Leg-focused high-weight resistance training improves ventricular stroke volume, exercise capacity and strength in young patients with a Fontan circulation.
Study Goal
The researchers aimed to determine whether a high-protein diet combined with leg-focused high-weight resistance training could improve exercise capacity, cardiac function, muscle strength, and quality of life in pediatric Fontan patients.
Results Summary
The study found that the intervention significantly improved peak oxygen uptake, stroke volume, muscle strength, and certain domains of quality of life, with no adverse effects reported.
Population
Pediatric Fontan patients (median age 12.9 years).
Effective Dosage
Not specified
Duration
12 weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
12-week leg-focused high-weight resistance training plus high-protein diet | increase | Peak oxygen uptake (PeakVO2/kg) | paediatric Fontan patients | +6.2 mL/kg/min (95%CI: 3.4-9.0) (+18%) | improved significantly | #1 |
12-week leg-focused high-weight resistance training plus high-protein diet | increase | Peak workload | paediatric Fontan patients | +22 Watts (95%CI: 12-32) (+18%) | improved significantly | #2 |
12-week leg-focused high-weight resistance training plus high-protein diet | increase | Indexed single ventricle stroke volume | paediatric Fontan patients | 43 mL/beat/m2 (40-49) vs. 46 (41-53) | increased significantly | #3 |
12-week leg-focused high-weight resistance training plus high-protein diet | increase | inferior vena cava flow | paediatric Fontan patients | 21 mL/beat/m2 (18-24) vs. 23 (20-28) | increased significantly | #4 |
12-week leg-focused high-weight resistance training plus high-protein diet | no change | superior vena cava flow | paediatric Fontan patients | - | remained unchanged | #5 |
12-week leg-focused high-weight resistance training plus high-protein diet | increase | strength of all measured leg-muscles | paediatric Fontan patients | - | increased significantly | #6 |
12-week leg-focused high-weight resistance training plus high-protein diet | increase | self-reported quality of life on the physical functioning and change in health domains | paediatric Fontan patients | - | improved | #7 |
12-week leg-focused high-weight resistance training plus high-protein diet | increase | parent-reported quality of life on the bodily pain, general health perception, and change in health domains | paediatric Fontan patients | - | improved | #8 |
AIMS: Effective therapy to improve exercise capacity in Fontan patients is lacking. Leg-focused high-weight resistance training might augment the peripheral muscle pump and thereby improve exercise capacity. METHODS AND RESULTS: This randomized semi-cross-over controlled trial investigated the effects of a 12-week leg-focused high-weight resistance training plus high-protein diet, on (sub)maximal exercise capacity, cardiac function (assessed with cardiovascular magnetic resonance), muscle strength, and quality of life in paediatric Fontan patients. Twenty-eight paediatric Fontan patients were included, 27 patients, (median age 12.9 [10.5-15.7]), and successfully completed the programme. Peak oxygen uptake (PeakVO2) at baseline was reduced [33.3 mL/kg/min (27.1-37.4), 73% (62-79) of predicted]. After training PeakVO2/kg and Peak workload improved significantly with +6.2 mL/kg/min (95%CI: 3.4-9.0) (+18%) P < 0.001 and +22 Watts (95%CI: 12-32) (+18%) P < 0.001, respectively, compared to the control period. Indexed single ventricle stroke volume increased significantly [43 mL/beat/m2 (40-49) vs. 46 (41-53), P = 0.014], as did inferior vena cava flow [21 mL/beat/m2 (18-24) vs. 23 (20-28), P = 0.015], while superior vena cava flow remained unchanged. The strength of all measured leg-muscles increased significantly compared to the control period. Self-reported quality of life improved on the physical functioning and change in health domains of the child health questionnaire, parent-reported quality of life improved the bodily pain, general health perception, and change in health domains compared to the control period. CONCLUSION: In a relatively large group of 27 older Fontan children, 12-weeks of leg-focused high-weight resistance training improved exercise capacity, stroke volume, (sub)maximal exercise capacity, muscle strength, and domains of quality of life. REGISTRATION: International Clinical Trials: Trial NL8181. Is leg-focused high-weight resistance training an effective therapy to improve reduced exercise capacity in patients with a Fontan circulation? Key Finding: Twelve weeks of leg-focused high-weight resistance training in children with a Fontan circulation improved exercise capacity, single ventricular stroke volume, (sub)maximal exercise capacity, muscle strength, and physical domains of quality of life. Take-home Message: Leg-focused high-weight resistance training results in improved exercise capacity, cardiac function, and quality of life patients with a Fontan circulation. Patients with a Fontan circulation should be motivated to perform lower limb strengthening exercises.