Improved Aerobic Capacity, Strength, And Flexibility In Adolescent Heart Transplant Patients After Phase II Cardiac Rehabilitation

PURPOSE: The positive physiologic effects of a Phase II Cardiac Rehabilitation (CR) program for adult patients with cardiopulmonary disease are well documented. Comparable results are seen in pediatric patients with various congenital cardiopulmonary diseases. CR is becoming a standard of practice for adolescent patients post heart transplant (HRT). We analyzed the physiologic effects in HRT patients participating in a CR program. METHODS: Retrospective study reviewing the physiologic outcome data for adolescent HRT patients participating in the CR program between 2014 to 2023. Each patient completed a cycle ergometer ramping protocol (CPET), a 6-minute walk test (6MWT), a handgrip strength test (HGS), timed arm curls with weight repetitions (AC), sit to stand repetitions (SnS) and sit and reach distance (SnR) pre and post CR. Maximal oxygen consumption indexed to body weight (VO2i), and oxygen pulse (O2Pulse) were measured during the CPET. Total meters walked (TMW) were measured during the 6MWT. Statistical comparisons were made using the paired t-test and significance was set at p < 0.05. RESULTS: 38 adolescent HRT patients completed CR during the period of review (12 females). Average age was 15.2 ± 2.2 years (range 11 to 20 years). There was a significant increase in VO2i (19.0 ± 4.5 vs 21.5 ± 5.2 cc/kg/min, p < 0.05), O2Pulse (8.6 ± 3.0 vs 10.3 ± 3.3 cc/beat, p < 0.05) and TMW (346 ± 109 vs 451 ± 106 meters, p < 0.001). HGS significantly increased (36.7 ± 21.5 to 44.8 ± 21.5 Kg, p < 0.001) along with AC (16.1 ± 4.5 vs 21.8 ± 5.4, p < 0.001), SnS (13.9 ± 4.8 vs 19.3 ± 6.5, p < 0.001) and SnR (16.2 ± 3.8 vs 19.2 ± 5.4, inches, p < 0.05). CONCLUSIONS: Participation in a Phase II CR program after HRT resulted in a significant increase in aerobic capacity and muscular strength, as well as improved flexibility in this group of adolescent heart transplant patients.