1. Healthy Hearts via Live Videoconferencing: An Exercise and Diet Intervention in Pediatric Heart Transplant Recipients
- Author
-
Jerrid Brabender, L. Barkoff, Angela C. Chen, Katie Jo Stauffer, Faustine D. Ramirez, Jeffrey Kazmucha, S. Stillman Berry, David N. Rosenthal, Donna C. Lee, C. Jason Wang, Susan E. Nourse, Inger Olson, Nancy McDonald, Elif Seda Selamet Tierney, and Sarah C. Couch
- Subjects
Male ,Percentile ,Time Factors ,Saturated fat ,medicine.medical_treatment ,Health Status ,030204 cardiovascular system & hematology ,Pediatrics ,0302 clinical medicine ,endothelial function ,Interquartile range ,Pediatric Cardiology ,030212 general & internal medicine ,Child ,Original Research ,Diet and Nutrition ,Heart transplantation ,education.field_of_study ,Age Factors ,VO2 max ,Treatment Outcome ,Female ,Diet, Healthy ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Adolescent ,Population ,03 medical and health sciences ,Young Adult ,Internal medicine ,medicine ,Humans ,education ,Exercise ,heart transplant ,Telerehabilitation ,Heart Failure ,Transplantation ,business.industry ,Recovery of Function ,Clinical trial ,Videoconferencing ,Feasibility Studies ,Heart Transplantation ,Patient Compliance ,live videoconferencing ,business ,Exercise Testing ,Body mass index ,Risk Reduction Behavior - Abstract
Background Pediatric heart transplant recipients have high‐risk cardiovascular profiles that can affect their long‐term outcomes; however, promoting exercise and healthy diet has not been a major focus in the field. The objective of this study was to test the feasibility and impact of a supervised exercise and diet intervention delivered via live videoconferencing in this population. Methods and Results Patients 8 to 19 years of age at least 1 year post heart transplantation were enrolled. The 12‐ to 16‐week intervention phase included live video–supervised exercise (×3/week) and nutrition (×1/week) sessions. The 12‐ to 16‐week maintenance phase included ×1/week live video–supervised exercise and nutrition sessions and ×2/week self‐directed exercise sessions. Cardiac, vascular, nutritional, and functional health indices were obtained at baseline, after intervention, and after maintenance. Fourteen patients (median age, 15.2; interquartile range, 14.3–16.7 years) at a median of 3.3 (interquartile range, 1.5–9.7) years after heart transplant completed the intervention. Patients attended 89.6±11% of exercise and 88.4±10% of nutrition sessions during the intervention and 93.4±11% of exercise and 92.3±11% of nutrition sessions during maintenance. After intervention, body mass index percentile (median, −27%; P =0.02), endothelial function (median, +0.29; P =0.04), maximum oxygen consumption (median, +2 mL/kg per minute; P =0.002). Functional Movement Screening total score (median, +2.5; P =0.002) and daily consumption of saturated fat (median, −6 g; P =0.02) improved significantly. After maintenance, improvements in maximum oxygen consumption (median, +3.2 mL/kg per minute; P =0.02) and Functional Movement Screening total score (median, +5; P =0.002) were sustained. Conclusions In pediatric heart transplant recipients, a live video–supervised exercise and diet intervention is feasible. Our results demonstrate excellent adherence with significant improvements in cardiovascular and functional health. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 02519946.
- Published
- 2020