入的试验进行了描述性分析。
共有来自 6 项试验的 9 篇文章（642 名患有不同疾病和疾病严重程度的参与者）被纳入。各试验之间的研究参与者和结果存在明显的差异。没有报道与运动干预相关的不良事件。这些文章报告了许多与临床相关的健身指标的积极变化。在 4 项有测量的试验中，有 3 项试验显示运动训练可提高运动能力。在 4 项试验中有 3 项试验显示心肺功能有改善。在 2 项试验中有 1 项试验显示神经肌肉功能增加。生理和代谢参数得到改善，在 2 项试验中没有观察到对几个重要临床指标（如肌肉氧合、心脏指标）的负面变化。在 3 项试验中有 1 项试验显示身体活动增加。没有文章报告身体成分测量值的变化。结果各不相同，对于测量或评估方法缺乏共识。
运动训练似乎是安全有效的，可以提高经过医疗团队适当筛查的先天性心脏病儿童和青少年的身体健康水平。但是，这些发现的证据确定性为低到中度。
