{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:19:10Z","timestamp":1790709550927,"version":"4.1.0"},"reference-count":54,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,7,18]],"date-time":"2019-07-18T00:00:00Z","timestamp":1563408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hum Biol"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>There is little evidence on interrelationships between physical activity, sedentary behaviors, and health\u2010related quality of life (HRQOL) among adolescents with congenital heart disease (CHD). We hypothesized that exercise capacity would have a mediating effect on the associations of either physical activity or sedentary behavior with HRQOL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adolescents with complex CHD (n = 111) were consecutively recruited from an outpatient clinic in a general hospital in South Korea. Physical activity and sedentary behavior were assessed using the global physical activity questionnaire. Exercise capacity was directly measured by peak oxygen uptake using a symptom\u2010limited maximal treadmill exercise test. HRQOL was evaluated by both adolescents and their parents using the Pediatric Quality of Life Inventory questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The self\u2010reported and parent proxy\u2010reported HRQOL were positively associated with physical activity (<jats:italic>\u00df<\/jats:italic> = 0.16, <jats:italic>P<\/jats:italic> = .003; <jats:italic>\u00df<\/jats:italic> = 0.12, <jats:italic>P<\/jats:italic> = .049) and exercise capacity (<jats:italic>\u00df<\/jats:italic> = 0.63, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001; <jats:italic>\u00df<\/jats:italic> = 0.66, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), but not with sedentary behavior in adjusted regression models. When both variables were entered in the same regression models, only exercise capacity remained significantly associated with the self\u2010reported (<jats:italic>\u00df<\/jats:italic> = 0.50, <jats:italic>P<\/jats:italic> = .008) and parent proxy\u2010reported HRQOL (<jats:italic>\u00df<\/jats:italic> = 0.62, <jats:italic>P<\/jats:italic> = .003). Exercise capacity acted as a full mediator variable on the relationship between physical activity and HRQOL (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05 for both).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present findings suggest that exercise capacity mediates the association between physical activity and HRQOL, highlighting the importance of improving exercise capacity to potentially enhance HRQOL in adolescents with complex CHD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajhb.23297","type":"journal-article","created":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T06:04:42Z","timestamp":1563516282000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Mediating effects of exercise capacity on the association between physical activity and health\u2010related quality of life among adolescents with complex congenital heart disease"],"prefix":"10.1002","volume":"31","author":[{"given":"Hyun Jeong","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Sport Science University of Seoul  Seoul South Korea"},{"name":"Department of Pediatrics Sejong General Hospital  Bucheon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0358-7866","authenticated-orcid":false,"given":"Sae Young","family":"Jae","sequence":"additional","affiliation":[{"name":"Department of Sport Science University of Seoul  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jina","family":"Choo","sequence":"additional","affiliation":[{"name":"College of Nursing Korea University  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ja Kyoung","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Sejong General Hospital  Bucheon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong\u2010Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Sejong General Hospital  Bucheon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"K\u00f6nigstein","sequence":"additional","affiliation":[{"name":"Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arno","family":"Schmidt\u2010Trucks\u00e4ss","sequence":"additional","affiliation":[{"name":"Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry A.","family":"Franklin","sequence":"additional","affiliation":[{"name":"Preventive Cardiology and Cardiac Rehabilitation William Beaumont Hospital  Royal Oak 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