Remotely Delivered Cardiac Rehabilitation for Adolescents with Congenital Heart Disease

为患有先天性心脏病的青少年提供远程心脏康复

基本信息

  • 批准号:
    10666389
  • 负责人:
  • 金额:
    $ 15.37万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2022
  • 资助国家:
    美国
  • 起止时间:
    2022-07-15 至 2027-06-30
  • 项目状态:
    未结题

项目摘要

PROJECT SUMMARY/ABSTRACT Adolescents with congenital heart disease [CHD], including repair of tetralogy of Fallot [TOF], dextro-transposi- tion of the great vessels [d-TGA], or functionally univentricular heart physiology [Fontan], have lower cardiorespir- atory fitness [FIT] compared with healthy peers. FIT is a well-established predictor of morbidity, quality of life [QOL], and heart transplantation and is among the strongest predictors of mortality in this population. However, adolescents with CHD have significantly lower FIT when compared to cardio-typical peers, due to abnormal hemodynamics as well as low durations and intensities of physical activity [PA] and exercise. Pediatric cardiac rehabilitation [CR] programs which prescribe aerobic and resistance exercise over 12-wks. have demonstrated improvements in FIT for patients with CHD which persist months after completion of the program. Unfortunately, few hospitals/clinics offer CR programming for children and adolescents due to the financial costs of building and maintaining a CR facility, as well as the travel cost, time requirement, and burden for parents/caregivers to transport their child to/from a hospital for CR exercise sessions multiple times per week. In-home CR reduces barriers related to patient access and the financial burden for hospitals, though data supporting the effectiveness of in-home CR for youth is limited. The use of group video conferencing technology via tablet computer repre- sents a novel and potentially transformational strategy for delivering real-time, live, supervised CR to groups of adolescents with CHD in their homes. The goal of this K23 research plan is to evaluate the effectiveness of video conferencing for the delivery of real-time CR to groups of adolescents with CHD in their homes. We propose a 12-wk. randomized-controlled clinical trial assigning 74 adolescents [12-19 years old] with 1 of 3 CHD diagnoses [Fontan, TOF, or d-TGA] to Remote CR [RCR] [in-home, live, remote group exercise, 3-45-min sessions/week.] or Active control [in-home, self-directed exercise]. Our aims will assess the effectiveness of the RCR approach by comparing between-group changes [0-12 weeks] in: FIT, cardiac function, lean body mass, and frailty. Ex- ploratory aims will assess between group differences [0-12 weeks] in physical function, QOL, PA self-efficacy, and will evaluate the impact of demographic characteristics on program participation and satisfaction, and daily PA. We hypothesize the RCR intervention will elicit greater improvements in each outcome compared to the control group. The PI’s short term career development goal of enhancing knowledge, skills, and experiences in clinical trials research, CHD physiology, and implementation and dissemination [I&D] outcomes research in youth with CHD will be accomplished through a multidisciplinary team of mentors, formal programming/coursework, independent study, and scientific meetings. Career development training and experiences and data from the research plan will prepare the PI to accomplish his long-term career goals to 1] establish an independently funded research program conducting clinical trials to evaluate the impact of exercise, FIT on physical and psy- chosocial function in youth with CHD; and 2] I&D of CR programs across multiple sites.
项目摘要/摘要 青少年先天性心脏病,包括法洛四联症修补术、右旋转位 大血管的破裂[d-TGA],或功能性单室心脏生理学[Fontan],具有较低的心脏呼吸 体能[适合度]与健康的同龄人相比。适合度是发病率、生活质量的可靠预测指标 [QOL]和心脏移植,是这一人群中死亡率的最强预测因素之一。然而, 与心脏正常的同龄人相比,患有冠心病的青少年的适合度明显较低,这是由于异常 血流动力学以及低持续时间和低强度的体力活动[PA]和锻炼。儿科心脏 规定12周以上的有氧运动和阻力运动的康复计划。已经展示了 改善冠心病患者的适合度,并在该计划完成后持续数月。不幸的是, 由于建设的财政成本,很少有医院/诊所为儿童和青少年提供CR方案 以及维护CR设施,以及父母/照顾者的旅行成本、时间要求和负担 每周多次运送他们的孩子往返医院进行CR锻炼。室内CR减少 尽管数据支持有效性,但与患者接触和医院的经济负担有关的障碍 针对年轻人的家庭CR是有限的。使用平板电脑代表的群组视频会议技术 提供一种新颖且具有潜在变革性的策略,用于向以下群体提供实时、实时、有监督的CR 患有冠心病的青少年在家中。这项K23研究计划的目标是评估视频的有效性 在家中为患有冠心病的青少年群体提供实时CR的会议。我们提出了一个 12周。74名青少年[12-19岁]被诊断为1/3的随机对照临床试验 [Fontan、TOF或d-TGA]到远程CR[RCR][在家、现场、远程集体锻炼,每周3-45分钟。] 或主动控制[在家中,自我指导的锻炼]。我们的目标将评估RCR方法的有效性 通过比较组间变化[0-12周]:健康、心功能、瘦体重和虚弱。前- 口述目标将评估两组之间[0-12周]在身体功能、生活质量、PA自我效能、 并将评估人口特征对计划参与度和满意度的影响,以及每天 爸。我们假设,与RCR干预相比,RCR干预将在每个结果中产生更大的改善 对照组。PI的短期职业发展目标是提高知识、技能和经验 临床试验研究、冠心病生理学以及在青年中实施和传播[I&D]成果研究 与CHD的合作将通过多学科的导师团队、正式的编程/课程工作、 自主学习,科学会议。职业发展培训和经验以及来自 研究计划将为PI做好准备,以实现他的长期职业目标1)建立独立的 资助的研究项目正在进行临床试验,以评估锻炼、健身对身体和心理健康的影响 CHD青年患者的选择社会功能;2]跨多个站点的CR项目的I&D。

项目成果

期刊论文数量(5)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
The influence of somatic maturity on the relationship between the triglyceride/high-density lipoprotein ratio and vascular health in children and adolescents with dyslipidemia.
体细胞成熟度对血脂异常儿童和青少年甘油三酯/高密度脂蛋白比值与血管健康关系的影响。
Development and Initial Validation of a Frailty Score for Pediatric Patients with Congenital and Acquired Heart Disease.
先天性和后天性心脏病儿科患者衰弱评分的制定和初步验证。
  • DOI:
    10.1007/s00246-022-03045-1
  • 发表时间:
    2024
  • 期刊:
  • 影响因子:
    1.6
  • 作者:
    Studyvin,Sarah;Birnbaum,BrianF;Staggs,VincentS;Gross-Toalson,Jami;Shirali,Girish;Panchangam,Chaitanya;White,DavidA
  • 通讯作者:
    White,DavidA
Pediatric Cardiology Fellowship Standards for Training in Exercise Medicine and Curriculum Outline.
运动医学培训小儿心脏病学奖学金标准和课程大纲。
  • DOI:
    10.1007/s00246-022-03048-y
  • 发表时间:
    2023
  • 期刊:
  • 影响因子:
    1.6
  • 作者:
    Huang,JH;Wittekind,SG;Opotowsky,AR;Ward,K;Lyman,A;Gauthier,N;Vernon,M;Powell,AW;White,DA;Curran,TJ;Orr,WB;Stephens,P;Robinson,B;Pham,TD;Mays,WA;Burstein,D;Carr,M;Paridon,S;Rhodes,J;Koenig,P
  • 通讯作者:
    Koenig,P
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David A White其他文献

Genetic and environmental factors affecting bone mineral density in large families.
影响大家庭骨矿物质密度的遗传和环境因素。
  • DOI:
  • 发表时间:
    1998
  • 期刊:
  • 影响因子:
    5.1
  • 作者:
    S. Yeap;Maribel Beaumont;Andy Bennett;Nicki A Keating;David A White;D. J. Hosking
  • 通讯作者:
    D. J. Hosking

David A White的其他文献

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{{ truncateString('David A White', 18)}}的其他基金

Remotely Delivered Cardiac Rehabilitation for Adolescents with Congenital Heart Disease
为患有先天性心脏病的青少年提供远程心脏康复
  • 批准号:
    10448915
  • 财政年份:
    2022
  • 资助金额:
    $ 15.37万
  • 项目类别:

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