Catherine M. Avitabile, Caroline O’Brien, Divya Dureja, Dana Albizem, Jena Mota, Melissa Xanthopoulos, Babette S. Zemel, Peter F. Cronholm
Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine and University of Pennsylvania.
United States
Pulmonary Circulation
Pulm Circ 2024; 14:
DOI: 10.1002/pul2.70000
Abstract
Therapeutic exercise has not been widely adopted in pediatric pulmonary hypertension (PH), despite adult data supporting its safety and efficacy. While physical limitations may prevent children with PH from participating in physical activity, other barriers to and facilitators of physical activity are unknown. Youth ages 8-18 years with World Symposium of PH diagnostic Groups 1-4, functional class I or II, and ambulatory status were prospectively enrolled in a cross-sectional study including separate 30-min participant and caregiver interviews regarding attitudes toward physical activity and a proposed exercise intervention in pediatric PH. Interview questions were guided by Social Cognitive Theory and explored autonomy, self-confidence, and self-efficacy. Interviews were transcribed, coded, and analyzed using an iterative process to determine themes and patterns. Demographics and relevant PH condition-specific data were abstracted from the medical record. Thirty PH participant/caregiver dyads were interviewed. Facilitators of physical activity included enjoyment/interest in the activity, socialization, incentivization, and feelings of safety and normalcy. Barriers to physical activity included lack of interest, fear/anxiety, and self-consciousness. Findings were similar in children and adults. Participants rarely reported restriction of activity by caregivers or medical providers. Attitudes toward engagement in a proposed exercise program were generally positive and reflected personal experiences with physical activity. Monitored exercise interventions that focus on patients’ interests, cultivate confidence, respect limitations, and acknowledge the need for extrinsic incentivization may have benefits in pediatric PH. Future trials should test the impact of these characteristics on patient wellbeing and clinical outcomes.
Category
Quality of Life Associated with Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes