Cardiac rehabilitation in the paediatric Fontan population: development of a home-based high-intensity interval training programme. (27th October 2020)

• Record Type: Journal Article
• Authors: Khoury, Michael; Phillips, Devin B.; Wood, Peter W.; Mott, William R.; Stickland, Michael K.; Boulanger, Pierre; Rempel, Gwen R.; Conway, Jennifer; Mackie, Andrew S.; Khoo, Nee S.
• Is Part Of: Cardiology in the young. Volume 30:Number 10(2020)
• Page Start: 1409
• Page End: 1416
• Publication Date: 2020-10-27
• Subjects: Cardiac rehabilitation, -- Fontan, -- high-intensity interval training, -- telemedicine; Pediatric cardiology -- Periodicals; 618.9212
• DOI: 10.1017/S1047951120002097
• Languages: English
• ISSNs: 1047-9511

Abstract

Abstract: Introduction: We evaluated the safety and feasibility of high-intensity interval training via a novel telemedicine ergometer (MedBIKE™) in children with Fontan physiology. Methods: The MedBIKE™ is a custom telemedicine ergometer, incorporating a video game platform and live feed of patient video/audio, electrocardiography, pulse oximetry, and power output, for remote medical supervision and modulation of work. There were three study phases: (I) exercise workload comparison between the MedBIKE™ and a standard cardiopulmonary exercise ergometer in 10 healthy adults. (II) In-hospital safety, feasibility, and user experience (via questionnaire) assessment of a MedBIKE™ high-intensity interval training protocol in children with Fontan physiology. (III) Eight-week home-based high-intensity interval trial programme in two participants with Fontan physiology. Results: There was good agreement in oxygen consumption during graded exercise at matched work rates between the cardiopulmonary exercise ergometer and MedBIKE™ (1.1 ± 0.5 L/minute versus 1.1 ± 0.5 L/minute, p = 0.44). Ten youth with Fontan physiology (11.5 ± 1.8 years old) completed a MedBIKE™ high-intensity interval training session with no adverse events. The participants found the MedBIKE™ to be enjoyable and easy to navigate. In two participants, the 8-week home-based protocol was tolerated well with completion of 23/24 (96%) and 24/24 (100%) of sessions, respectively, and no adverse events across the 47 sessions in total. Conclusion: The MedBIKE™ resulted in similar physiological responses as compared to a cardiopulmonary exercise test ergometer and the high-intensity interval training protocol was safe, feasible, and enjoyable in youth with Fontan physiology. A randomised-controlled trial of a home-based high-intensity interval training exercise intervention using the MedBIKE™ will next be undertaken.