Physical Activity and Sports Participation of Children with Congenital Heart Disease: A Nationwide Survey

Objectives: In children with congenital heart disease (CHD), a sedentary lifestyle should be avoided and usually WHO recommendations on physical activity (PA) should be followed. To obtain representative data regarding the real-life situation of the amount of PA and sports participation (and potential barriers) in children with CHD living in Germany we performed a nationwide online survey.

Methods: Participants were contacted and recruited via the patient database of the German National Registry for Congenital Heart Defects.PA and sports participation was assessed using the validated comprehensive questionnaire of the “Motorik-Modul” (MoMo) from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), thus allowing the comparison of obtained data with a representative age-matched subset of 4,134 participants of the MoMo wave-2 study(2014–2017). The questionnaire for CHD-patients was amended by specific questions regarding medical care, sports recommendations and restrictions. Statistical analysis was performed using Pearson’s Chi-square test, univariable and multivariable ANCOVA.

Result: From a total of 21,354 eligible patients aged 6 to 17 years, 1,718 patients and their caregivers agreed to participate, resulting in a total of 1,198 complete datasets. Of those, 34.3% had simple, 35.3% moderate, and 30.4% had complex CHD. Compared with MoMo participants, CHD patients reached significantly less common the WHO recommended level of 60 minutes of daily PA (9 vs. 12%; p < 0.001). Participation in sports clubs was significantly reduced in children with complex CHD compared with MoMo participants (53.6 vs. 67.6%; p < 0.001). Both, interest and enjoyment in sports were almost equally distributed across CHD groups and MoMo participants, and was strongly correlated with the level of physical activity (r = 0.42; p < 0.0001). Remarkably, 49.2% of children with complex CHD, 31.7% with moderate CHD, and even 13.1% of children with simple CHD were advised by their physician to restrict PA.

Conclusion: According to this nationwide survey, PA is reduced in children with CHD, while interest and enjoyment in sports appears to be preserved. An important reason for this might be the unexpected high rate of physician-recommended restrictions on levels of PA.