[Evaluation of the effectiveness and safety of aerobic cyclical trainings in children after surgical correction of congenital heart diseases and features of short-term adaptation depending on the type of pathology].

Abstract

Aerobic cyclical trainings in children with congenital heart diseases (CHDs) are insufficiently covered in the literature. Nevertheless, they are the most effective and safe for improvement of aerobic capacity in case of individually adjusted intensity of the load and with a strict pulse control during the exercises.

Objective: To evaluate the effectiveness and safety of aerobic cyclical trainings on cycle ergometers in children in the long term after surgical correction of CHDs and to study the features of short-term adaptation of the child's body to exercises on stationary bicycles in setting of rehabilitation center depending on the type of CHD.

Material and methods: The study included 80 children with CHDs aged between 10 and 17 years in the long term after Fontan procedure, aortic valve replacement, surgical correction of aortic coarctation or septal defects hospitalized for rehabilitation course in 2023. Intensity of exercises on stationary bicycles was determined based on clinical examination results in the absence of contraindications. The trainings were performed under the control of electrocardiography, tonometry and oxygen saturation; the intensity of exercises was automatically adjusted depending on the reaction of the cardiovascular system to the load.

Results: Anthropometric and anamnestic data of the studied group were analyzed. Low physical activity was characteristic of most children with CHDs, that has affected the results of exercise tolerance test. A number of trainings equal from 6 to 9 (Me=6) were performed during the course of cardiac rehabilitation. A statistically significant increase in the load in training sessions during hospitalization, comparing the first exercise both with the last training (p=0.05) and with one with the maximum capacity (p<0.001), has been found. The dynamics of load in trainings according to the type of CHD was analyzed, including a deeper analysis of subgroups of children after Fontan procedure, as well as individual clinical examples of examinations and trainings of children with different CHDs in case of re-hospitalization were presented. No adverse events were noted during the study.

Conclusion: Aerobic cyclical trainings on cycle ergometer are safe for children with CHDs with adequately selected intensity of trainings. The performed study allowed to indicate the features of «urgent» adaptation to exercises on cycle ergometers in adolescents with different CHDs and to develop the theme of formation of adaptive mechanisms to physical load.