One of my day-to-day worries as a heart parent is trying to work out just how much exercise is safe for my heart child. I know that it is important for her to get a good amount of exercise, but I worry about her overexerting herself and potentially putting strain on her heart. We have been told that she will self-limit but sometimes it is hard not to step in and restrict her if I think she is getting tired. I was recently invited to give feedback on some booklets which are being produced by Heart Research UK as part of their physical activity toolkit which they are hoping to launch next spring. They will be a great resource for helping answer some of the questions that heart children and their parents may have regarding exercise and have helped reinforce some of the information I have previously read from other resources.
The benefits of regular exercise
Regular exercise helps us to maintain a healthy weight, improve fitness levels and increase exercise capacity levels, and reduces the risk of developing cardiovascular disease. Recommendations published in the European Journal of Preventive Cardiology advise that children with congenital heart defects should have “60 minutes or more of moderate-to-vigorous physical activity” each day.
How much is too much?
Although the general recommendation is that children with CHDs participate in 60 minutes of physical activity per day, this does not need to be in one session. It is important for heart children not to push themselves too far and put extra strain on their heart. Little Hearts Matter state that the golden rule for knowing how much is too much is this:
What activities are suitable for heart children?
Which types of exercise are suitable depends on your child’s specific heart condition and medical needs. Dynamic activities – those that use lots of muscle groups with plenty of movement – e.g. jogging, swimming or tennis, are best for improving cardiovascular fitness whereas static activities, such as weight lifting, which use muscles but involve very little movement, are less advisable. It is important to discuss which activities are suitable for your heart child with your cardiologist as some activities may be fine for some heart children but not for others.
Whilst taking part in certain sports recreationally may be fine, heart children may be advised not to take part competitively. This is because children may tempted to push themselves too far due to wanting to win or do well, and the pressure of this may also cause emotional stress. It is important to discuss with your child’s cardiologist whether certain sports can be taken part in competitively, recreationally or not at all.
Children on anticoagulant therapy, such as aspirin or warfarin, may be advised to avoid contact sports as they are at increased risk of bruising or excessive bleeding. Contact sports are also likely to be inadvisable if your child has a pacemaker as an impact could cause damage to the pacemaker device or to the area around the pacemaker.
How can I help encourage my child to exercise?
Making exercise fun – finding activities that your child enjoys, or that involve social interaction can help. Activities that the whole family can enjoy are also a great way of encouraging exercise – for example, going out for walks together, kicking a ball around the park, having a dance at a party. Most children respond well to praise and encouragement and nagging is best avoided, particularly with older children and teenagers! Keeping an activity log may also be useful for keeping track of opportunities to include small chunks of exercise in normal daily life.
- Takken et al (2011) Recommendations for physical activity, recreation sport, and exercise training in paediatric patients with congenital heart disease, European Journal of Preventive Cardiology – abstract available here.
- Heart Research UK website.
- Little Hearts Matter website.
- Little Hearts Matter Sports and Exercise booklet (also includes info about school PE lessons and advice for teachers on what to do if child becomes too breathless to talk and when to seek emergency assistance.)
Disclaimer: I am a heart parent sharing general advice about exercise from a variety of sources, including information leaflets from heart charities. Please note that all heart children are different and have different needs. Any concerns should be discussed with your child’s cardiology team.