Should we be concerned regarding physical activity levels in children and adolescents with congenital heart disease? A comprehensive narrative review

The paradigm shift toward a holistic and proactive approach in the aftercare of individuals diagnosed with congenital heart disease (CHD) underscores the significance of regular physical activity (PA) in this at-risk group. The aim of this narrative review was to present and contrast objectively measured PA levels in children and adolescents with CHD with those of their healthy counterparts or broader normative groups, capitalizing on the recent surge in research in this field. Four databases were systematically searched for relevant studies published from their inception through September 2023. Observational studies concentrating on youths with CHD, wherein objectively quantified PA levels in the CHD group were assessed and compared with healthy controls or normative data, were included. Two independent authors performed the study selection and data abstraction. Sixteen studies representing 1164 targeted patients were included. Our findings revealed that, contrary to general belief, the PA levels of youths with CHD were generally comparable to those of healthy peers or normative samples. Diminished PA was exclusively discerned in certain subgroups of CHD cases in a limited number of studies. Our findings suggest that PA levels of youths with CHD are generally comparable to those of their healthy peers or normative samples. However, considering the global pandemic of physical inactivity and lifetime health risks for patients with CHD, sustained efforts to monitor and improve PA remain vital. Collaborating on initiatives to help patients with CHD attain age-appropriate PA recommendations is essential and should not be underestimated. • Contrary to general belief, activity levels of youth with congenital heart disease (CHD) are generally comparable to those of their healthy peers or large normative samples. • Reduced physical activity levels compared to healthy peers or normative samples have been only detected in certain CHD subgroups, as elucidated by a very limited number of studies. • More focus is needed on assessing and promoting physical activity in young CHD patients in middle- and low-income countries.