(CCSP127) THE IMPACT OF PHYSICAL ACTIVITY IN PEDIATRIC PATIENTS WITH FONTAN PHYSIOLOGY

Background: As survival for children with single ventricle physiology has improved there is increased interest in optimizing physical functioning, psychological well-being and reducing long term morbidities. Children with single ventricle physiology who have undergone a Fontan operation have decreased exercise tolerance and physical activity levels compared healthy controls. The purpose of this study was to objectively quantify the intensity of physical activity (PA), according to Canadian movement guidelines, using accelerometers in children with Fontan physiology, and correlate findings with subjective, self-reported PA from the Vascular Health Questionnaire.

METHODS AND RESULTS:
This study was a cross sectional assessment of children with Fontan circulation, aged 4-18 years, who are followed at the University of Alberta, Stollery Children’s hospital. Subjects completed the Vascular Health Questionnaire and were provided with an accelerometer (Actigraph GT3X+) worn for seven consecutive days during wake hours. Comparisons were made between the proportion of time the sample engaged in sedentary time, light physical activity, and moderate-vigorous physical activity, as measured with accelerometers.

Results:
Based on the Vascular Health Questionnaire, 37.5% of subjects reported their overall health as “very good”. This is despite only, 28.6% of subjects exercising or taking part in physical activity, of which on 2/7 days were considered MVPA. Among older children and youth, 80% of subjects reported spending zero days in the past week engaging in exercise to strengthen or tone muscles. For accelerometer measurements, median sedentary time was measured at 494.5 mins/d (IQR 411.6, 593.3), light physical activity at 297.3 mins/d (IQR 249.4, 368.0), and moderate-vigorous physical activity (MVPA) at 15.0 mins/d (IQR 7.1, 29.8). Median sedentary time for boys was 505.8 mins/d (IQR 415.8, 581.5) and for girls, 486.3 mins/d (IQR 409.4, 628.9), with no significant differences between the two (p=NS). Similarly, there were no significant differences when boys were compared to girls with respect to light physical activity, [296.0 (257.6, 391.3) vs 299.0 (227.6, 350.0) mins/d], and MVPA, [21.3 (11.6, 40.6) vs 13.0 (5.4, 17.9) min/d]. None of the children and youth met the Canadian 24-hour movement guidelines for PA.

Conclusion: Only one-third of subjects with Fontan physiology self-report taking part in MVPA. This is supported by the objective measures and indicate that children and youth who underwent Fontan procedure do not met the Canadian 24-hour movement guidelines for PA. This raises concerns for the long term sequelae of a sedentary lifestyle in the context of Fontan physiology and the potential for increased risk of cardiovascular disease.