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Published on: June 5, 2019
Physical activity evaluation in children with congenital heart disease
Christine Voss1, Kevin C Harris1
1Division of Cardiology, Department of Pediatrics, University of British Columbia, British Columbia, Canada.
Insights
Accurate physical activity measurement in children with congenital heart disease (CHD) is crucial for promoting cardiovascular health. This overview details clinical tools for assessing activity levels to guide exercise and counselling.
Area of Science:
- Pediatric Cardiology
- Exercise Science
- Rehabilitation Medicine
Background:
- Advances in congenital heart disease (CHD) management improve survival, increasing focus on physical activity for long-term health.
- Optimizing physical activity in children with CHD is essential for healthy development and cardiovascular well-being.
- Clinical evaluation of physical activity is recommended for tailored counselling and exercise prescription.
Purpose of the Study:
- To provide an overview of physical activity measurement techniques for children with CHD within a clinical setting.
- To discuss the utility and limitations of various measurement tools for pediatric populations with cardiac conditions.
- To inform clinicians on selecting appropriate methods for assessing physical activity in routine care.
Main Methods:
- Review of objective and subjective methods for physical activity assessment.
- Discussion of accelerometers, pedometers, wearable activity trackers, and questionnaires.
- Consideration of exercise testing in relation to habitual physical activity measurement.
Main Results:
- Objective measures like accelerometers provide detailed data but are costly and require expertise.
- Pedometers offer a cost-effective alternative, though step counts have limitations for guideline comparison.
- Wearable activity trackers provide valid estimates and enable remote monitoring, while questionnaires are time- and cost-efficient but prone to recall bias.
- Routine exercise testing assesses functional status, not habitual physical activity.
Conclusions:
- Understanding the spectrum of physical activity measurement tools is vital for clinicians managing children with CHD.
- Appropriate selection of measurement techniques can optimize physical activity counselling and exercise prescription.
- Integrating physical activity assessment into clinical care supports improved cardiovascular health outcomes in pediatric CHD patients.
Abstract:
Significant advances in the management of children with congenital heart disease (CHD) have resulted in marked improvements in survival and life expectancy. Thus, there is an increased emphasis on promoting physical activity to optimise healthy development and long-term cardiovascular health. Evaluation of physical activity levels as part of ongoing clinical care is recommended to facilitate physical activity counselling and/or exercise prescription. Physical activity is a complex health behaviour that is challenging to evaluate. We provide an overview of techniques for measuring physical activity in children with CHD with a focus on how to do this in the clinical context. Accelerometers are devices that objectively assess intensity and duration of physical activity under free living conditions. They enable evaluation against physical activity guidelines, but are costly and require advanced technical expertise. Pedometers are a simple-to-use and cost-effective alternative, but an outcome metric of daily step count limits classification against guidelines. Commercial wearable activity trackers offer an appealing user experience and can provide valid estimates in children. Furthermore, activity trackers enable remote monitoring of physical activity levels, which may facilitate exercise prescription and activity counselling. Questionnaires are the most cost-effective and time-effective method, but recall error in younger children is a consideration. Routine exercise testing in children with CHD provides important insight into functional status but should not be viewed as a proxy measure of habitual physical activity. Understanding the spectrum and role of physical activity measurement tools is important for clinicians focused on optimising cardiovascular health in children with CHD.
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