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Peripheral and respiratory muscle strength in children and adolescents with CHD: systematic review and meta-analysis

Published online by Cambridge University Press:  06 October 2022

Camila da C. Niedermeyer Open the ORCID record for Camila da C. Niedermeyer [Opens in a new window] ,
Maria Luiza Y. Shizukuishi ,
Camila W. Schaan  and
Janice L. Lukrafka
Camila da C. Niedermeyer*
Affiliation:
Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
Maria Luiza Y. Shizukuishi
Affiliation:
Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
Camila W. Schaan
Affiliation:
Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
Janice L. Lukrafka
Affiliation:
Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
*
Author for correspondence: Camila da Cunha Niedermeyer, Rua Sarmento Leite, 245 - Centro Histórico, Porto Alegre, RS 90050-170, Brazil. E-mail: [email protected]
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Abstract

Patients with CHD are less active if compared with controls and have limited functional capacity, related to muscle weakness and fatigue. The aim of this study was to evaluate the peripheral and respiratory muscle strength of children and adolescents with CHD with systematic review and meta-analysis. The review included observational and randomised control trial studies which evaluated peripheral and respiratory muscle strength in children and adolescents with CHD under 18 years old. The peripheral muscle strength was evaluated through dynamometry and respiratory muscle strength through manovacuometry. In studies that compared patients with CHD and respective control groups, it was possible to perform a meta-analysis. A total of 5634 articles met the criteria of eligibility, 15 were included in the systematic review, and 4 were included in the meta-analysis. Twelve studies assessed peripheral muscle strength with a reduction in patients with CHD. In the meta-analysis, patients with CHD had lower muscle strength than controls (−34.07 nm; 95% CI, −67.46 to −0.68; I2 47%; p for heterogeneity = 0.05), and the meta-analysis of the handgrip muscle strength showed no significant difference between patients with CHD and controls (0.08 nm; 95% CI, −6.39 to 6.55; I2 98%; p for heterogeneity <0.00001). The meta-analysis in the present study  showed lower limb muscle strength in patients with CHD in comparison to controls. In contrast, no difference was found regarding hand grip strength. Also, the review showed lower respiratory muscle strength in patients with CHD, yet no meta-analysis was possible to perform.

Keywords

Heart defectsCongenitalMuscle strengthChildAdolescentReviewMeta-analysis
Type
Review
Information
Cardiology in the Young , Volume 32 , Issue 11 , November 2022 , pp. 1728 - 1741
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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References

Pinto Junior, VC, Branco, KM, Cavalcante, RC, et al. Epidemiology of congenital heart disease in Brazil. Rev Bras Cir Cardiovasc. 2015; 30: 219–224.Google ScholarPubMed
van der Linde, D, Konings, EE, Slager, MA, et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol. 2011; 58: 2241–2247.10.1016/j.jacc.2011.08.025CrossRefGoogle ScholarPubMed
McCrindle, BW, Williams, RV, Mital, S, et al. Physical activity levels in children and adolescents are reduced after the Fontan procedure, independent of exercise capacity, and are associated with lower perceived general health. Arch Dis Child. 2007; 92: 509–514.10.1136/adc.2006.105239CrossRefGoogle ScholarPubMed
Abassi, H, Gavotto, A, Picot, MC, et al. Impaired pulmonary function and its association with clinical outcomes, exercise capacity and quality of life in children with congenital heart disease. Int J Cardiol. 2019; 285: 86–92.CrossRefGoogle ScholarPubMed
Ferrer-Sargues, FJ, Peiro-Molina, E, Salvador-Coloma, P, et al. Cardiopulmonary rehabilitation improves respiratory muscle function and functional capacity in children with congenital heart disease. a prospective cohort study. Int J Environ Res Public Health 2020; 17: 4328.CrossRefGoogle ScholarPubMed
Longmuir, PE, Tyrrell, PN, Corey, M, Faulkner, G, Russell, JL, McCrindle, BW. Home-based rehabilitation enhances daily physical activity and motor skill in children who have undergone the Fontan procedure. Pediatr Cardiol. 2013; 34: 1130–1151.10.1007/s00246-012-0618-8CrossRefGoogle ScholarPubMed
Savage, PA, Shaw, AO, Miller, MS, et al. Effect of resistance training on physical disability in chronic heart failure. Med Sci Sports Exerc 2011; 43: 1379–1386.10.1249/MSS.0b013e31820eeea1CrossRefGoogle ScholarPubMed
Feltez, G, Coronel, CC, Pellanda, LC, Lukrafka, JL. Exercise capacity in children and adolescents with corrected congenital heart disease. Pediatr Cardiol. 2015; 36: 1075–1082.10.1007/s00246-015-1129-1CrossRefGoogle ScholarPubMed
Hornby, B, McClellan, R, Buckley, L, Carson, K, Gooding, T, Vernon, HJ. Functional exercise capacity, strength, balance and motion reaction time in Barth syndrome. Orphanet J Rare Dis 2019; 14: 37.CrossRefGoogle ScholarPubMed
Posner, AD, Soslow, JH, Burnette, WB, et al. The correlation of skeletal and cardiac muscle dysfunction in duchenne muscular dystrophy. J Neuromuscul Dis. 2016; 3: 91–99.CrossRefGoogle ScholarPubMed
Rashed, AM, Abdel-Wahab, N, Moussa, EMM, Hammam, N. Association of hand grip strength with disease activity, disability and quality of life in children and adolescents with Juvenile Idiopathic Arthritis. Adv Rheumatol 2018; 58: 11.CrossRefGoogle ScholarPubMed
Deliva, RD, Hassall, A, Manlhiot, C, Solomon, M, McCrindle, BW, Dipchand, AI. Effects of an acute, outpatient physiotherapy exercise program following pediatric heart or lung transplantation. Pediatr Transplant. 2012; 16: 879–886.10.1111/petr.12003CrossRefGoogle ScholarPubMed
West, SL, Banks, L, Schneiderman, JE, et al. Physical activity for children with chronic disease; a narrative review and practical applications. BMC Pediatr 2019; 19: 12.CrossRefGoogle ScholarPubMed
Tsiros, MD, Grimshaw, PN, Shield, AJ, Buckley, JD. The Biodex isokinetic dynamometer for knee strength assessment in children: advantages and limitations. Work. 2011; 39: 161–167.CrossRefGoogle ScholarPubMed
Wind, AE, Takken, T, Helders, PJ, Engelbert, RH. Is grip strength a predictor for total muscle strength in healthy children, adolescents, and young adults? Eur J Pediatr. 2010; 169: 281–287.CrossRefGoogle ScholarPubMed
Inuzuka, R, Diller, GP, Borgia, F, et al. Comprehensive use of cardiopulmonary exercise testing identifies adults with congenital heart disease at increased mortality risk in the medium term. Circulation. 2012; 125: 250–259.10.1161/CIRCULATIONAHA.111.058719CrossRefGoogle ScholarPubMed
Greutmann, M, Le, TL, Tobler, D, et al. Generalised muscle weakness in young adults with congenital heart disease. Heart. 2011; 97: 1164–1168.10.1136/hrt.2010.213579CrossRefGoogle ScholarPubMed
Moalla, W, Elloumi, M, Chamari, K, et al. Training effects on peripheral muscle oxygenation and performance in children with congenital heart diseases. Appl Physiol Nutr Metab. 2012; 37: 621–630.10.1139/h2012-036CrossRefGoogle ScholarPubMed
Turquetto, ALR, Dos Santos, MR, Agostinho, DR, et al. Aerobic exercise and inspiratory muscle training increase functional capacity in patients with univentricular physiology after Fontan operation: a randomized controlled trial. Int J Cardiol. 2021; 330: 50–58.10.1016/j.ijcard.2021.01.058CrossRefGoogle ScholarPubMed
Smith, MP, Muller, J, Neidenbach, R, Ewert, P, Hager, A. Better lung function with increased handgrip strength, as well as maximum oxygen uptake, in congenital heart disease across the lifespan. Eur J Prev Cardiol. 2019; 26: 492–501.CrossRefGoogle ScholarPubMed
Higgins, J, Thomas, J, Chandler, J, et al. Cochrane Handbook for Systematic Reviews of Interventions. John Wiley & Sons, Chichester (UK), 2019.10.1002/9781119536604CrossRefGoogle Scholar
Page, MJ, McKenzie, JE, Bossuyt, PM, et al. The PRISMA, 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372, n71.Google ScholarPubMed
Wells, GA, Shea, B, O'Connell, D, et al., The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses, Canada, University of Ottawa, Accessed Jan 2021. Available in:. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp,Google Scholar
Patra, J, Bhatia, M, Suraweera, W, et al. Exposure to second-hand smoke and the risk of tuberculosis in children and adults: a systematic review and meta-analysis of 18 observational studies. PLoS Med 2015; 12: e1001835.CrossRefGoogle ScholarPubMed
McPheeters, ML, Kripalani, S, Peterson, NB, et al. Closing the quality gap: Revisiting the state of the science. Quality improvement Interventions to address health disparities (Appendix G). In Evidence Reports/Technology Assessments. vol. 208, Thresholds for Quality Assessment, 2012, Available from: https://www.ncbi.nlm.nih.gov/books/NBK107322/ Google Scholar
Ferrer-Sargues, FJ, Peiro-Molina, E, Cebria, IIMA, et al. Effects of cardiopulmonary rehabilitation on the muscle function of children with congenital heart disease: a prospective cohort study. Int J Environ Res Public Health 2021; 18: 5870.10.3390/ijerph18115870CrossRefGoogle ScholarPubMed
Holm, I, Fredriksen, PM, Fosdahl, MA, Olstad, M, Vøllestad, N. Impaired motor competence in school-aged children with complex congenital heart disease. Arch Pediatr Adolesc Med. 2007; 161: 945–950.CrossRefGoogle ScholarPubMed
Klausen, SH, Wetterslev, J, Sondergaard, L, et al. Health-related fitness profiles in adolescents with complex congenital heart disease. J Adolesc Health. 2015; 56: 449–455.10.1016/j.jadohealth.2014.11.021CrossRefGoogle ScholarPubMed
Longmuir, PE, Brothers, JA, de Ferranti, SD, et al. Promotion of physical activity for children and adults with congenital heart disease: a scientific statement from the American Heart Association. Circulation. 2013; 127: 2147–2159.10.1161/CIR.0b013e318293688fCrossRefGoogle ScholarPubMed
Longmuir, PE, Corey, M, Faulkner, G, Russell, JL, McCrindle, BW. Children after fontan have strength and body composition similar to healthy peers and can successfully participate in daily moderate-to-vigorous physical activity. Pediatr Cardiol. 2015; 36: 759–767.CrossRefGoogle ScholarPubMed
Longmuir, PE, Russell, JL, Corey, M, Faulkner, G, McCrindle, BW. Factors associated with the physical activity level of children who have the Fontan procedure. Am Heart J. 2011; 161: 411–417.CrossRefGoogle ScholarPubMed
McKillop, A, Grace, SL, Ghisi, GLM, et al. Adapted motivational interviewing to promote exercise in adolescents with congenital heart disease: a pilot trial. Pediatr Phys Ther. 2018; 30: 326–334.CrossRefGoogle ScholarPubMed
Moalla, W, Dupont, G, Costes, F, Gauthier, R, Maingourd, Y, Ahmaidi, S. Performance and muscle oxygenation during isometric exercise and recovery in children with congenital heart diseases. Int J Sports Med. 2006; 27: 864–869.CrossRefGoogle ScholarPubMed
Sandberg, C, Frisk, E, Hansson, L, et al. Impaired knee extension muscle strength in adolescents but not in children with Fontan circulation. Cardiol Young. 2020; 30: 1138–1143.10.1017/S1047951120001675CrossRefGoogle Scholar
Zaqout, M, Vandekerckhove, K, De Wolf, D, et al. Determinants of physical fitness in children with repaired congenital heart disease. Pediatr Cardiol. 2021; 42: 857–865.10.1007/s00246-021-02551-yCrossRefGoogle ScholarPubMed
Zaqout, M, Vandekerckhove, K, Michels, N, Bove, T, Francois, K, De Wolf, D. Physical fitness and metabolic syndrome in children with repaired congenital heart disease compared with healthy children. J Pediatr. 2017; 191: 125–132.CrossRefGoogle ScholarPubMed
Laohachai, K, Winlaw, D, Selvadurai, H, et al. Inspiratory muscle training is associated with improved inspiratory muscle strength, resting cardiac output, and the ventilatory efficiency of exercise in patients with a Fontan circulation. J Am Heart Assoc 2017; 6: 133.CrossRefGoogle ScholarPubMed
Brandlistuen, RE, Stene-Larsen, K, Holmstrom, H, Landolt, MA, Eskedal, LT, Vollrath, ME. Motor and social development in 6-month-old children with congenital heart defects. J Pediatr 2010; 156: 265–269.e1.10.1016/j.jpeds.2009.08.035CrossRefGoogle ScholarPubMed
Brassard, P, Poirier, P, Martin, J, et al. Impact of exercise training on muscle function and ergoreflex in Fontan patients: a pilot study. Int J Cardiol. 2006; 107: 85–94.CrossRefGoogle ScholarPubMed
Turquetto, ALR, Dos Santos, MR, Sayegh, ALC, et al. Blunted peripheral blood supply and underdeveloped skeletal muscle in Fontan patients: the impact on functional capacity. Int J Cardiol. 2018; 271: 54–59.CrossRefGoogle Scholar
CdS, Rêgo, Pinho, CPS. Força muscular em crianças e adolescentes hospitalizados com cardiopatia congênita. Nutr Clín Diet Hosp 2020; 40.Google Scholar
Fricke, O, Witzel, C, Schickendantz, S, Sreeram, N, Brockmeier, K, Schoenau, E. Mechanographic characteristics of adolescents and young adults with congenital heart disease. Eur J Pediatr. 2008; 167: 331–336.10.1007/s00431-007-0495-yCrossRefGoogle Scholar
Wiggin, M, Wilkinson, K, Habetz, S, Chorley, J, Watson, M. Percentile values of isokinetic peak torque in children six through thirteen years old. Pediatr Phys Ther. 2006; 18: 3–18.CrossRefGoogle ScholarPubMed
McQuiddy, VA, Scheerer, CR, Lavalley, R, McGrath, T, Lin, L. Normative values for grip and pinch strength for 6- to 19-year-olds. Arch Phys Med Rehabil. 2015; 96: 1627–1633.10.1016/j.apmr.2015.03.018CrossRefGoogle ScholarPubMed
Banks, L, Rosenthal, S, Manlhiot, C, et al. Exercise capacity and self-efficacy are associated with moderate-to-vigorous intensity physical activity in children with congenital heart disease. Pediatr Cardiol. 2017; 38: 1206–1214.10.1007/s00246-017-1645-2CrossRefGoogle ScholarPubMed
Fredriksen, PM, Kahrs, N, Blaasvaer, S, et al. Effect of physical training in children and adolescents with congenital heart disease. Cardiol Young. 2000; 10: 107–114.CrossRefGoogle ScholarPubMed
Turquetto, ALR, Caneo, LF, Agostinho, DR, et al. Impaired pulmonary function is an additional potential mechanism for the reduction of functional capacity in clinically stable Fontan patients. Pediatr Cardiol. 2017; 38: 981–990.CrossRefGoogle ScholarPubMed
Wu, FM, Opotowsky, AR, Denhoff, ER, et al. A pilot study of inspiratory muscle training to improve exercise capacity in patients with Fontan physiology. Semin Thorac Cardiovasc Surg. 2018; 30: 462–469.CrossRefGoogle ScholarPubMed
Barbour-Tuck, E, Boyes, NG, Tomczak, CR, et al. A cardiovascular disease risk factor in children with congenital heart disease: unmasking elevated waist circumference - a CHAMPS* study *CHAMPS: Children’s Healthy-Heart Activity Monitoring Program in Saskatchewan. BMC Cardiovasc Disord 2020 May 19; 20: 231.CrossRefGoogle Scholar