Cardiol Young 2000; 10: 107-114 © Greenwich Medical Media Ltd. ISSN 1047-9511 Original Article Effect of physical training in children and adolescents with congenital heart disease Per Morten Fredriksen, 1 N. Kahrs, 2 S. Blaasvaer, 3 E. Sigurdsen, 4 O. Gundersen, 4 O. Roeksund, G. Norgaand,' J.T. Vik, 6 O. Soerbye," F. Ingjer, 8 E. Thaulow 1 'Pediatm Heart Section, The National Hospital, University of Oslo: 'Department of Sport and Social Science, Norwegian University of Sport and Physical Education; ^Beitostolen Healtbsports Centre; 4 Valnesfjord Rehabilitation Hospital, Fauske; ^Department of Pediatrics. Haukeland Hospital, Bergen; b Dep. of Physical Medicine and Rehabilitation, University Hospital of Trondheim; Region Center for Education and Research, Center for Child and Adolescent Psychiatry, University of Oslo; ^Laboratory of Physiology, Nonvegian University of Sport and Physical Education, Oslo, Norway Abstract In order to test the effect of systematic supervised physical training, we divided a total of 129 children and adolescents with congenital heart disease into a group undergoing intervention and a control group. All patients underwent exercise tests, measurements of physical activity, and a survey of psychosocial factors. An improvement in uptake of peak level of oxygen was observed after intervention. There was also an improvement in physical activity in both groups measured by a monitor, although this was significant only in those with intervention. The psychosocial scales measured by the Child Behavior Checklist showed a decrease in internalizing scores for those subjected to intervention. This was decreased due to decreased withdrawal and somatic complaints. In conclusion, we recommend systematic supervised training, including testing of routine follow-ups, in patients with congenital heart disease. Keywords Children, adolescents, physical exercise, activity level, psychosocial behavior P HYSICAL ACTIVITY AND PHYSICAL FITNESS ARE important factors for the assessment of health. The level of physical activity achieved in adulthood may depend on regular activity during childhood and adolescence. 1 Physical activity positively influences obesity, level of choles- terol, self-efficacy and stress, and is beneficial for preservation of acquired cardiac disease. 1 In children and adolescents with congenital heart disease, any acquired cardiac disease will complicate the outcome. It is important to actively stimulate physical activity in patients with congenital heart disease in children and adults. There is an ongoing discussion whether growing children achieve any benefit from physical training. 2 Growth often precludes assessment of Correspondence to Per Morten Frednksen, Pcdiatrit Heart Section, The National Hospital Piiestredet *>2, 00 2~! Oslo, Norway, Tel +-T 22 86 90 92, Fax +47 22 86 91 01, E-mail permfO' galenos uio no Accepted for publication 2"" September 1999 physical fitness and the effect of training in children and adolescents. The problem has been to separate the effects of training from growth and matu- ration. 3 Peak uptake of oxygen is often used to measure physical fitness. It is claimed that healthy trained children exhibit higher level of uptake than healthy untrained children, provided training programs are of sufficient intensity, frequency and duration.' Few studies however, have been carried out in children and adolescents with congenital heart disease. Little data are available regarding either physio- logical or psychological effects of training, but the development of behavioral functions may be dependent upon physical activity and physical fitness. 5 Thus when studying the effect of training in children and adolescents, psychosocial factors should also be examined. The aim of our study, therefore, was to assess the effects of systematic, supervised physical training in patients with congenital heart disease on aerobic capacity, physical activity level and psychosocial behavior.