先心病与运动.pptVIP

Lynne Kendall Exercise congenital heart disease 2009 Sport, exercise congenital cardiac conditions Lynne Kendall Clinical Specialist Physiotherapist June 2009 Is exercising good for everyone? What do you think re exercise: Who needs to exercise? How much? How often? What type? How much exercise? Public health guidelines for children: Recommend 60 minutes (daily total, it can be done in 15” chunks) of moderate level activity on most days of the week (minimum of 5). ‘Moderate’ level means enough to make you breathe harder (bit ‘puffed out’) feel warmer. Exercise intolerance common in CHD Due to individual cardiac anatomy physiology and differences in how the heart circulation work during exercise Other factors such as: habitual low level physical activity; exercise not encouraged or allowed in childhood; possible overprotection or apathy in some schools What do we know?Problems in Adult CHD - lessons to be learned? Poor exercise tolerance /or low habitual PA may ‘mask’ changes in cardiac function ACHD px’s ‘used to’ poor ex tolerance and may not c/o symptoms until advanced changes in heart function Misconceptions: exercise; ‘cured’ condition Other factors: Overweight; unfit; ‘deconditioning’ → long-term consequences on health? Types of Exercise Dynamic or isotonic exercise Changes in muscle length joint movement, rhythmic contractions [steady state] Static or isometric exercise Sudden, large intramuscular force, little/no change in muscle length/joint movement [Most activities involve a combination of the two] Exercise and congenital cardiac defects Problems can be due to 3 main factors: Limitations due to the nature of the cardiac condition Restrictions imposed by clinicians because of the condition (safety) ‘Other’ restrictions or misconceptions re exercise Condition (symptom) limited Many conditions are ‘symptom limited’ Often complex conditions e.g. Fontan; HLHS; PHT… Reduced exercise tolerance