Abstract 4143923: Home-based Exercise Intervention for Children and Adolescents with Hypertrophic Cardiomyopathy: A Consensus of Experts on a Safe and Acceptable Exercise Protocol

Background: Physical activity (PA) is a mainstay for cardiovascular health. However, those with hypertrophic cardiomyopathy (HCM) are often counselled to limit PA due to the potential risk of sudden cardiac death. The emphasis placed on restriction has put this population more susceptible for acquired cardiovascular (CV) risk factors, and poor long-term CV health from physical inactivity. To date, no consensus exists about what is appropriate and safe in terms of exercise for this population. Project Aim: Use a modified Delphi method to gain consensus amongst subject matter experts on a proposed home-based exercise intervention for children 10 to 19 years of age with HCM. Methods: A panel of experts, including pediatric cardiologists, sports cardiologists, exercise physiolologists, obesity experts, and parent/patient representatives met a series of five times to develop a home-based exericse program. The proposed program was converted into a survey and sent out through the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) from October 2023 to June 2024. Utilizing a modified Delphi method, each of the 11 components of the intervention were voted on regarding the degree of agreement by responders. For those who disagreed, they were prompted to provide feedback in order to modify that aspect of the exercise program. The participants were provided with feedback after each round. We aimed for 90% agreement on each component to declare consensus. Results: At total of 49 individuals completed the first round of the survey with 84% identified as a pediatric cardiologists, 75% working in a University center and two-thirds having more than five years of experience. After Round 1 consensus was reached on 3/11 and up to 8/11 after Round 2. The progression to the final home-based exercise protocol is outlined in Table 1. Conclusion: A home-based exercise program for children with HCM was developed, adapted from feedback, and the components were agreed to by experts in the field using a modified Delphi method. The next step in this process is to assess the safety and feasibility of this program in an in-hospital setting, prior to its evaluation through a multi-center, home-based exercise intervention.