Post heart transplantation children may have some physical deconditioning, muscle weakness and reduction in the maximal aerobic capacity. Thus, improving their muscle weakness, physical fitness and quality of life through structured Cardiac Rehabilitation (CR) programs is essential.

Aims of cardiac rehabilitation

The overall aims of the CR program are to help patients to achieve an independent, satisfying existence and to improve their quality of life to return them to a life-style that approximates normal. These aims would be achieved by adjusting physical and emotional situation, improving the physical fitness and reducing the cardiovascular risk factors through structured CR exercise program.

The CR program for pediatric consists of three Phases: Exercises program is sited on an individual basis depending on pre-operative situation, sex, and age and patient expectations

• Phase I which is pre-operative stage (waiting list period)
• Phase II is the inpatient period which may take 5 -10 days depend on the outcome of the surgery
• Phase III is the out-patient period which start immediately after discharge and may last up to 4 – 8 weeks. CR program of pediatric patients is influenced by the degree of preoperative condition, in addition to the usual effects of sternotomy, surgical trauma and postoperative status.

There is suggestive evidence that an appropriately graded training regimen facilitates restoration of lean tissue and, thus, functional denervation recovery, reducing the risk of rejection and improving long-term survival.

Patient and families (or primary caregiver) has to have a full knowledge about the importance of health nutrition, exercise and his/her medication, and be independent in taking them (with parent/family supervision)