WOFAPS 2025 8th World Congress of Pediatric Surgery

Jiajia Zhu, Mengyi Chen, Hongcheng Jin, Jiajia Li, Jihua Zhu

Children's Hospital ZheJiang Univisity School Of Medicine

Purpose:
Children and adolescents with congenital heart disease (CHD) often engage in lower levels of physical activity (PA) than their healthy peers, which increases their risk of cardiovascular and psychosocial complications. This review aimed to evaluate the effectiveness of PA-promoting interventions in this population and to identify commonly used behavior change techniques (BCTs).

Method:
A systematic search was conducted in PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, CNKI and WanFang databases from inception to April 2025. Randomized controlled trials (RCTs) and non-randomized studies (NRSIs) targeting PA improvement in children and adolescents with CHD were included. Two reviewers independently screened articles, extracted data, and assessed risk of bias using RoB 2 and ROBINS-I tools. BCTs were coded based on the Behavior Change Technique Taxonomy version 1 (BCTTv1). Due to heterogeneity in study designs and outcomes, a narrative synthesis was conducted.

Results:
Fourteen studies with 1322 participants (9 RCTs, 1 cluster-RCT, 4 NRSIs) were included. Interventions varied in setting, duration, and theoretical framework, including self-determination theory and social cognitive theory. Commonly used BCTs were action planning, feedback on behavior, and prompts or cues. Three studies reported significant increases in moderate-to-vigorous physical activity (MVPA) with personalized counseling and exercise prescriptions. Structured training improved cardiorespiratory fitness, while effects on overall PA were inconsistent. Eight studies measured psychosocial outcomes, but few addressed PA motivation. Interventions based solely on digital approaches showed no significant effects. Most studies lacked long-term follow-up.

Conclusion:
Multicomponent interventions that include behavioral counseling, individualized exercise plans, and supervised training show promise for improving PA in children and adolescents with CHD. Solely digital strategies appear ineffective. Future research should emphasize psychological mechanisms and include long-term follow-up for sustainable implementation.