A 12-week lifestyle intervention: effects on fatigue, fear, and nutritional status in children with a Fontan circulation
IntroductionChildren and adolescents with a Fontan circulation are less physically active compared to healthy peers. In the current study, effects of a 12-week lifestyle intervention on fatigue, fears regarding exercise, caloric intake, rest energy expenditure (REE), and body composition were measur...
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| Format: | Article |
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Frontiers Media S.A.
2023-11-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1154015/full |
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| author | L. E. Scheffers L. E. Scheffers L. E. Scheffers L. E. Scheffers W. A. Helbing T. Pereira S. Walet E. M. W. J. Utens E. M. W. J. Utens E. M. W. J. Utens K. Dulfer L. E. van den Berg |
| author_facet | L. E. Scheffers L. E. Scheffers L. E. Scheffers L. E. Scheffers W. A. Helbing T. Pereira S. Walet E. M. W. J. Utens E. M. W. J. Utens E. M. W. J. Utens K. Dulfer L. E. van den Berg |
| author_sort | L. E. Scheffers |
| collection | DOAJ |
| description | IntroductionChildren and adolescents with a Fontan circulation are less physically active compared to healthy peers. In the current study, effects of a 12-week lifestyle intervention on fatigue, fears regarding exercise, caloric intake, rest energy expenditure (REE), and body composition were measured in children with a Fontan circulation.MethodsThis study was a semi-cross-over randomized controlled trial. The lifestyle intervention consisted of a 12-week high-weight resistance training (three supervised training sessions a week) supported by high-protein diet (>2 g/kg) and tailored recommended caloric intake. Fatigue (measured by the validated PedsQol Multidimensional Fatigue Scale), fears regarding exercise (measured on a fear thermometer), REE (measured using indirect calorimetry), caloric intake and body composition using air displacement plethysmography, and four-skinfold method were measured before and after the intervention and control period.ResultsTwenty-seven pediatric Fontan patients, median age 12.9 years (IQR: 10.5–16.2), of the included 28 patients successfully completed the program. Before training, both child- and parent-reported levels of fatigue were significantly worse on all domains (general, sleep/rest, and cognitive fatigue) compared to healthy peers. After training, parent-reported fatigue significantly improved on the general and cognitive fatigue domains [effect size +16 points (7–25), p < 0.001, and +10 points (2–17), p = 0.015, compared to the control period]. Before training, fear regarding exercise scored on the fear thermometer was low for both children and parents (median score 1 and 2, respectively, on a scale of 0–8). After training, child-reported fear decreased further compared to the control period [effect size −1.4 points (−2.3 to −0.6), p = 0.001]. At baseline, children had increased REE +12% compared to reference values, which did not change after exercise. Children ate an average of 637 calories below recommended intake based on REE, caloric deficit became smaller after the intervention, and protein intake increased compared to the control period [−388 calories (−674 to −102), p = 0.008, and +15 g (0.4–30), p = 0.044]. Body fat percentage did not change significantly.ConclusionA 12-week lifestyle intervention improved parent-reported fatigue symptoms in the children, further decreased child-reported fears, and increased caloric and protein intake. |
| first_indexed | 2024-03-11T12:25:55Z |
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| id | doaj.art-a00e3c81a9bd447bbd40472f096bbba6 |
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| language | English |
| last_indexed | 2024-03-11T12:25:55Z |
| publishDate | 2023-11-01 |
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| series | Frontiers in Pediatrics |
| spelling | doaj.art-a00e3c81a9bd447bbd40472f096bbba62023-11-06T09:59:09ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-11-011110.3389/fped.2023.11540151154015A 12-week lifestyle intervention: effects on fatigue, fear, and nutritional status in children with a Fontan circulationL. E. Scheffers0L. E. Scheffers1L. E. Scheffers2L. E. Scheffers3W. A. Helbing4T. Pereira5S. Walet6E. M. W. J. Utens7E. M. W. J. Utens8E. M. W. J. Utens9K. Dulfer10L. E. van den Berg11Department of Paediatrics, Division of Paediatric Cardiology, Erasmus MC Sophia Children’s Hospital, Rotterdam, NetherlandsDepartment of Paediatrics, Division of Gastroenterology, Erasmus MC Sophia Children’s Hospital, Rotterdam, NetherlandsRespiratory Medicine and Allergology, Department of Paediatrics, University Medical Center, Erasmus MC Sophia Children’s Hospital, Rotterdam, NetherlandsDepartment of Paediatrics, Center for Lysosomal and Metabolic Diseases, Erasmus MC, Rotterdam, NetherlandsDepartment of Paediatrics, Division of Paediatric Cardiology, Erasmus MC Sophia Children’s Hospital, Rotterdam, NetherlandsDepartment of Paediatrics, Division of Paediatric Cardiology, Erasmus MC Sophia Children’s Hospital, Rotterdam, NetherlandsDivision of Dietetics, Department of Internal Medicine, Erasmus MC, Rotterdam, NetherlandsDepartment of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children’s Hospital, Rotterdam, NetherlandsResearch Institute of Child Development and Education, University of Amsterdam, Amsterdam, NetherlandsDepartment of Child and Adolescent Psychiatry, Amsterdam University Medical Center/Levvel, Amsterdam, NetherlandsIntensive Care Unit, Department of Paediatrics and Paediatric Surgery, Erasmus Medical Centre Sophia Children’s Hospital, Rotterdam, Netherlands0Department of Orthopedics and Sports Medicine, Erasmus MC, Rotterdam, NetherlandsIntroductionChildren and adolescents with a Fontan circulation are less physically active compared to healthy peers. In the current study, effects of a 12-week lifestyle intervention on fatigue, fears regarding exercise, caloric intake, rest energy expenditure (REE), and body composition were measured in children with a Fontan circulation.MethodsThis study was a semi-cross-over randomized controlled trial. The lifestyle intervention consisted of a 12-week high-weight resistance training (three supervised training sessions a week) supported by high-protein diet (>2 g/kg) and tailored recommended caloric intake. Fatigue (measured by the validated PedsQol Multidimensional Fatigue Scale), fears regarding exercise (measured on a fear thermometer), REE (measured using indirect calorimetry), caloric intake and body composition using air displacement plethysmography, and four-skinfold method were measured before and after the intervention and control period.ResultsTwenty-seven pediatric Fontan patients, median age 12.9 years (IQR: 10.5–16.2), of the included 28 patients successfully completed the program. Before training, both child- and parent-reported levels of fatigue were significantly worse on all domains (general, sleep/rest, and cognitive fatigue) compared to healthy peers. After training, parent-reported fatigue significantly improved on the general and cognitive fatigue domains [effect size +16 points (7–25), p < 0.001, and +10 points (2–17), p = 0.015, compared to the control period]. Before training, fear regarding exercise scored on the fear thermometer was low for both children and parents (median score 1 and 2, respectively, on a scale of 0–8). After training, child-reported fear decreased further compared to the control period [effect size −1.4 points (−2.3 to −0.6), p = 0.001]. At baseline, children had increased REE +12% compared to reference values, which did not change after exercise. Children ate an average of 637 calories below recommended intake based on REE, caloric deficit became smaller after the intervention, and protein intake increased compared to the control period [−388 calories (−674 to −102), p = 0.008, and +15 g (0.4–30), p = 0.044]. Body fat percentage did not change significantly.ConclusionA 12-week lifestyle intervention improved parent-reported fatigue symptoms in the children, further decreased child-reported fears, and increased caloric and protein intake.https://www.frontiersin.org/articles/10.3389/fped.2023.1154015/fullFontan circulationlifestyle interventionfatiguefearsbody compositionrest energy expenditure |
| spellingShingle | L. E. Scheffers L. E. Scheffers L. E. Scheffers L. E. Scheffers W. A. Helbing T. Pereira S. Walet E. M. W. J. Utens E. M. W. J. Utens E. M. W. J. Utens K. Dulfer L. E. van den Berg A 12-week lifestyle intervention: effects on fatigue, fear, and nutritional status in children with a Fontan circulation Frontiers in Pediatrics Fontan circulation lifestyle intervention fatigue fears body composition rest energy expenditure |
| title | A 12-week lifestyle intervention: effects on fatigue, fear, and nutritional status in children with a Fontan circulation |
| title_full | A 12-week lifestyle intervention: effects on fatigue, fear, and nutritional status in children with a Fontan circulation |
| title_fullStr | A 12-week lifestyle intervention: effects on fatigue, fear, and nutritional status in children with a Fontan circulation |
| title_full_unstemmed | A 12-week lifestyle intervention: effects on fatigue, fear, and nutritional status in children with a Fontan circulation |
| title_short | A 12-week lifestyle intervention: effects on fatigue, fear, and nutritional status in children with a Fontan circulation |
| title_sort | 12 week lifestyle intervention effects on fatigue fear and nutritional status in children with a fontan circulation |
| topic | Fontan circulation lifestyle intervention fatigue fears body composition rest energy expenditure |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1154015/full |
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