The provision and impact of rehabilitation provided by physiotherapists in children and young people with congenital heart disease following cardiac surgery: a scoping review

Stephanie L Clarke; Natalie C Milburn; Julie C Menzies; Nigel E Drury

doi:10.1016/j.physio.2023.09.001

The provision and impact of rehabilitation provided by physiotherapists in children and young people with congenital heart disease following cardiac surgery: a scoping review

Physiotherapy. 2024 Mar:122:47-56. doi: 10.1016/j.physio.2023.09.001. Epub 2023 Sep 29.

Authors

Stephanie L Clarke¹, Natalie C Milburn², Julie C Menzies³, Nigel E Drury⁴

Affiliations

¹ Department of Physiotherapy, Birmingham Women's and Children's Hospital NHS Foundation Trust, Steel House Lane, Birmingham B4 6NH, UK. Electronic address: stephanie.clarke17@nhs.net.
² Department of Physiotherapy, Birmingham Women's and Children's Hospital NHS Foundation Trust, Steel House Lane, Birmingham B4 6NH, UK. Electronic address: n.hemming@nhs.net.
³ Paediatric Intensive Care, Birmingham Women's and Children's Hospital NHS Foundation Trust, Steel House Lane, Birmingham B4 6NH, UK. Electronic address: julie.menzies2@nhs.net.
⁴ Department of Paediatric Cardiac Surgery, Birmingham Children's Hospital, Steel House Lane, Birmingham B4 6NH, UK; Institute of Cardiovascular Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Electronic address: n.e.drury@bham.ac.uk.

PMID: 38241942
DOI: 10.1016/j.physio.2023.09.001

Abstract

Introduction: Children with congenital heart disease (CHD) are at risk of delayed motor development with increased risk for those requiring cardiac surgical intervention. We conducted a scoping review to identify the provision and impact of physiotherapy-delivered rehabilitation in children and young people with CHD following cardiac surgery.

Methods: CINAHL, EMBASE, PUBMED, AHMED, EMCARE, Cochrane Database of Systematic Reviews, NHS Evidence databases were searched (2000-2022). Included studies were published in full, in English and reported the use of physiotherapy in CHD (participants 0-18years) post-surgical procedure. Articles were screened by title and abstract and through full-text review with results structured in accordance with the PAGER framework and PRISMA- ScR checklist.

Results: Seven full text peer reviewed papers published 2014-2021 were identified from 5747 papers screened. Included papers were predominantly non-randomised cohort studies with a sample size of between one and 247. Study participants ranged from eight days to 16 years, with a variety of congenital heart defects and surgical procedures. The provision of physiotherapy varied with a range of rehabilitation formats and physiotherapeutic interventions utilised. Physiotherapy provision appeared to have a positive impact on functional/ developmental outcomes and muscle strength.

Discussion: Assessing the impact and provision of physiotherapy in CHD post-surgical intervention is challenging based on the published literature, due to small sample sizes, lack of control groups, heterogeneous demographics and variable intervention and formats delivered. Further research is required to identify the optimum format of physiotherapy provision and establish the potential impact of physiotherapy delivered rehabilitation on motor function and development. CONTRIBUTION OF THE PAPER.

Keywords: Congenital heart disease; Motor development; Paediatrics; Physical therapy; Physiotherapy; Rehabilitation.

Publication types

Systematic Review
Review

MeSH terms

Adolescent
Cardiac Surgical Procedures*
Child
Heart Defects, Congenital* / surgery
Humans
Physical Therapists*
Physical Therapy Modalities