Supported Exercise programme for Adults with Congenital Heart disease (SEACHange)

Purpose

Congenital heart disease is a lifelong condition. Many patients will require repeated open heart surgeries during their lifetime and others may go on to develop heart failure, arrhythmia or other problems associated with acquired heart disease. The benefits of regular exercise are well known. The overall aim of this pilot study is to determine the feasibility of introducing a supported exercise programme in to clinical practice to support physical and psychological well being in adults with congenital heart disease living in Scotland.

80%
Group 1 - Ten patients were recruited and eight completed the programme.
83%
Group 2 - 18 patients were recruited and 15 completed the programme.
Group 1 participants (n=10)
were supplied with a Powerbreathe inspiratory muscle trainer and a Salaso exercise programme.

Group 2 participants (n=18)
were given a daily step goal and a Salaso exercise programme.

Approach

Patients attending the Adult Congenital Heart Disease review clinic in GJNH were given a patient information leaflet explaining the purpose of the pilot study with contact details if they wished to take part. Those who volunteered were initially assessed using a 6 minute walk test to identify the appropriate group for their baseline level of fitness. Group 1 participants walked less than 450m and Group 2 more than 450m. Further baseline measurements (Grip strength, Bicep strength, Quad strength, PHQ-9, GAD-7 and BMI) were also completed for both groups. In addition SNIP testing was completed for the Group 1 participants.

Group 1 participants (n=10) were supplied with a Powerbreathe inspiratory muscle trainer and a Salaso exercise programme.

Group 2 participants (n=18) were given a daily step goal and a Salaso exercise programme.

Outcomes

The baseline measurements were repeated for both groups after 12 weeks.

Results: Group 1 - Ten patients were recruited and eight completed the programme (80%).Group 2 - 18 patients were recruited and 15 completed the programme (83%)

Improvements were found across measurements in both groups, with the largest gains in the Group 1 participants.

Cost and savings

The project cost was £2000. 

Implications

Exercise in the adult cardiac congenital population is safe and effective when patients are given guidance and structure. There are both physical and psychological benefits which may have an economical benefit to the health service. This is an area which warrants further exploration in a larger congenital population.

We anticipate this pilot will help establish a programme that will help to improve the way we support adults who were born with a heart condition to participate in physical activity on a long term basis.

Top three learning points

  1. Congenital cardiac patients are keen to exercise when given structure.
  2. In most cases they have the capacity to improve like their peers.
  3. Our preconceived ideas about their exercise tolerance often does not match theirs.

Fund acknowledgements

This work was funded by Professor Hillis Adult Congenital Fund. 

Additional notes

This work was presented at Physiotherapy UK 2019.

Please see the attached Innovations poster below. 

 

For further information about this work please contact Shelagh Brown.