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Cardiac rehabilitation in the paediatric Fontan population: development of a home-based high-intensity interval training programme

Published online by Cambridge University Press:  27 July 2020

Michael Khoury Open the ORCID record for Michael Khoury [Opens in a new window] ,
Devin B. Phillips ,
Peter W. Wood ,
William R. Mott ,
Michael K. Stickland ,
Pierre Boulanger ,
Gwen R. Rempel Open the ORCID record for Gwen R. Rempel [Opens in a new window] ,
Jennifer Conway ,
Andrew S. Mackie  and
Nee S. Khoo
Michael Khoury*
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta, Canada
Devin B. Phillips
Affiliation:
Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
Peter W. Wood
Affiliation:
Division of General Internal Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
William R. Mott
Affiliation:
Department of Computing Science, Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
Michael K. Stickland
Affiliation:
Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
Pierre Boulanger
Affiliation:
Department of Computing Science, Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
Gwen R. Rempel
Affiliation:
Faculty of Health Disciplines, Athabasca University, Alberta, Canada
Jennifer Conway
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta, Canada
Andrew S. Mackie
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta, Canada
Nee S. Khoo
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Stollery Children’s Hospital, University of Alberta, Edmonton, Alberta, Canada
*
Author for correspondence: Michael Khoury, MD FRCPC, Assistant Professor, Pediatric Cardiology, Department of Pediatrics, Stollery Children’s Hospital, 8440-112th St. NW, Edmonton, ABT6G 2B7, Canada. Tel: +1 (780) 407-8361; Fax: +1 (780) 407-3954. E-mail: Khoury1@ualberta.ca
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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.

Keywords

Cardiac rehabilitationFontanhigh-intensity interval trainingtelemedicine
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 10 , October 2020 , pp. 1409 - 1416
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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