Exercise capacity and muscle strength in patients who have undergone the Fontan procedure: a retrospective follow-up study

Haluk Tekerlek, M. Sağlam, S. N. Selçuk, H. Aykan, N. Vardar Yağlı, Ebru Çalık Kütükcü, Deniz İnal İnce, Tevfik Karagöz
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Abstract

Background. Due to their relationship with clinical progression, follow-up of exercise capacity and muscle strength is important for optimal disease management in patients who have undergone the Fontan procedure. We aimed to retrospectively analyze exercise capacity and muscle strength trajectory over approximately 2 years. Methods. Exercise capacity was assessed using an exercise stress test with the modified Bruce protocol on a treadmill, hand grip and knee extensor strength using a hand dynamometer, and body composition using a bioelectrical impedance device. Exercise capacity, muscle strength, and body composition follow-up data recorded between 2020 and 2022 were compared. Results. Fifteen patients [median age from 17 (first assessment) to 18 years (last assessment), 5 females)] with a 20-month median follow-up time were analyzed retrospectively. There was an increase in weight, height, body mass index, and body fat weight (p<0.05). There was a tendency for increased handgrip strength (%) (p=0.069), but no significant difference was observed in the knee extensor strength of patients during the follow-up period (p>0.05). The changes in heart rate (HR) and oxygen saturation were higher in the last test than in the first test (p<0.05). Maximum HR (HRmax), % predicted HRmax and HR reserve recorded during the test and HR 1 minute after the test were similar between the first and last tests (p>0.05). Conclusions. After 20 months of follow-up, exercise capacity and muscle strength did not decline; instead, the body mass index and fat weight increased. Patients who have undergone the Fontan procedure may not be experiencing a decline in exercise capacity and muscle strength over relatively short time periods during childhood, adolescence, and early adulthood.
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丰坦手术患者的运动能力和肌肉力量:一项回顾性随访研究
背景。由于运动能力和肌力与临床进展的关系,对其进行随访对于优化丰坦手术患者的疾病管理非常重要。我们的目的是回顾性分析约两年的运动能力和肌力轨迹。我们在跑步机上使用改良布鲁斯方案进行运动负荷测试,评估运动能力;使用手部测力计评估手部握力和膝关节伸展肌力;使用生物电阻抗仪评估身体成分。对 2020 年至 2022 年期间记录的运动能力、肌肉力量和身体成分随访数据进行了比较。对 15 名患者(年龄中位数为 17 岁(首次评估)至 18 岁(最后一次评估),5 名女性)进行了回顾性分析,随访时间中位数为 20 个月。体重、身高、体重指数和体脂重量均有所增加(P0.05)。最后一次测试的心率(HR)和血氧饱和度的变化高于第一次测试(P0.05)。经过20个月的随访,运动能力和肌肉力量没有下降,相反,体重指数和脂肪重量有所增加。接受过方坦手术的患者在童年、青春期和成年早期可能不会在相对较短的时间内出现运动能力和肌肉力量的下降。
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