A Pilot Study to Assess the Feasibility and Impact of a Home Exercise Program on Heart Rate and Heart Rate Variability in Children with Muscular Dystrophy (P4.163)

Objective: To determine if a home exercise program is feasible and beneficial in a pediatric muscular dystrophy (MD) population.

Background: Research has shown that children with MD exhibit tachycardia and decreased heart rate variability (HRV), sometimes reversible with aerobic exercise. Whether aerobic exercise will improve long-term clinical outcomes in children with MD is unknown. Feasibility and barriers with respect to a voluntary, aerobic home exercise program are poorly studied.

Design/Methods: A 4-week voluntary game-based home exercise program was created and trialed by 12 children (3–11 yrs) with MD. Fitbit Charge HR bands were worn to track heart rate (HR). Satisfaction surveys and Pediatric Quality of Life Neuromuscular Module (Peds QOL:NM) were submitted weekly by parents. 24-hour Holter monitoring was performed concurrently with Fitbit in a subset of subjects.

Results: 12 games were created to provide exercise at a mean of 25 minutes three times weekly (with 95% rate of positive feedback). 75% of the participants completed participation with 82% of total surveys returned. Peds QOL: NM demonstrated a high baseline quality of life without interval change. 60% of the HR recordings during exercise were adequate. These demonstrated tachycardia for age at baseline (mean 113 BPM) with a mean increase during exercise of 7 BPM. 24-hour Holter monitoring was performed on 3 subjects simultaneously wearing a Fitbit. Holter HR and Fitbit HR were comparable with Holter mean HR consistently higher than Fitbit mean HR (+2.0% to +8.4%). The average cost per exercise kit was $3.88.

Conclusions: A novel, inexpensive aerobic exercise program was trialed allowing children with MD to exercise at home in an enjoyable, cost-effective manner. Fitbit Charge HR is an inexpensive, long term HR monitor that recorded values comparable to Holter HR monitoring. Fitbit HR averages are slightly lower than Holter monitoring likely due to inability to capture short bursts of tachycardia.

Study Supported by: AAN Medical Student Summer Research Scholarship

Disclosure: Dr. Zelikovich has nothing to disclose. Dr. Oswald has nothing to disclose. Dr. Kuntz has received personal compensation for activities with National Advisory Board for Biogen, AveXis, Catalyst, Cytokinetics, Marathon, PTC, and Sarepta as an advisory board member and consultant and with CureSMA and MGFA as an adviser.