Adaptive Digital Exercise Rehabilitation for Children After CHD Surgery
5 mai 2026 mis à jour par: The Children's Hospital of Zhejiang University School of Medicine
Development and Evaluation of a Just-in-Time Adaptive Digital Exercise Rehabilitation Program for Children After Congenital Heart Disease Surgery
The goal of this clinical trial is to evaluate whether a Just-in-Time Adaptive Intervention (JITAI)-based digital exercise rehabilitation program can improve postoperative recovery in children after congenital heart disease (CHD) surgery. The study will examine whether this system can:
Improve cardiopulmonary endurance, cardiac function, and muscle strength Increase rehabilitation adherence and enhance training experience while reducing exercise-related fear Researchers will compare children receiving the adaptive digital exercise rehabilitation program with those receiving standard postoperative rehabilitation to determine whether the digital program provides additional clinical and behavioral benefits.
Participants will:
Wear non-invasive monitoring devices to collect real-time physiological data Engage in daily structured exercise rehabilitation sessions guided by the digital system Receive adaptive adjustments in exercise intensity based on real-time physiological feedback Complete questionnaires on recovery, emotional status, and rehabilitation experience
Aperçu de l'étude
Statut
Pas encore de recrutement
Type d'étude
Interventionnel
Inscription (Estimé)
130
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Coordonnées de l'étude
- Nom: hua ji Zhu
- Numéro de téléphone: +86 13588326715
- E-mail: jihuazhu@zju.edu.cn
Lieux d'étude
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Zhejiang
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Hangzhou, Zhejiang, Chine, 31000
- Zhejiang University School of Medicine Children's Hospital
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Contact:
- hua ji Zhu
- Numéro de téléphone: +86 13588326715
- E-mail: jihuazhu@zju.edu.cn
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
- Enfant
Accepte les volontaires sains
Non
La description
Inclusion Criteria:
- Children aged 6 to 12 years
- Diagnosed with congenital heart disease (CHD) and have undergone cardiac surgery
- Clinically stable after transfer to the general ward, with stable circulatory, respiratory, musculoskeletal, and neurological status, and assessed by the clinician as suitable to begin active exercise rehabilitation
- Able to understand and cooperate with basic exercise training requirements
- Written informed consent provided by the child and the legally authorized guardian
Exclusion Criteria:
- Absolute contraindications to exercise rehabilitation, including uncontrolled arrhythmia, acute heart failure, hemodynamic instability, severe aortic stenosis, acute myocarditis, or acute pericarditis
- Severe comorbid conditions that could interfere with rehabilitation, including severe hepatic or renal dysfunction, malignancy, or acute infection
- Musculoskeletal or neuromuscular disorders that would prevent participation in or completion of the rehabilitation training
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Soins de soutien
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Expérimental: Adaptive Digital Rehabilitation (JITAI-Based) Group
Participants will receive the JITAI-based adaptive digital exercise rehabilitation program supported by wearable monitoring devices and the digital rehabilitation platform.
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This behavioral intervention uses a Just-in-Time Adaptive Intervention (JITAI)-based digital rehabilitation program to provide individualized exercise guidance for children recovering from congenital heart disease (CHD) surgery.
The program integrates wearable monitoring devices with a digital rehabilitation platform to deliver real-time exercise prompts, adaptive training intensity adjustments, and continuous feedback based on physiological signals and exercise performance.
During the intervention, participants receive structured postoperative exercise training that includes daily activity guidance, monitoring of heart rate and oxygen saturation, safety alerts, and automated recommendations to support adherence and optimize training effectiveness.
The system aims to improve cardiopulmonary endurance, functional capacity, and recovery-related behaviors while ensuring safety through real-time monitoring and adaptive adjustments.
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Comparateur actif: Standard Rehabilitation Care Group
Participants will receive standard postoperative exercise rehabilitation according to current clinical guidelines, without adaptive digital adjustments.
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A conventional post-operative exercise rehabilitation program based on existing pediatric cardiac rehabilitation guidelines.
The program includes routine breathing training, early mobilization, and graded activity exercises supervised by clinical staff.
No adaptive algorithm or real-time system-driven adjustments are used.
Wearable devices may be used for data collection only, without influencing the intervention.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change in Six-Minute Walk Distance (6MWD)
Délai: Baseline to post-intervention (approximately 7-10 days postoperative period)
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Six-minute walk distance will be measured to assess changes in functional exercise capacity in children after congenital heart disease surgery.
The outcome will compare the improvement in 6MWD between the adaptive digital rehabilitation group and the usual care group.
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Baseline to post-intervention (approximately 7-10 days postoperative period)
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Cardiac Function Parameters (LVEF, FS)
Délai: Baseline to Post-intervention (within 7-10 days after surgery)
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Left ventricular ejection fraction (LVEF) assessed via echocardiography to evaluate changes in cardiac function following rehabilitation.
Higher values indicate better cardiac performance.
Measurements will be compared across study arms.
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Baseline to Post-intervention (within 7-10 days after surgery)
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Lower Extremity Muscle Strength
Délai: Baseline to Post-intervention (within 7-10 days after surgery)
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Assessment of lower-limb muscle strength using standardized pediatric strength testing (e.g., manual muscle testing or dynamometer as applicable).
Measures reflect postoperative physical recovery and response to the adaptive rehabilitation intervention.
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Baseline to Post-intervention (within 7-10 days after surgery)
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Training Adherence Rate
Délai: Assessed at discharge
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Percentage of prescribed training sessions completed by participants.
Higher percentage indicates better adherence.
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Assessed at discharge
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Change in Exercise Fear (TSK-C Score)
Délai: From baseline to 4 weeks after the intervention
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Change in fear of movement/exercise measured using the Tampa Scale for Kinesiophobia for Children (TSK-C).
Total scores range from 11 to 44, with higher scores indicating worse kinesiophobia (greater fear of movement/exercise) and lower scores indicating improvement.
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From baseline to 4 weeks after the intervention
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Exercise enjoyment score
Délai: Within 24 hours after completion of the intervention
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Participant-reported exercise enjoyment measured using a child-appropriate version of the Physical Activity Enjoyment Scale (PACES).
Total scores range from 16 to 80, with higher scores indicating greater enjoyment and a more positive exercise experience.
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Within 24 hours after completion of the intervention
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Incidence, number, and type of exercise-training safety events
Délai: From baseline (first exercise training session) through hospital discharge, up to [30 days].
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Incidence, number, and type of safety events occurring during exercise training, including abnormal heart rate, oxygen desaturation, unstable blood pressure, or early termination of treatment due to prespecified safety criteria.
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From baseline (first exercise training session) through hospital discharge, up to [30 days].
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Publications générales
- Gonul S, Namli T, Huisman S, Laleci Erturkmen GB, Toroslu IH, Cosar A. An expandable approach for design and personalization of digital, just-in-time adaptive interventions. J Am Med Inform Assoc. 2019 Mar 1;26(3):198-210. doi: 10.1093/jamia/ocy160.
- Nahum-Shani I, Smith SN, Spring BJ, Collins LM, Witkiewitz K, Tewari A, Murphy SA. Just-in-Time Adaptive Interventions (JITAIs) in Mobile Health: Key Components and Design Principles for Ongoing Health Behavior Support. Ann Behav Med. 2018 May 18;52(6):446-462. doi: 10.1007/s12160-016-9830-8.
Liens utiles
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Estimé)
30 décembre 2026
Achèvement primaire (Estimé)
30 janvier 2029
Achèvement de l'étude (Estimé)
28 février 2029
Dates d'inscription aux études
Première soumission
28 janvier 2026
Première soumission répondant aux critères de contrôle qualité
5 mai 2026
Première publication (Réel)
8 mai 2026
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
8 mai 2026
Dernière mise à jour soumise répondant aux critères de contrôle qualité
5 mai 2026
Dernière vérification
1 décembre 2025
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 2026-IRB-0019
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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