Related Experiment Video
Updated: Jan 18, 2026
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
In-Clinic Activity Promotion for Children With Congenital Heart Disease: Randomized Clinical Trial
Patricia E Longmuir1, Jane Lougheed2, Andrew S Mackie3
1Children's Hospital of Eastern Ontario Research Institute and University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.
Insights
A new in-clinic counseling intervention improved physical activity in children with congenital heart disease. This approach is feasible for clinicians and helps children meet daily activity goals.
Area of Science:
- Pediatrics
- Cardiology
- Exercise Science
Background:
- Children with congenital heart disease (CHD) require effective strategies to promote physical activity.
- Current clinical practice often falls short of recommended physical activity promotion for pediatric CHD patients.
- There is a need for feasible interventions that clinicians can integrate into routine care.
Purpose of the Study:
- To evaluate the feasibility and efficacy of a brief, in-clinic physical activity counseling intervention for children with moderate to severe CHD.
- To assess the impact of the intervention on daily physical activity levels over a 6-month period.
- To determine the healthcare system impacts, including clinician compliance and patient perceptions.
Main Methods:
- A pragmatic, single-blind, multicenter randomized clinical trial involving 155 children (aged 5-17 years) with CHD.
- Intervention group received standardized counseling and kinesiologist support during clinic visits.
- Primary outcome: daily steps measured by pedometer over 6 months; secondary outcomes: counseling rates, visit length, perceptions, referrals.
Main Results:
- Intervention participants maintained daily activity above 12,000 steps, while control group activity declined significantly by month 5.
- Highly active participants at baseline maintained their activity levels in both groups.
- The intervention was feasible, with 97% of participants counseled and no increase in clinic visit duration.
Conclusions:
- A brief, standardized in-clinic counseling intervention with kinesiology support effectively increased and maintained physical activity in children with CHD.
- The intervention is feasible for clinicians, enabling compliance with recommended activity promotion guidelines.
- This approach supports children with CHD in achieving recommended daily physical activity levels.
Background:
An effective in-clinic physical activity counseling intervention is needed to increase physical activity motivation and participation among children with moderate or severe congenital heart disease and enable clinicians to comply with activity promotion recommendations.
Methods:
This pragmatic, single-blind multicenter randomized clinical trial evaluated the intervention feasibility/efficacy among children aged 5-17 years. Clinicians delivered key messages, encouraged activity questions and discussion, and provided kinesiologist support. The primary outcome was daily activity (PiezoRx pedometer steps), assessed after the clinic visit and then monthly for 6 months. Clinic visit length, % counseled, patient/family perceptions, and kinesiology referral assessed health care system impacts.
Results:
A total of 155 children (60 female, 10.8 ± 3.6 years of age) with moderate (n = 119) or severe (n = 36) diagnoses were included in this study. Initial daily step counts, adjusted for age, did not differ between the groups (mean difference = 776 ± 515 steps per day, P = 0.13). Typically active intervention participants' mean daily steps over 6 months (adjusted for baseline age, sex, season, and steps) were stable above 12,000 steps per day. Typically active control steps declined, becoming significantly below intervention participants by month 5 (P = 0.006). Highly active participants at baseline (>14,000 steps per day) in both study groups maintained their activity (P = 0.91). Virtually all (97%) intervention participants were counseled, and the clinic visit duration did not differ by group (P = 0.95).
Conclusions:
Over 6 months, participants receiving a brief, standardized in-clinic activity counseling intervention with on-going kinesiology support were more likely to achieve the recommended daily physical activity. Counseling was feasible for clinicians to deliver during a routine clinic visit enabling compliance with recommended practice.
Clinical Trial Registration:
ClinicalTrials.gov #NCT03435354.
Related Concept Videos
01:11Clinical Trials: Overview
01:16Clinical Trials
There are four phases in a clinical trial. A phase one...
01:26Coronary Artery Disease IV: Preventive Measures
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:26Heart Failure Drugs: Inotropic Agents
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...