Home-Based Long-Term Cardiopulmonary and Inspiratory muscle Training for Children and Adults with Fontan's Circulation. An Intermediate Result

Objectives: Cardiopulmonary function training, as well as inspiratory muscle training in patients with Fontan's circulation, seems to be very important in improvement of the duration of the stable hemodynamics and quality of life. A specialized long-term home-based Fontan's physical and respiratory training program was introduced in our institution to verify these hypotheses.

Methods: Eighteen patients with Fontan's circulation have been included in a 22-month individually adapted bicycle-ergometer training program, as well as a daily inspiratory muscle training, with a hand-held training gadget. The bicycle training volume includes 90 minutes per week split up in 3 to 6 training units for 15 or accordingly 30 minutes. Compliance, heart rate, and activity are determined by activity trackers and training journals. According to the study design, follow-up visits are planned at 4- to 6-month intervals including cardiopulmonary exercise testing (CPET), body plethysmography, and standardized quality of life questionnaires with following readjustment of patients' individual training schedule.

Result: All patients (age, 11–43, 56% male and 50% adults) have reached the 10-month benchmark. Intermediate results of CPET and inspiratory muscle strength have been analyzed and showed significant increase of the maximum workload (mean: 1.91 ± 0.15–2.14 ± 0.18 W/kg [p = 0.017]), whereas the improvement in cardiopulmonary capacity (VO2max, mean: 26.07 ± 2.13–27.55 ± 1.92 mL/min/kg [p = 0.262]) in the total study population was not statistically significant. Otherwise, in adolescents and adults, values for VO2max improved significantly (mean: 22.02 ± 1.61–25.53 ± 2.34 mL/min/kg; p = 0.014). Body plethysmography showed significant improvement of the inspiratory muscle training (mean: 6.75 ± 0.6–8.85 ± 0.9 kPa; p = 0.002).

Conclusion: The specialized long-term home-based Fontan's training program seems to be realizable and effective. After the first half of testing period, we can already state a statistical significant effect in inspiratory muscle strength, maximum workload, and cardiopulmonary capacity, especially in adolescents and adults. We hope for further interesting results including analysis of the quality of life after ending the study.

Publication History

Article published online:
21 February 2021