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
- In this study we highlight that the role of physiotherapy in the rehabilitation of children with CHD is an emerging area of research which needs further exploration. To the authors knowledge there are currently no published articles that have fully explored and reviewed the literature surrounding this topic.
- Children with CHD are at increased risk of motor developmental delay and loss of motor function, thus requiring a period of rehabilitation by a physiotherapist. Currently, clinical practice is widely based on anecdotal evidence and local service provision.
- The articles included in this review suggest that physiotherapeutic intervention can be helpful. However, due to the heterogeneous methodologies employed it is not possible to use the current published literature to generate universal guidelines that can be transferred into clinical practice. Key themes highlighted in the literature were the need for clarification regarding what format is optimal and the impact physiotherapeutic interventions have on outcomes.