Sport, exercise, and physical activity in children with cardiovascular disease. A Clinical Consensus Statement of the European Association of Preventive Cardiology (EAPC) of the ESC, the Association of Cardiovascular Nursing & Allied Professions (ACNAP) of the ESC, and the Association for European Paediatric and Congenital Cardiology (AEPC)
Abstract
Regular physical activity offers numerous benefits to children's health and well-being and is essential for reducing cardiovascular risk in children with cardiovascular disease. Despite increasing evidence supporting its benefits, many young patients remain insufficiently active because of concerns regarding exercise related risks, limited expertise. This clinical consensus statement provides practical guidance for the prescription of exercise and physical activity in children and adolescents aged 6 to 17 years with cardiovascular disease. The document aims to bridge the gap between evidence supporting the benefits of physical activity and its implementation in daily clinical practice, promoting safe participation in sport and exercise across a broad spectrum of cardiovascular conditions. This consensus statement outlines an individualised, patient-centred approach to exercise prescription based on clinical assessment, cardiovascular risk stratification, and the FITT principle: frequency, intensity, time, and type. Specific recommendations are provided for congenital and acquired heart disease, cardiomyopathies, arrhythmias, pulmonary hypertension, cardio-oncology patients, and children with physical disabilities or syndromes. The document emphasises the importance of multidisciplinary care, periodic follow up, exercise testing when indicated, and tailored programs adapted to the child's clinical condition, developmental stage, and personal preferences. The overarching goal is to encourage safe and enjoyable participation in physical activity, improve quality of life and functional capacity, and foster lifelong healthy behaviours in children with cardiovascular disease.
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Authors: Monica Tiberi, Flavio D’Ascenzi, Elena Cavarretta, Jessica Joan Orchard, Mark Abela, Maria Bäck, Martin Bahls, Frank A Casey, Silvia Castelletti, Guido Claessen, Fabrizio Drago, Thijs M.H. Eijsvogels, Gherardo Finocchiaro, Sabiha Gati, Henner Hanssen, Martin Halle, Viviana Maestrini, Aneil Malhotra, Nicola Mochi, Jan Marco Müller, Josef Niebauer, Rhoia Clara Neidenbach, David Niederseer, Michael Papadakis, Antonio Pelliccia, María Sanz‐de la Garza, Monika Siegrist, Graham Stuart, Alessandro Zorzi, Craig Anthony Williams, Guido E. Pieles
Institutions: University of Padua, The University of Sydney, University of Exeter, University of Basel, KU Leuven, University of Bristol, University College London, Sahlgrenska University Hospital, Queen's University Belfast, Radboud University Nijmegen, University Hospital Zurich, Azienda Usl Toscana Centro, German Centre for Cardiovascular Research, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Linköping University, Sapienza University of Rome, Technical University of Munich, Hasselt University, Institute of Sports Medicine and Science, Radboud University Medical Center, Paracelsus Medical University, Universitätsmedizin Greifswald, University of Siena, Azienda di Rilievo Nazionale ed Alta Specializzazione, University Medical Center, Bambino Gesù Children's Hospital, Royal Brompton Hospital, English Institute of Sport, Ospedale Santa Maria della Misericordia di Udine, Manchester Metropolitan University, Azienda Socio Sanitaria Territoriale Lariana, University of Malta, Misericordia University, St George’s University Hospitals NHS Foundation Trust, St. George's University, Hartcentrum Hasselt, Institute for Sports Medicine, Biomedical Research Institute, CK-CARE, Hochgebirgsklinik Davos, Mater Dei Hospital, Qatar Orthopaedic and Sports Medicine Hospital