{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T08:38:22Z","timestamp":1772181502056,"version":"3.50.1"},"reference-count":41,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,5,30]],"date-time":"2021-05-30T00:00:00Z","timestamp":1622332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008057","name":"Fundaci\u00f3n para la Investigaci\u00f3n del Hospital Universitari La Fe","doi-asserted-by":"publisher","award":["2017\/0506"],"award-info":[{"award-number":["2017\/0506"]}],"id":[{"id":"10.13039\/100008057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Critical medical and surgical advances have led to a shift in the care and management of children with congenital heart disease (CHD). These patients present with muscle deconditioning, which negatively influences their response to exercise, functional capacities, and quality of life. This study evaluates the influence of a cardiopulmonary rehabilitation program (CPRP) on the function of peripheral musculature of children with CHD. A single-center prospective cohort study was designed. Fifteen CHD subjects, between 12 and 16 years of age, with reduced aerobic capacity on a cardiopulmonary exercise test, were included in a three-month, 24-session CPRP. Measurements of the subjects\u2019 handgrip strength, biceps brachii and quadriceps femoris strength, and triceps surae fatigue process were collected at the beginning of the program, after completion, and six months after the end of the intervention. A substantial and statistically significant improvement was observed in the subjects\u2019 handgrip strength (kg) (p &lt; 0.001), biceps brachii and quadriceps femoris strength (N) (p &lt; 0.001), as well as triceps surae fatigue process (repetitions) (p = 0.018), with a maintenance of the results six months after the intervention. These results suggest that a CPRP could potentially improve the peripheral muscle function of children with CHD. Additional research is needed to confirm and expand on this hypothesis.<\/jats:p>","DOI":"10.3390\/ijerph18115870","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T00:22:15Z","timestamp":1622420535000},"page":"5870","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Effects of Cardiopulmonary Rehabilitation on the Muscle Function of Children with Congenital Heart Disease: A Prospective Cohort Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9016-5543","authenticated-orcid":false,"given":"Francisco Jos\u00e9","family":"Ferrer-Sargues","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Alfara del Patriarca, 46113 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7177-0171","authenticated-orcid":false,"given":"Esteban","family":"Peir\u00f3-Molina","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Section, Hospital Universitari i Polit\u00e8cnic La Fe, 46026 Valencia, Spain"},{"name":"Regenerative Medicine and Heart Transplantation Unit, Instituto de Investigaci\u00f3n Sanitaria La Fe, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8803-3963","authenticated-orcid":false,"given":"Maria \u00c0ngels","family":"Cebri\u00e0 i Iranzo","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Universitat de Val\u00e8ncia, 46010 Valencia, Spain"},{"name":"Rehabilitation and Physical Medicine Service, Hospital Universitari i Polit\u00e8cnic La Fe, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Ignacio","family":"Carrasco Moreno","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Section, Hospital Universitari i Polit\u00e8cnic La Fe, 46026 Valencia, Spain"},{"name":"Regenerative Medicine and Heart Transplantation Unit, Instituto de Investigaci\u00f3n Sanitaria La Fe, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Cano-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Section, Hospital Universitari i Polit\u00e8cnic La Fe, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Isabel","family":"V\u00e1zquez-Arce","sequence":"additional","affiliation":[{"name":"Rehabilitation and Physical Medicine Service, Hospital Universitari i Polit\u00e8cnic La Fe, 46026 Valencia, Spain"},{"name":"Faculty of Medicine and Health Sciences, Universidad San Vicente M\u00e1rtir, 46001 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Insa Albert","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Section, Hospital Universitari i Polit\u00e8cnic La Fe, 46026 Valencia, Spain"},{"name":"Regenerative Medicine and Heart Transplantation Unit, Instituto de Investigaci\u00f3n Sanitaria La Fe, 46026 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3370-0196","authenticated-orcid":false,"given":"Pablo","family":"Salvador-Coloma","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Alfara del Patriarca, 46113 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1016\/S0735-1097(02)01886-7","article-title":"The incidence of congenital heart disease","volume":"39","author":"Hoffman","year":"2002","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"141","DOI":"10.5830\/CVJA-2013-028","article-title":"The global burden of congenital heart disease","volume":"24","author":"Hoffman","year":"2013","journal-title":"Cardiovasc. J. Afr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1161\/CIRCULATIONAHA.114.012033","article-title":"Achievements in congenital heart defect surgery: A prospective, 40-year study of 7038 patients","volume":"131","author":"Erikssen","year":"2015","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1007\/s00246-015-1201-x","article-title":"Quality of Life of Children with Congenital Heart Diseases: A Multicenter Controlled Cross-Sectional Study","volume":"36","author":"Amedro","year":"2015","journal-title":"Pediatr. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1136\/heart.85.3.295","article-title":"Lung function and aerobic capacity in adult patients following modified Fontan procedure","volume":"85","author":"Fredriksen","year":"2001","journal-title":"Heart"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2915","DOI":"10.1093\/eurheartj\/ehq249","article-title":"ESC Guidelines for the management of grown-up congenital heart disease (new version 2010)","volume":"31","author":"Baumgartner","year":"2010","journal-title":"Eur. Heart J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1136\/hrt.2010.213579","article-title":"Generalised muscle weakness in young adults with congenital heart disease","volume":"97","author":"Greutmann","year":"2011","journal-title":"Heart"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Acosta-Dighero, R., Torres-Castro, R., Rodr\u00edguez-N\u00fa\u00f1ez, I., Rosales-Fuentes, J., Vilar\u00f3, J., Fregonezi, G., and Lopetegui, B. (2020). Physical activity assessments in children with congenital heart disease: A systematic review. Acta Paediatr. Int. J. Paediatr.","DOI":"10.1111\/apa.15478"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1542\/peds.2004-2697","article-title":"Impact of cardiac rehabilitation on the exercise function of children with serious congenital heart disease","volume":"116","author":"Rhodes","year":"2005","journal-title":"Pediatrics"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.1161\/CIR.0b013e318293688f","article-title":"Promotion of physical activity for children and adults with congenital heart disease: A scientific statement from the American Heart Association","volume":"127","author":"Longmuir","year":"2013","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1542\/peds.107.6.1470","article-title":"Strength training by children and adolescents","volume":"107","author":"Bernhardt","year":"2001","journal-title":"Pediatrics"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1519\/1533-4287(1996)010<0109:TEOSTA>2.3.CO;2","article-title":"The Effects of Strength Training and Detraining on Children","volume":"10","author":"Faigenbaum","year":"1996","journal-title":"J. Strength Cond. Res."},{"key":"ref_13","unstructured":"Thompson, P. (2017). ACSM Guidelines for Exercise Testing and Prescription Benefits and Risks Associated with Physical Activity, Lippincott Williams & Wilkins. [10th ed.]."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/s00246-015-1270-x","article-title":"Impact of Exercise Training in Aerobic Capacity and Pulmonary Function in Children and Adolescents After Congenital Heart Disease Surgery: A Systematic Review with Meta-analysis","volume":"37","author":"Saquetto","year":"2016","journal-title":"Pediatr. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/eurheartj\/ehaa554","article-title":"2020 ESC Guidelines for the management of adult congenital heart disease: The Task Force for the management of adult congenital heart disease of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Adult Congenital Heart Disease (ISACHD)","volume":"42","author":"Baumgartner","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1164\/arrd.1984.129.2P2.S47","article-title":"Gas Exchange Response to Exercise in Children","volume":"129","author":"Cooper","year":"1984","journal-title":"Am. Rev. Respir. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.anpedi.2017.12.016","article-title":"Body mass index and tri-ponderal mass index of 1,453 healthy non-obese, non-undernourished millennial children. The Barcelona longitudinal growth study","volume":"89","author":"Carrascosa","year":"2018","journal-title":"An. Pediatr\u00eda"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1093\/ageing\/afr051","article-title":"A review of the measurement of grip strength in clinical and epidemiological studies: Towards a standardised approach","volume":"40","author":"Roberts","year":"2011","journal-title":"Age Ageing"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.pmrj.2010.10.025","article-title":"Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: A systematic review","volume":"3","author":"Stark","year":"2011","journal-title":"PM R"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1093\/ptj\/66.2.206","article-title":"Test-retest reliabilty of hand-held dynamometry during a single session of strength assessment","volume":"66","author":"Bohannon","year":"1986","journal-title":"Phys Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.jsams.2008.12.628","article-title":"Raising the standards of the calf-raise test: A systematic review","volume":"12","author":"Schneiders","year":"2009","journal-title":"J. Sci. Med. Sport"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1080\/003655098444156","article-title":"Muscle fatigue in a standing heel-rise test","volume":"30","author":"Svantesson","year":"1998","journal-title":"Scand. J. Rehab. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/PEP.0b013e318227ccff","article-title":"Isometric muscle strength in youth assessed by hand-held dynamometry: A feasibility, reliability, and validity study: A feasibility, reliability, and validity study","volume":"23","author":"Maltais","year":"2011","journal-title":"Pediatr. Phys. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S187","DOI":"10.21037\/cdt.2019.09.16","article-title":"The value of hand grip strength (HGS) as a diagnostic and prognostic biomarker in congenital heart disease","volume":"9","author":"Neidenbach","year":"2019","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_25","first-page":"267","article-title":"Different continuous training modalities result in distinctive effects on muscle structure, plasticity and function","volume":"12","author":"Pallone","year":"2020","journal-title":"Biomed. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Stout, K.K., Daniels, C.J., Aboulhosn, J.A., Bozkurt, B., Broberg, C.S., Colman, J.M., Crumb, S.R., Dearani, J.A., Fuller, S., and Gurvitz, M. (2019). 2018 AHA\/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines. J. Am. Coll. Cardiol., 139.","DOI":"10.1161\/CIR.0000000000000603"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Ferrer-Sargues, F.J., Peir\u00f3-Molina, E., Salvador-Coloma, P., Carrasco Moreno, J.I., Cano-S\u00e1nchez, A., V\u00e1zquez-Arce, M.I., Insa Albert, B., Sepulveda Sanchis, P., and Cebri\u00e0 i Iranzo, M.\u00c0. (2020). Cardiopulmonary rehabilitation improves respiratory muscle function and functional capacity in children with congenital heart disease. A prospective cohort study. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17124328"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"728","DOI":"10.2466\/pms.2003.96.3.728","article-title":"Grip strength: A summary of studies comparing dominant and nondominant limb measurements","volume":"96","author":"Bohannon","year":"2003","journal-title":"Percept. Mot. Skills"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1007\/s00431-005-0030-y","article-title":"Outcome of muscle and bone development in congenital heart disease","volume":"165","author":"Witzel","year":"2006","journal-title":"Eur. J. Pediatr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/s00431-007-0495-y","article-title":"Mechanographic characteristics of adolescents and young adults with congenital heart disease","volume":"167","author":"Fricke","year":"2008","journal-title":"Eur. J. Pediatr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.ijcard.2013.11.014","article-title":"Muscle function in adults with congenital heart disease","volume":"170","author":"Johansson","year":"2014","journal-title":"Int. J. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1055\/s-2006-923787","article-title":"Performance and muscle oxygenation during isometric exercise and recovery in children with congenital heart diseases","volume":"27","author":"Moalla","year":"2006","journal-title":"Int. J. Sports Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s10741-007-9053-y","article-title":"Central adaptations to exercise training in patients with chronic heart failure","volume":"13","author":"Mezzani","year":"2008","journal-title":"Heart Fail. Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1139\/h2012-036","article-title":"Training effects on peripheral muscle oxygenation and performance in children with congenital heart diseases","volume":"37","author":"Moalla","year":"2012","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.ijcard.2005.02.038","article-title":"Impact of exercise training on muscle function and ergoreflex in Fontan patients: A pilot study","volume":"107","author":"Brassard","year":"2006","journal-title":"Int. J. Cardiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.jadohealth.2013.12.010","article-title":"Aerobic exercise influences quality of life of children and youngsters with congenital heart disease: A randomized controlled trial","volume":"55","author":"Dulfer","year":"2014","journal-title":"J. Adolesc. Health"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Small, C. (2013). Kinetic Control\u2014The Management of Uncontrolled Movement, Elsevier.","DOI":"10.1016\/j.ptsp.2012.09.001"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/j.apmr.2019.12.006","article-title":"Acute Hemodynamic Effects of Virtual Reality\u2013Based Therapy in Patients of Cardiovascular Rehabilitation: A Cluster Randomized Crossover Trial","volume":"101","author":"Ribeiro","year":"2020","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1159\/000481264","article-title":"Effectiveness of a home-based active video game programme in young cystic fibrosis patients","volume":"95","author":"Blanco","year":"2018","journal-title":"Respiration"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.ypmed.2017.06.027","article-title":"The influence of fathers on children\u2019s physical activity: A review of the literature from 2009 to 2015","volume":"102","author":"Neshteruk","year":"2017","journal-title":"Prev. Med."},{"key":"ref_41","first-page":"49","article-title":"Physical activity and sport participation in youth with congenital heart disease: Perceptions of children and parents","volume":"25","author":"Moola","year":"2008","journal-title":"Adapt. Phys. Act. Q."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/11\/5870\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:09:00Z","timestamp":1760162940000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/11\/5870"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,30]]},"references-count":41,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["ijerph18115870"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18115870","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,30]]}}}