Heart-defect kids do well with rehab

NEW YORK (Reuters Health) - For children born with serious heart disease, a 12-week cardiac rehabilitation program leads to improvements in exercise capacity that are "consistent, substantial, and sustained," cardiologists at Children's Hospital in Boston report.

Previous trials have documented improved exercise capacity after similar programs but none have evaluated the long-term effects, Dr. Jonathan Rhodes and his associates note in their report in the medical journal Pediatrics.

The current program consisted of 1-hour sessions twice a week for 12 weeks and included stretching, aerobic and light resistance and weight exercises. Patients were encouraged to exercise at home at least twice more each week.

To promote motivation, the program included games and small prizes, as well as a monetary reward after the last evaluation, the team explains.

The 15 patients underwent exercise tests prior to the program, again two weeks after it had ended, and finally four to nine months later. Test results were compared with those of 18 similar children who were unable to participate in the program.

The researchers saw that the exercise function of the study subjects was maintained until the last test, approximately 7 months after completing the program. Improvements in peak work rate, peak exercise heart rate and blood pressure, and respiratory efficiency remained at the final follow-up.

The magnitude of improvements ranged from 7.8 percent to 21.8 percent compared with measurements taken at the start of the program. No significant differences were observed during the same period in the comparison group.

Scores on a standard questionnaire improved significantly in the areas of self-esteem, behavior, and emotional state among the rehabilitation participants, but declined slightly in the other children.

The team notes that the rehabilitation program did not lead to exercise capacity in the normal range. Nevertheless, they maintain that the results were "substantial and clinically significant" and this kind of rehab program "should be incorporated into the care plan of these patients."

SOURCE: Pediatrics, September 2006.