Abstract 2208: Factors Associated with the Objectively Measured Activity Levels for Children after the Fontan Procedure
Children who have had the Fontan operation have sedentary lifestyles which pose a risk to heart health. We sought to identify factors associated with objective measures of activity (5 weekday, 2 weekend, omni-directional accelerometer) to support the development of effective interventions to encourage more active lifestyles. Activity monitoring and standardized tests of exercise capacity, health-related fitness, gross motor skill and physical activity self-efficacy were completed by 63 children (25 female), 6 to 11 years. Questionnaires elicited parents’ perspectives on activity. Mean minutes of moderate/vigorous activity per week were 343 ± 129, range 43 to 708 (56 ± 21 weekday minutes; 37 ± 21 weekend minutes) per day. Initial analyses indicated no gender influence, but activity levels were higher (p<.04) if the child’s age was younger, either at time of testing or at time of Fontan. Adjusting for age at testing and at Fontan, factors significantly related to higher activity level (Table 1⇓) were greater gross motor skill, child’s increased self rating of activity adequacy, predilection and level relative to peers, and the use of anti-thrombotic medication. Cardiac diagnosis, type of Fontan, other medications, exercise capacity (peak VO2/HR), health-related fitness, and parent involvement in and support for activity were not related to activity level. These results suggest that activity participation in this at-risk population depends primarily on gross motor skill and the same psychosocial factors that are recognized predictors of activity participation among healthy children. Traditional clinical measures of physical function, such as peak exercise capacity, fitness or diagnosis/medical factors appear to be largely unrelated to the amount of daily activity in these patients. Cardiac rehabilitation programs to encourage more active lifestyles should be based on behavior change theory and focus on the acquisition of age-appropriate gross motor skills.