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Children with congenital heart disease exhibit seasonal variation in physical activity
Mimi T Y Kuan1,2, Christine Voss1,2, Jimmy Lopez1
1Children's Heart Centre, BC Children's Hospital, Vancouver, British Columbia, Canada.
Insights
Children with congenital heart disease (CHD) show seasonal changes in physical activity. Awareness of these fluctuations is key for accurate assessment and tailored clinical guidance.
Area of Science:
- Pediatrics
- Cardiology
- Exercise Science
Background:
- Children with congenital heart disease (CHD) often have reduced physical activity.
- Understanding seasonal variations in physical activity is crucial for accurate health assessments in this population.
Purpose of the Study:
- To investigate seasonal patterns in physical activity among children with CHD.
- To compare the ability of different measurement tools to capture these seasonal variations.
Main Methods:
- A prospective cohort study involving 156 children (aged 9-16 years) with moderate-to-severe CHD.
- Continuous 1-year monitoring of daily steps using activity trackers (Fitbit Charge 2™).
- One-time assessments using accelerometers (ActiGraph) and physical activity questionnaires.
Main Results:
- Activity trackers revealed seasonal peaks in late spring and autumn, and dips during winter and summer holidays, with daily steps consistently below 12,000.
- Conventional accelerometry indicated 26% met physical activity guidelines, varying by season (Spring: 39%, Summer: 11%, Fall: 20%, Winter: 39%).
- Questionnaires showed walking and running as primary activities, with seasonal differences in their reporting; overall seasonal variation was consistent across children.
Conclusions:
- Physical activity levels in children with CHD exhibit significant seasonal fluctuations.
- Clinicians should consider seasonal variations when assessing and interpreting physical activity data.
- Season-specific counseling on physical activity may enhance management strategies for children with CHD.
Objective:
We sought to identify seasonal variation in physical activity that different physical activity measurement tools can capture in children with congenital heart disease.
Methods:
Data were collected as part of a prospective cohort study at BC Children's Hospital, Vancouver, Canada. Daily step counts of children aged 9-16 years with moderate-to-severe CHD were assessed continuously for 1-year via a commercial activity tracker (Fitbit Charge 2™). Physical activity levels were also assessed conventionally at one time-point via accelerometers (ActiGraph) and physical activity questionnaires.
Results:
156 children (mean age 12.7±2.4 years; 42% female) participated in the study. Fitbit data (n = 96) over a 1-year period clearly illustrated seasonal peaks (late spring and autumn) and dips (winter and summer school holidays) in physical activity levels, with group mean values being below 12,000 steps per day throughout the year. According to conventional accelerometry data (n = 142), 26% met guidelines, which tended to differ according to season of measurement (spring: 39%, summer: 11%, fall: 20%, winter: 39%; p-value = 0.053). Questionnaire data (n = 134) identified that the most widely reported activities were walking (81%) and running (78%) with walking being the highest in summer and fall and running in winter and spring. Furthermore, regardless of overall activity levels the children exhibit similar seasonal variation.
Conclusions:
We demonstrated that physical activity level changes across seasons in children with CHD. It is important to be aware of these fluctuations when assessing and interpreting physical activity levels. Season specific counselling for physical activity may be beneficial in a clinical setting.
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