{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:03:35Z","timestamp":1792735415311,"version":"4.5.0"},"reference-count":47,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T00:00:00Z","timestamp":1649289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Children with congenital heart disease (CHD) are often restricted from some types of physical activity (PA) despite the lack of evidence regarding the need to restrict recreational PA, apart from those with rhythm disorders. This study retrospectively investigated the associations between parent-reported activity restrictions (on-going need to restrict exertion, body contact or competition) and measures of health-related fitness among 236 children (8.2 \u00b1 2.1 years, range 4\u201312 years) treated for single ventricle (n = 104), tetralogy of Fallot (n = 48), transposition of the great arteries (n = 47) or atrial septal defect (n = 37). Body mass index (BMI), moderate-to-vigorous physical activity (MVPA; 7 day accelerometry), strength, flexibility, and movement skill assessment results were collected from the baseline assessment research records for two studies completed in Ontario, Canada. A subset of 62 children also had physician-reported activity restrictions. Regression models empirically tested the goodness of fit between the dependent and independent variables. Participants with body contact restrictions from both parents and physicians had significantly higher BMI z-scores (0.23 \u00b1 1.19 vs. \u22120.32 \u00b1 0.85; t = 2.55; p = 0.04 and 0.66 \u00b1 1.33 vs. \u22120.02 \u00b1 0.98; t = 2.25; p = 0.02 for CDC and WHO scores, respectively). Otherwise, BMI z-score was not associated with patient variables (p &gt; 0.36; sex, cardiac diagnosis, age, or activity restriction). Children with any type of parent-reported restriction (0.98 \u00b1 2.06 vs. \u22120.08 \u00b1 1.99; t = 3.77; p = 0.0002) were less flexible. Movement skill (TGMD-2) scores were 50% lower (25.1 \u00b1 31.2 vs. 52.6 \u00b1 28.6; F = 6.93; p = 0.009) among children with parent-reported competitive sport restrictions. Weekly MVPA (p &gt; 0.18) and strength (p &gt; 0.05) were not associated with activity restriction. Children whose parents reported PA restrictions were less flexible, and had decreased movement skill and increased BMI z-scores if the restrictions impacted competitive sport or body contact, respectively. Future research is recommended to confirm these results among larger samples of children who have both parent- and physician-specified PA restrictions.<\/jats:p>","DOI":"10.3390\/ijerph19084426","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T13:39:51Z","timestamp":1649338791000},"page":"4426","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The Impact of Physical Activity Restrictions on Health-Related Fitness in Children with Congenital Heart Disease"],"prefix":"10.3390","volume":"19","author":[{"given":"Joel","family":"Blanchard","sequence":"first","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada"},{"name":"School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian W.","family":"McCrindle","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4827-0870","authenticated-orcid":false,"given":"Patricia E.","family":"Longmuir","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada"},{"name":"School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1542\/peds.103.6.1175","article-title":"The Relation of Overweight to Cardiovascular Risk Factors among Children and Adolescents: The Bogalusa Heart Study","volume":"103","author":"Freedman","year":"1999","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1038\/oby.2011.392","article-title":"Relationships between Neighborhoods, Physical Activity, and Obesity: A Multilevel Analysis of a Large Canadian City","volume":"20","author":"Prince","year":"2012","journal-title":"Obesity"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jsams.2011.07.005","article-title":"Correlation between BMI and motor coordination in children","volume":"15","author":"Lopes","year":"2012","journal-title":"J. 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