Exercise rehabilitation in pediatric cardiomyopathy☆

Abstract 

Children with cardiomyopathy carry significant risk of morbidity and mortality. New research and technology have brought about advancements to the diagnosis and clinical management of children with cardiomyopathy. However, currently heart transplantation remains the standard of care for children with symptomatic and progressive cardiomyopathy. Cardiovascular rehabilitation programs have yielded success in improving cardiac function, overall physical activity, and quality of life in adults with congestive heart failure from a variety of conditions. There is encouraging and emerging data on its effects in children with chronic illness and with its proven benefits in other pediatric disorders, the implementation of a program for children with cardiomyopathy should be considered. Exercise rehabilitation programs may improve specific endpoints such as quality of life, cardiovascular function and fitness, strength, flexibility, and metabolic risk. With the rapid rise in pediatric obesity, children with cardiomyopathy may be at similar risk for developing these modifiable risk factors. Furthermore, there are potentially more detrimental effects of inactivity in this population of children. Future research should focus on the physical and social effects of a medically supervised cardiac rehabilitation program with correct determination of the dosage and intensity of exercise for optimal benefits in this special population of children. It is imperative that more detailed recommendations for children with cardiomyopathy be made available with evidence-based research.

Keywords: Exercise, Cardiomyopathy, Cardiac rehabilitation, Exercise testing, Cardiac function