In-Clinic Activity Promotion for Children With Congenital Heart Disease: Randomized Clinical Trial

CJC Pediatric and Congenital Heart Disease Pub Date : 2025-06-01 DOI:10.1016/j.cjcpc.2025.01.003

Patricia E. Longmuir PhD , Jane Lougheed MD , Andrew S. Mackie MD , Kambiz Norozi MD, PhD , Jenna Yaraskavitch MHK , Alyssa Chappell BScN, RN , Adam Dempsey PhD , Angelica Blais MSc , Rae Foshaug , Andrew Willan PhD , Jennifer Graham BSc

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Abstract

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.

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促进先天性心脏病患儿的临床活动：随机临床试验

背景：需要一种有效的临床体育活动咨询干预来增加中度或重度先天性心脏病儿童的体育活动动机和参与，并使临床医生遵守活动促进建议。方法本实用的单盲多中心随机临床试验评估5-17岁儿童干预的可行性/有效性。临床医生传递关键信息，鼓励活动问题和讨论，并提供运动学家支持。主要结果是日常活动（PiezoRx计步器步数），在门诊就诊后评估，然后每月评估6个月。门诊就诊时间、接受咨询的百分比、患者/家属的认知和运动学转诊评估了卫生保健系统的影响。结果共纳入155例患儿，其中女性60例，年龄10.8±3.6岁，诊断为中度（119例）和重度（36例）。经年龄调整后的初始每日步数在两组之间没有差异（平均差异= 776±515步/天，P = 0.13）。典型的积极干预参与者在6个月内的平均每日步数（根据基线年龄、性别、季节和步数进行调整）稳定在每天12,000步以上。典型的主动控制步骤下降，到第5个月显著低于干预参与者（P = 0.006）。在两个研究组中，在基线时高度活跃的参与者（每天14,000步）保持了他们的活动（P = 0.91）。几乎所有（97%）的干预参与者都接受了咨询，并且诊所访问时间在组间没有差异（P = 0.95）。在6个月的时间里，接受简短的、标准化的临床活动咨询干预和持续的运动机能学支持的参与者更有可能达到推荐的日常身体活动。咨询是可行的，临床医生提供在常规诊所访问，使遵守推荐的做法。临床试验注册中心clinicaltrials .gov #NCT03435354。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CJC Pediatric and Congenital Heart Disease

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