Systematic review of the effects of physical exercise training programmes in children and young adults with congenital heart disease

Int J Cardiol. 2013 Oct 3;168(3):1779-87. doi: 10.1016/j.ijcard.2013.05.086. Epub 2013 Jun 6.


Background: Most patients with congenital heart disease (ConHD) do not perform regular physical exercise. Consensus reports have stated that exercise should be encouraged and regularly performed in these patients, but this is not common practise. We reviewed the literature on actual evidence for either negative or positive effects of physical exercise training programmes in children and young adults with ConHD.

Methods: Using the Medline database, we systematically searched for articles on physical exercise training programmes in ConHD.

Results: A total of 31 articles met all inclusion criteria; in total, 621 subjects (age range 4 to 45 years) were included. Most studies used training programmes with a duration of 12 weeks. On average, the number of training sessions was 3 times per week. In 12 studies, training intensity was set at a percentage of peak heart rate. Outcome measures reported were PeakVO2, activity levels and muscle strength. Twenty-three studies (72%) found a significant positive change in the main outcome measure after the physical exercise training period. None of the studies reported negative findings related to physical exercise training in ConHD. Cardiac effects have hardly been studied.

Conclusion: In most studies, participation in a physical exercise training programme was safe and improved fitness in children and young adults with ConHD. We recommend that patients with ConHD participate in physical exercise training. Cardiac effects need to be studied more extensively.

Keywords: Congenital heart disease; Fontan circulation; Obstructive lesions; Physical exercise training programme; Tetralogy of Fallot; Transposition of great arteries.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Exercise / physiology*
  • Exercise Therapy / methods*
  • Heart Defects, Congenital / physiopathology
  • Heart Defects, Congenital / rehabilitation*
  • Humans
  • Physical Fitness / physiology*
  • Program Evaluation*
  • Young Adult