A new "complex exercise test" for children with cardiac diseases

In view of the characteristics of children's play or exercise activity, we designed a new method of exercise testing for children, called the "Complex Exercise Test" (CET), which includes three kinds of exercise test: (1) a graded exercise test on the treadmill, (2) a simple bending and stretching test to evaluate momentary exercise tolerance and (3) a swimming test with the ECG in the water. The CET was applied to a total of 25 cases which included 10 cases of postoperative tetralogy of Fallot and 15 cases with ventricular premature contraction (VPC). A two-way exercise test, which included the treadmill test and the simple bending and stretching test, was also applied to 36 postoperative cases (21 cyanotic and 15 non-cyanotic), 20 VPC cases and 16 control children without any organic cardiac disorders, for a total of 72 cases. The treadmill test was useful to evaluate the maximal exercise tolerance. The simple bending and stretching test, on the other hand, seemed useful for observation of VPC changes by exercise (including postoperative VPC), since the heart rate immediately after bending and stretching exceeded that observed at the time VPC disappeared during the treadmill test, thus proving VPC disappearance by this testing. With ECG during diving, it is possible to detect VPC associated with possible risks which could not be identified by the above two methods of testing. Since each one of the three different types of exercise tests has different characteristics, it seems desirable to control children's exercise after performing the CET.