Pilot Project: Heart Chargers-A Successful Model for a Home-Based Physical Activity Program Utilizing Telemedicine for Fontan Patients.

Autor: Fernie JC; Children's Hospital Colorado, Heart Institute, Aurora, Colorado, USA., Wylie L; Children's Hospital Colorado, Heart Institute, Aurora, Colorado, USA., Schäfer M; Children's Hospital Colorado, Heart Institute, Aurora, Colorado, USA., Carnegie K; Children's Hospital Colorado, Heart Institute, Aurora, Colorado, USA., Miyamoto SD; Children's Hospital Colorado, Heart Institute, Aurora, Colorado, USA.; Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA., Jacobsen RM; Children's Hospital Colorado, Heart Institute, Aurora, Colorado, USA. Roni.Jacobsen@childrenscolorado.org.; Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA. Roni.Jacobsen@childrenscolorado.org.; Department of Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA. Roni.Jacobsen@childrenscolorado.org.
Jazyk: angličtina
Zdroj: Pediatric cardiology [Pediatr Cardiol] 2023 Oct; Vol. 44 (7), pp. 1506-1513. Date of Electronic Publication: 2023 Jun 22.
DOI: 10.1007/s00246-023-03215-9
Abstrakt: Fontan patients have decreased exercise capacity which further declines throughout adolescence. A positive exercise capacity trajectory in children predicts better adult Fontan outcomes. Hospital-based physical activity programs improve exercise capacity and attenuate the age-expected decline in Fontan patients. The purpose of this project was to investigate the feasibility and safety of a partially reimbursable 12-month, home-based, individualized physical activity program (Heart Chargers) for Fontan patients utilizing telemedicine. The Heart Chargers team included a cardiologist, nurse coordinator, and exercise physiologists. Eligible participants with a Fontan completed a baseline cardiopulmonary exercise test (CPET) and consented to participate in Heart Chargers, a 12-month home-based exercise prescription. The individualized exercise prescription focused on skeletal and respiratory muscle strength training and aerobic activities. Participants received a Garmin© device to monitor adherence. Telephone check-ins ranged from weekly to monthly as participants gained independence. Pre- and post-program CPET and informal surveys of physical activity self-efficacy were completed. Nine participants have completed the Heart Chargers program. There was no pre-post difference in maximal or submaximal oxygen consumption (VO2), peak heart rate, or oxygen saturation. There was a significant pre-post increase in systolic blood pressure (p-value 0.004) and minute ventilation (p-value 0.012) at peak exercise. Per subjective report, exercise-related self-efficacy increased after program completion. There were no adverse events. At present, 7 participants remain actively enrolled in the program. Heart Chargers, a novel, home-based, partially reimbursable, 12-month individualized exercise program using telemedicine was successfully implemented in Fontan patients with no adverse events. The lack of decline in exercise capacity for participants is encouraging.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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