1. Hospital and outpatient rehabilitation for children with heart disease
Dominique Hansen, PhD, FESC

2. Disclosure statement
None to be declared

6. Exercise physiology

7. Exercise physiology

8. Exercise physiology

9. Exercise physiology

10. Exercise physiology

11. Exercise physiology

12. Exercise physiology

13. Exercise physiology
The sympathetic and parasympathetic nervous system, which plays an important role in the modulation of HR during exercise, can be affected by ischemia and/or denervation resulting from surgical procedure or, in cases of cyanotic CHD, by chronic hypoxemia.

14. Impact of surgical repair?

15. But is it safe to execute CPET?
1,037 tests were performed in 916 patients

16. But is it safe to execute CPET?

17. Let’s exercise?

19. Preparticipation screening
Do a good screening, as
Coexisting pulmonary pathology is common among patients with congenital heart
Including restrictive lung disease, obstructive lung disease, diaphragmatic paralysis, recurrent pulmonary infections, etc.
Usually not the main factor limiting exercise capacity, but could contribute to exercise limitation during submaximal effort
Respiratory physiotherapy may therefore improve the congenital heart disease patient’s cardiorespiratory response to exercise
Cardiol Young Jun;22(3):

20. Preparticipation screening
Do a good screening, as
Coexisting neurologic pathology is common among patients with congenital heart
May range from major syndromes such as hemiparesis, cerebral palsy, or epilepsy to more subtle symptoms such as neurodevelopmental delays, learning disabilities, or attention deficit disorders
These disabilities may be appropriate targets for rehabilitation therapy and/or may influence the structure of an individual’s rehabilitation programme.
Cardiol Young Jun;22(3):

21. Preparticipation screening
Do a good screening, as
Coexisting orthopedic pathology is common among patients with congenital heart
Musculoskeletal abnormalities are among the most common extracardiac anomalies associated with congenital heart disease.
Scoliosis and other thoracic deformities, connective tissue disorders, hypotonia, etc. all of which may be relevant to one or more aspects of a patient’s rehabilitation programme
Cardiol Young Jun;22(3):

22. Preparticipation screening

23. Preparticipation screening

24. Preparticipation screening

25. Preparticipation screening

26. How to choose sports? Choose wisely…

27. Recommendations for healthy kids

28. Recommendations for congenital heart disease

29. Recommendations for congenital heart disease

30. Recommendations for congenital heart disease

31. Recommendations for congenital heart disease

32. Syncope during exercise
Some more details…
Syncope during exercise
Always execute futher examination
Avoid the risk to fall
Hypoxia
Use Talk-test and avoid vigorous exercise
Anticoagulants and devices
Avoid contact sports
Ventricular arrhythmias and/or aortic dilation
Low-to-moderate exercise intensities

34. In association with increments in muscle strength

37. Conclusion
Patients with congenital heart should be stimulated to exercise to avoid worsening in CVD risk and physical fitness
A good preparticipation screening is key to optimized exercise prescription
Specific guidelines for exercise in different diseases is available and are, in general, progressive
Exercise intervention is effective to enhance health

38. Contact: dominique.hansen@uhasselt.be