Physical activity recommendations for adolescents with repaired tetralogy of Fallot: review of the literature and guidelines for practitioners
Adolescents living with congenital heart defects (CHDs) are a growing population in the United States. While in the 1960s and 1970s, the risk of dying after cardiac surgery was high at 30%, over the past few decades, this risk has decreased to approximately 5%, with the majority of children born with CHD living into adulthood (American Heart Association [AHA], 2006c; Jones, Willis, & Uzark, 2006). One of the most common CHDs is tetralogy of Fallot (TOF), occurring in 9% to 14% of the children born with a CHD and approximately 5 out of every 10,000 births (AHA, 2006a, b; National Heart Lung and Blood Institute [NHLBI], 2007). The need for primary care providers to manage the health of adolescents with TOF has developed as the population and lifespan of children born with TOF has increased.
One of the most important roles of a primary care provider is to educate adolescents and their families to facilitate the achievement and maintenance of optimal health. This includes counseling adolescents, especially those living with TOF, of the importance of regular exercise and participation in sport activities as necessary factors for their physical, emotional, and social growth and development (Bar-Or & Rowland, 2004). Physical activity is also essential for the prevention of long-term cardiovascular and obesity-related health problems (AHA, 2006d). Primary care providers cannot assume the cardiologist has effectively provided this education.
Unfortunately, the literature indicates adolescents with TOF do not feel well informed regarding their cardiac condition, their physical activity allowances, or possible physical limitations (Birks, Sloper, Lewin, & Parsons, 2006; Canobbio, 2001; Cheuk, Wong, Choi, Chau, & Cheung, 2004; Falk et