Abstract：
Pediatric cardiac fitness and rehabilitation programs vary widely in structure and content. The Cardiac Fitness Program (CFP) is built on traditional training pillars of aerobic, strength, and flexibility, and adds a fourth, training a positive mindset. This study assesses whether the systematic and comprehensive framework of the CFP results in broad benefits for a range of patients with congenital heart disease (CHD). Data from participants between 01/2017 and 12/2022 were analyzed. Pre- and post-CFP cardiopulmonary exercise test parameters, strength and flexibility metrics, and mindset survey results were compared overall, and by sex, age, diagnosis, and hemodynamic level. Of 62 participants (median age 15.5 years, range 8 to 23, 50% female), 3% had simple, 37% complex, 24% single ventricle CHD, and 35% arrhythmia, cardiomyopathy, or transplant. Significant improvements were noted in aerobic fitness (mean 9 ± 15% increase in % predicted peak oxygen consumption, p < 0.001). Strength metrics significantly improved (each p < 0.001), as did flexibility (p < 0.001). Patient-reported positive mindset scores did not improve significantly (mean increase 1.8 ± 5.1, p = 0.10, n = 25), whereas parents reported significant improvements (5.9 ± 10.4, p = 0.02, n = 20). Improvements were not significantly different by sex, age, diagnosis, or hemodynamic level. Comprehensive training across four pillars of fitness yields significant improvements in aerobic fitness, strength, flexibility, and parent-reported mindset scores for pediatric CHD patients, regardless of patient characteristics, diagnosis type, or severity of hemodynamic limitation. Further study is warranted into optimal standardization of training and whether a comprehensive approach amplifies individual pillars to create more than the sum of its parts.
摘要：
小儿心脏健身和康复计划在结构和内容上差异很大。心脏健身计划（CFP）建立在传统的有氧训练支柱上，力量,和灵活性，并增加了第四个，培养积极的心态。这项研究评估了CFP的系统和全面框架是否为一系列先天性心脏病（CHD）患者带来了广泛的益处。分析了2017年1月至2022年12月的参与者数据。CFP前后心肺运动试验参数，强度和灵活性指标，和心态调查结果进行了总体比较，和性别，年龄,诊断,和血液动力学水平。在62名参与者中(平均年龄15.5岁，范围8到23，50%为女性)，3%有简单,37%复杂，24%单心室CHD,和35%的心律失常,心肌病,或移植。注意到有氧健身方面的显着改善（预测峰值耗氧量平均增加9±15％，p<0.001)。强度指标显著改善(每个p<0.001)，灵活性也是如此(p<0.001)。患者报告的积极心态评分没有显着改善（平均增加1.8±5.1，p=0.10，n=25），而父母报告显着改善（5.9±10.4，p=0.02，n=20）。性别的改善没有显着差异，年龄,诊断,或血液动力学水平。跨越健身四大支柱的综合训练显著改善了有氧健身，力量,灵活性,和家长报告的儿科冠心病患者的心态得分，不管患者特征如何，诊断类型,或血液动力学限制的严重程度。需要进一步研究培训的最佳标准化，以及全面的方法是否可以扩大各个支柱，以创造比各部分总和更多的东西。
