"One game they particularly enjoyed was 'punch the doctor,'" says Rhodes, referring to a game in which children threw punches at pieces of matting. "A lot of the kids were timid in the beginning, but they were really moving by the end. Being with other kids with heart disease who had never exercised helped melt away a lot of their anxiety. It was quite a metamorphosis."
Heart rate was checked before each session, and 2 to 3 times during the session. For safety, a pulse oximeter and external defibrillator were available on site, but were never needed.
At the end of the program, 15 of 16 children had significantly improved peak work rate, peak oxygen consumption, or both: their hearts were pumping more blood with each beat, and their muscles were using more oxygen. Improvements were as high as 20 percent on some parameters of function. There were no adverse events.
Rhodes's team also conducted follow-up exercise testing 1 year after the pre-program tests (about 7 months after program completion). The results, now under review for publication, showed that participants' cardiac benefits were sustained, whereas non-participating children showed a slight decline in cardiac function. On questionnaires, participants reported exercising more than in the past and had higher behavioral, emotional and self-esteem scores.
Children's plans to launch a formal cardiac rehabilitation program in fall 2006 or spring 2007, when facilities at Children's Hospital Boston at Waltham a new outpatient specialty center in Waltham, Mass. are complete. Rhodes believes that about two-thirds of children with serious congenital heart disease will be eligible to participate. In the pilot study, fewer than 10 percent of children with reduced exercise capacity had conditions that made it dangerous to exercise.
"With the approval of a pediatric cardiologist, and after careful exercise testing, exercise is gener
Contact: Bess Andrews
Children's Hospital Boston