Avaliação da capacidade funcional de crianças e adolescentes com cardiopatia congênita: uma revisão sistemática

Abstract

Introduction: Children and adolescents with congenital heart disease have impaired functional capacity due to the long period of physical inactivity related to the hemodynamic repercussions of the disease, such as low cardiac output and cyanosis, but also to parental overprotection. Evaluating functional capacity due to lack of exercise tolerance is an important clinical decision making tool that can be performed using functional tests. Objective: To systematize knowle dge about submaximal cardiopulmonary exercise tests used to assess physical fitness in children and adolescents with congenital heart disease. Methods: This is a systematic review. A survey was carried out in August and September 2022, through the indexed databases PEDro, PubMed, Lilacs and Medline using the following descriptors and Booleans in the English language: congenital heart disease AND exercise tolerance, “six minute walk test” OR “incremental shuttle walk test”. Clinical trials and observational studies (cross sectional studies and/or cohort studies) in children and adolescents with mild to severe congenital heart disease, repaired or not, aged between 6 and 18 years were included. Exclusion criteria were duplicate articles and population under 6 years old and over 18 years old Results: 9 of the 1,953 identified studies met the inclusion crite ria. The average age ranged from 12 to 14 years with a predominance of males. The most frequent types of congenital heart defects were Tetralogy of Fallot and single ventricle. Children and young people with heart disease have lower functional capacity com pared to controls. Muscle strength, flexibility, speed and coordination are physical abilities that are also diminished. No difference was found in health related quality of life between children with congenital heart defects and healthy peers. Conclusion: This review found that the 6MWT is the most used test to assess the functional capacity of children and adolescents with congenital heart disease. In addition, the FITNESSGRAM and EUROFIT test battery and the KINDL R questionnaire were mentioned for asses sing physical fitness and health related quality of life, respectively.