Exercise for Children and Adults Living with Moderate and Complex Congenital Heart Disease: Adaptations, Barriers and Interventions

Abstract

Advances in medical care have shifted the focus for individuals living with moderate to complex congenital heart disease (CHD) from improving survival to optimising long-term health outcomes. Regular physical activity is essential for improving exercise capacity, muscle function, body composition and psychosocial wellbeing. This thesis examines barriers and facilitators to physical activity participation in the CHD cohort, evaluates telehealth exercise programs, assesses physiological and behavioural outcomes following exercise interventions, and explores participant experiences to inform future program design.

A review of the literature highlights CHD-related comorbidities, barriers and facilitators to exercise engagement and the importance of lifelong physical activity participation. In Chapter 3 we sought to investigate the feasibility of a telehealth delivered supervised exercise intervention for young children with CHD and their families. In Chapter 4 we aimed to explore the changes in submaximal exercise capacity, muscular strength and body composition following a 4-month face-to-face delivered exercise intervention in children. In Chapter 5 we analysed preliminary physical activity data generated from our clinical trial, CH-FIT to understand shifts in habitual physical activity and sedentary behaviour following a 4-month supervised exercise intervention in children and adults. In Chapter 6 we explored experiences of participation in our adult supervised exercise program.

Collectively, these findings highlight the feasibility of telehealth exercise delivery and underpin the importance of tailored, developmentally appropriate and family-supported interventions to promote sustained physical activity participation in individuals living with CHD.