Physical activity participation in youth with surgically corrected congenital heart disease: Devising guidelines so Johnny can participate.

While most youth with congenital heart disease have simple structural lesions and near-normal activity tolerance and functioning, youth with complex structural defects may be affected by significant morbidity. Efforts are being made to consider the impact of exercise and physical activity on quality of life. The benefits of physical activity are well documented; however, the levels of participation and self-efficacy for activity remain low, thus increasing the risk of obesity and cardiovascular morbidity. Rehabilitation is a novel and emerging area, and decisions regarding advocacy versus restriction of physical activity may pose a challenge for both cardiologists and nonspecialists. The present article outlines the rationale for physical activity recommendations in youth with surgically corrected congenital heart disease and the psychosocial determinants of participation. Clinical recommendations and future directions are proposed.