The effect of rehabilitation therapy in children with intervened congenital heart disease: a study protocol of randomized controlled trial comparing hospital and home-based rehabilitation

Abstract

[Abstract] Background/Objectives: Children who suffer from congenital heart defects (CHDs) have a decreased ability to perform physical exercise and consequently have a decrease in their functional capacity. The main causes of this decrease in functional capacity have been related on the one hand to residual hemodynamic defects and, at the same time, to a situation of physical deconditioning due to inactivity, as well as problems in lung function, especially the presence of restrictive patterns that influence the amount of O2 insufflated (decreased maximum VO2), consequently generating a deficient maximum O2 consumption and maximum work rate. This represents an important prognostic value, since it constitutes an independent predictor of death and hospitalization. This study aims to determine the benefits obtained regarding respiratory function, exercise capacity, and quality of life after implementing a hospital-based cardio-respiratory rehabilitation program compared to a home-based Cardio-respiratory Physical Activity Program in patients with intervened CHDs.

Methods: This is a randomized controlled trial on the effectiveness of two different rehabilitation programs on respiratory function, exercise capacity, and quality of life in patients with CHDs conducted at the Child Cardiology and Congenital Heart Disease Unit of the University Hospital Complex of A Coruña (CHUAC). There will be two groups: Cardio-respiratory rehabilitation group program conducted in a face-to-face format at the hospital (n = 26) and a study group that follows a home-based Cardio-respiratory Physical Activity Program (TELEA) (n = 26). The measurement variables will be respiratory function, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), maximum expiratory flow (PEF), the Tiffeneau index (FEV1 /FVC), forced expiratory flow (FEF25%, FEF50%, FEF75%, FEF25-75%), exercise capacity (peak VO2), and the quality of life of these children and their families.

Conclusions: The implementation of cardiac and pulmonary rehabilitation programs in children with CHDs is essential to improve their quality of life, exercise tolerance, and socialization. These programs optimize life expectancy and promote integration, being crucial for their physical and emotional well-being.