Physical activity – What if my child has a congenital heart condition? Advice for parents and carers If you have a child who has a congenital heart condition, this booklet is for you. This booklet does not replace the advice that health professionals involved in the care of your child may give, as they know more about your child’s condition. Contents About this booklet 5 Is it safe for my child to do physical activity? 6 How much physical activity should my child do? 9 What are the benefits of regular physical activity for my child? 12 Where can I get information about the activity my child can do? 15 What are the signs and symptoms to look out for when my child is active? 18 What can I do to help? 22 Are some types of physical activity better than others for people with congenital heart conditions? 24 Are there any types of physical activity that my child should avoid? 33 What about taking part in PE, sports and physical activity at school? 38 What else can I do to encourage my child to be active? 40 What to do if someone has a cardiac arrest 43 About the British Heart Foundation 50 For more information 51 About this booklet If you have a child who has a congenital heart condition, this booklet is for you. (A congenital heart condition is when there is an abnormality in the heart, or in the main blood vessels that are joined to the heart, which was there at birth.) The booklet: explains why it is good for your child to be physically active ❤❤ provides information to help you make it easy and enjoyable for your child to be physically active safely, within the limits of their condition ❤❤ aims to make sure your child is not put off being active because of unnecessary anxiety about their heart condition ❤❤ looks at the worries that you or your child may have about physical activity and how they can be overcome. ❤❤ 5 Is it safe for my child to do physical activity? Yes. There are very few children and young people who will be advised not to do any physical activity. (You should have been told if this was the case for your child. If you’re not sure, ask your paediatric cardiac nurse specialist or congenital cardiologist.) Your child’s paediatric cardiac nurse specialist or congenital cardiologist will tell you what your child can do and if there is anything your child should avoid doing. Everyone is different, so you must get individual advice about your child’s heart condition. 6 How much physical activity should my child do? To improve health, experts recommend that children and young people aged 5-17 years should do at least 60 minutes of moderate to vigorous intensity physical activity every day. This applies to all children and young people, including those with medical conditions. Moderate-intensity activity is activity that may raise your child’s pulse, and make them breathe slightly faster and feel a little warmer – for example, brisk walking, dancing, steady cycling, roller-skating or active play. Vigorous-intensity activity is activity that will make your child ‘huff and puff’ and make them feel sweaty – for example, organised games such as football and netball as well as activities such as running, fast cycling, swimming laps, and jumping and climbing over obstacles. See page 24 for information on which of the activities mentioned above are most suitable for your child. 9 The 60 minutes activity doesn’t have to be done all at once. It can be spread across the whole day by doing several shorter amounts of activity – for example, two short bouts of 15 minutes activity running round in the playground combined with a longer bout of programmed activity such as PE or supervised recreational activity. How much your child can do depends on their particular heart condition and how well their heart functions during physical activity. Your child’s congenital cardiologist can tell you this. Your child may need to think about how much effort they put into their activity. For example, they may need to take part at a lower level of intensity than other children or young people of their age, and stop to rest at regular intervals. Most people can do more than they think, and being short of breath during physical activity may be due to being unfit and may not have anything to do with your child’s heart condition. 10 The talk test A simple way to find out if your child is doing the appropriate level of activity is to use the ‘talk test’. Your child should aim to feel warm and a bit ‘puffed’ but should still be able to talk in full sentences during a physical activity session. If your child is too breathless to talk, they are probably working too hard and need to slow down or stop to rest. They can usually re-start the activity when their breathing is more controlled. If they have enough breath to be able to sing, they are not exercising hard enough to gain the benefits of physical activity. If your child is currently inactive, they should gradually increase the amount of physical activity they do, and should aim to eventually achieve the 60 minutes a day target. If your child is currently not doing any physical activity, doing some activity – even if it’s below the recommended level – will bring more benefits than doing no physical activity at all. Any physical activity is better than none, and generally the more the better. 11 What are the benefits of regular physical activity for my child? There is lots of evidence that children and young people benefit from being physically active. This applies to all children and young people, including those with a congenital heart condition. Regular physical activity can: ❤❤ promote healthy growth and development As well as the benefits listed opposite, regular physical activity has the following important benefits for children and young people with congenital heart conditions. ❤❤ The heart is a muscle, and regular physical activity can improve the function of the heart and circulation. ❤❤ It can help improve lung function and lung capacity. ❤❤ Physical activity boosts the immune system and improves the feeling of well-being. ❤❤ When they first start doing more physical activity, some children and young people with congenital heart conditions feel more tired, but with time stamina and energy levels improve. ❤❤ help develop strong muscles and bones ❤❤ improve balance and flexibility ❤❤ help achieve and maintain a healthy body weight ❤❤ make them feel good, improve their mood and help them cope with the stresses of everyday life ❤❤ improve self-esteem and body image ❤❤ provide opportunities to make friends ❤❤ build confidence and help develop social skills. 12 13 Where can I get information about the activity my child can do? It’s important to get information about what activity your child can do, and if there is anything they should avoid doing. You can get this information from the paediatric cardiac nurse specialist or the congenital cardiologist based at the specialist cardiac centre (rather than from the local hospital cardiac clinic which your child may attend). Questions to ask the paediatric cardiac nurse specialist: 1 Are there any particular symptoms to look out for when my child is doing physical activity? 2 Is my child taking regular medication for their heart condition? And if so, does this have any implications for the type or level of physical activity they can do? 3 Should my child’s involvement in physical activity be restricted? 15 You can also ask the paediatric cardiac nurse specialist for specific guidance about your child so that this can be passed on to your child’s school. The school can then make sure that this information is accessible to all teachers and physical activity leaders, to help them plan appropriate activities for your child. The information should be updated at the start of each school year, and also if there is any medical change in your child’s condition – for example, if he or she has surgery or another type of treatment. 16 What are the signs and symptoms to look out for when my child is active? It’s OK and ‘normal’ for your child to feel warm, breathe harder, look ‘flushed’ and feel his or her heart beat faster during physical activity. What to do If you notice any of the signs and symptoms listed opposite: ❤❤ Get your child to stop and rest. ❤❤ Stay with them and reassure them. ❤❤ If they don’t get better quite quickly, or if the symptoms get worse, call 999 for an ambulance (unless you have been specifically advised to act differently by your child’s paediatric cardiac nurse specialist or congenital cardiologist). Your child should stop to rest if he or she: ❤❤ says they feel dizzy or feel faint ❤❤ becomes so breathless they cannot speak ❤❤ says they have palpitations ❤❤ becomes very pale and clammy ❤❤ complains of severe tiredness or fatigue ❤❤ becomes extremely blue (if they have a cyanotic heart condition), or ❤❤ develops new or unusual symptoms during, or immediately after, a physical activity session. 18 19 In the very unlikely event that your child collapses and becomes unconscious, call 999 straight away and ask for an ambulance. Tell them it is for an unconscious child or young person and whether they are breathing normally or not. ❤❤ If your child is breathing normally, place him or her in the recovery position. ❤❤ If they are not breathing normally, start cardiopulmonary resuscitation (CPR) immediately. (See page 43 for how to do this.) Continue doing CPR until: the ambulance crew arrives and takes over, or ❤ ❤ your child starts to show signs of regaining consciousness such as coughing, opening their eyes, speaking or moving purposefully and starts to breathe normally, or you become exhausted. ❤ If your child develops any new or unusual symptoms either during or immediately after a physical activity session, you should report this to your child’s GP and to the paediatric cardiac nurse specialist or congenital cardiologist. 20 What can I do to help? Encourage your child to be active. Everyone should try to do regular physical activity. If, as a result of their heart condition, your child has symptoms – such as breathlessness – that limit the amount of activity they can do, just let them do what they can, but at their own pace and their own level. Try a range of different activities. Encourage your child to try a range of different activities to find out which ones they enjoy and which ones they can cope with better. See page 24 for some physical activity ideas. Teach your child to warm up and cool down. Your child should always warm up for at least 10 minutes before physical activity, and cool down gradually afterwards, to allow their breathing and heart rate to return gradually to their normal level. Warming up means beginning physical activity slowly and building up gradually. Cooling down means taking time to slow down and not stopping physical activity suddenly. 22 Ask for individual advice for your child. Always ask your child’s congenital cardiologist or paediatric cardiac nurse specialist for individual guidance and advice about your child. Remember that everyone is different and your child’s heart condition may change with time. So always ask about physical activity at clinic appointments. If you have any queries in between appointments, phone or email the paediatric cardiac nurse specialist. Make sure your child has a BHF card. If your child is aged 13 to 19, make sure they have a BHF card. Your child can use this ‘ID card’ in situations where they need to prove they have a heart condition and to show what type of heart condition they have. This can help teachers and physical activity leaders to have a better understanding of what type of physical activity your child can and cannot do, although they will still need to know about your child’s individual abilities and limitations. The card also gives information on what to do in case of an emergency. The BHF card is only issued by cardiac specialists. Ask your child’s congenital cardiologist or paediatric cardiac nurse specialist for a BHF card at their next appointment. 23 Are some types of physical activity better than others for people with congenital heart conditions? You may need to think about the type of physical activity that your child can do, especially if they are very limited by their symptoms. This is because some activities are better than others for people with congenital heart conditions. Dynamic aerobic activities such as walking, running, swimming, cycling, dancing and non-contact team games are generally better for children with congenital heart conditions, as these can be done at low impact, low intensity and intermittently. (Intermittently means doing periods of activity interspersed with activity of a reduced intensity.) If your child has been advised by their specialist cardiac centre to restrict their activity in any way, good questions to ask yourself are: ‘Can my child be relied on to take part at a lower level of intensity?’ and ‘Will they slow down or stop to rest when they need to?’ Team games Some children and young people with congenital heart conditions may struggle to complete a full team game of, for example, football, netball, hockey or basketball. However, they may be able to cope if they are allowed to take part in short sessions with rests in between. If possible, the rest periods should include some activity such as walking or keeping the feet moving while sitting down. Playing in positions that need less movement around the field or pitch may be helpful. Make sure that peer pressure or ‘competitive spirit’ does not make your child over-exert themselves, either because they don’t want to let their team mates down, or out of a desire to ‘do better’. The most important issue with taking part in physical activity is your child’s level of participation in the activity, and their competitive spirit, rather than the particular sport or activity itself. For example, if your child is very competitive by nature and/or has difficulty in self-regulating their physical activity, they may need more supervision than someone with a more relaxed attitude. 24 25 Racquet and net games Striking and fielding games Activities such as tennis, badminton and volleyball are often suitable for children and young people with congenital heart conditions, as they can be done at a lower intensity if necessary. Some children and young people, especially those with a cyanotic heart condition (a condition which causes blueness), may find it difficult to complete a singles match but may cope better if playing doubles, or if the activity is adapted, or if a smaller playing area is used. The point about peer pressure or competitive spirit mentioned on page 24 also applies to racquet and net games. Activities such as cricket, rounders and softball may be suitable for children and young people with congenital heart conditions, as they are all games where some players can be inactive while others may work intensively for short periods. To accommodate children and young people with congenital heart conditions, teachers or physical activity leaders may need to adapt the activity. For example, if your child is batting in cricket, they could have someone who ‘runs for them’. 26 27 Target games Activities such as golf, bowls, archery and pétanque are low‑intensity activities which are ideal for children and young people who have reduced exercise tolerance due to their congenital heart condition. (‘Reduced exercise tolerance’ means that they are limited in how much physical activity they can do because of their heart condition.) Athletics and distance running Endurance activities such as distance running and crosscountry may present problems for some children and young people with congenital heart conditions, due to their lower exercise tolerance. These activities may need to be adapted for children and young people with congenital heart conditions. For example, they may be able to take part but at a lower intensity or walking pace, or alternate jogging and walking, or complete a shorter course. Take care with throwing and jumping activities that require a lot of short bursts of intense effort, as these may put stress on the body. Gymnastics and dance activities With these activities, the level of participation can be controlled relatively easily and there is less of a competitive element. Your child should be able to do these activities, provided they are allowed to pace their activity themselves. 28 If your child takes warfarin or has a pacemaker or ICD, they should take care when doing gymnastic apparatus work. Yoga, pilates and T’ai Chi Yoga, pilates and T’ai Chi may be suitable activities for children and young people with congenital heart conditions. Personal fitness programmes If your child wants to do a personal fitness training programme, before starting the programme first check with your child’s congenital cardiologist or paediatric cardiac nurse specialist at the specialist cardiac centre. This is particularly important if high-intensity activities or weight-training are planned as part of the programme. Swimming Recreational swimming indoors is a good activity for most children and young people with congenital heart conditions as they can do it at their own pace. However, swimming is not suitable for any child or young person who has frequent fainting or dizzy spells. You should get individual advice from the specialist cardiac centre about whether swimming is a good activity for your child. Your child should avoid breath-holding and surface-diving activities such as searching for objects at the bottom of the pool. 29 Those with cyanotic (blue) conditions may not tolerate a very cold pool and may need extra time for changing and getting dressed, as they may get breathless and tired more easily. For information about high-intensity activities such as swim training and competition-level swimming, see page 34. Adventure and outdoor activities Many children and young people with a congenital heart condition may be able to attend outdoor activity centres and school trips and take part in, for example, water sports, rock climbing, hiking, skiing, orienteering, paintballing, mountain biking and Duke of Edinburgh challenges. However, you should get individual advice from your child’s specialist cardiac centre before your child takes part in activities such as these. Important ❤❤ You should get individual advice from your child’s specialist cardiac centre before your child takes part in any activity where the level of participation or the emotional stress involved is higher than in their normal everyday or school activities. ❤❤ Some of the activities listed on pages 24-30 may not be suitable for some children and young people with heart conditions. ❤❤ See pages 35 to 36 for extra precautions for children and young people who: have a cyanotic heart condition (a condition that causes blueness) ❤ sometimes get dizziness or fainting ❤ are taking the anticoagulant warfarin, or ❤ have a pacemaker or an implantable cardioverter defibrillator (ICD). ❤ 30 31 Are there any types of physical activity that my child should avoid? Ask your child’s congenital cardiologist or paediatric cardiac nurse specialist if there are any activities that it would be better for your child to avoid. Everyone is different, and your child’s heart condition may change over time, so you need to make sure you always have up-to-date information. If you’re not sure, check with your specialist cardiac centre. Breath-holding activities As a general guide, it is better for children and young people with a congenital heart condition to avoid activities that cause breath-holding. There is often a tendency to do this when lifting heavy weights, or doing sit-ups, push-ups or chin-ups. It also includes breath-holding during stretching exercises, and in swimming during breath-holding and surface-diving activities such as searching for objects at the bottom of the pool. (And it includes playing some brass and woodwind instruments.) 33 Activities that involve breath-holding may be harmful in some people with congenital heart conditions for the following reasons. ❤❤ It causes a sudden rise in blood pressure, which puts strain on the heart and major blood vessels. ❤❤ In some congenital heart conditions, the sudden rise in blood pressure can direct blood to the lungs and this can result in a significant drop in cardiac output. ❤❤ It often means there’s more force on the chest wall. If your child has a surgical scar on their chest, this may become stretched or strained, particularly in the early months after surgery. High-intensity activities Some children and young people with heart conditions may be advised to avoid high-intensity, sustained, dynamic activities such as basketball, triathlon, competitive-level swimming, cycling or distance running and competitive team sports. Your child’s paediatric cardiac nurse specialist or congenital cardiologist will tell you if this applies to your child. 34 Important ❤❤ If your child has a cyanotic heart condition (which causes blueness) In children and young people who have a cyanotic heart condition, the blueness can be seen as a ‘dusky’ or blue tinge to the skin, lips and tongue. It is more difficult to see in children with darker skin tones. Children with cyanotic heart conditions have a much lower exercise tolerance than other children of their age, but most can take part in physical activities provided they ‘pace’ themselves and stop to rest when they are tired. These are some ways you can help: Make sure your child is appropriately dressed for activity during very hot or very cold weather, or when it is very windy. ❤ Allow your child more time to carry out their activities – for example, getting changed for activities, or getting dry and dressed after swimming. ❤ Avoid your child getting dehydrated at any time, to minimise the risk of headaches. ❤ ❤❤ If your child sometimes gets symptoms such as dizziness or fainting, they should avoid activities where a fall could be very harmful, such as water-based activities, horse-riding, motor sports, climbing and skiing. 35 ❤❤ If your child takes warfarin, or if they have a pacemaker or an ICD, it is better for them to avoid activities or contact sports where there is a repeatedly high risk of body collision – either with other people or with hard surfaces or equipment – for example, hockey, rugby, football, judo, kick-boxing and gymnastic apparatus work. This is because there is a small risk of bleeding or bruising, or of damaging the leads of the pacemaker or ICD. If your child is taking warfarin, they should take particular care with the head and abdomen. If your child has an ICD that has recently delivered an electrical shock (to restore a normal heart rhythm), they should also follow the advice for those who sometimes get symptoms of dizziness or fainting, shown on page 35. This is because they will have lost consciousness when the ICD delivered the shock. 36 What about taking part in PE, sports and physical activity at school? How you can help ❤❤ Encourage your child to take part in PE and physical activity at school and in after-school clubs – at their own pace and within their own limitations. ❤❤ Make sure you keep your child’s teachers and physical Taking part in Physical Education (PE) and other physical activities at school is important for your child, both for their long-term health and well-being and to make sure they are fully involved in school life. activity leaders (for example, after-school club leaders or coaches) fully informed about your child’s heart condition. Give them detailed information about what type and level of activity your child can do, any restrictions your child has, and what they should do if your child gets any symptoms. You can ask your child’s paediatric cardiac nurse specialist for help with this. ❤❤ Talk to your child’s teacher about how your child is coping with PE and other physical activities at school. ❤❤ If you feel that your child’s teachers or physical activity leaders are ‘over-protecting’ your child in terms of the amount of activity he or she is allowed to do, show them the report provided by the paediatric cardiac nurse specialist. 38 39 What else can I do to encourage my child to be active? ❤❤ Remember that your child doesn’t have to be ‘sporty’ or join a team or a gym in order to take part in physical activity. Walking, or dancing to their favourite music, for example, are excellent forms of activity and cost nothing. ❤❤ Encourage them to try new activities with friends and join local or after-school activity clubs. ❤❤ Limit the amount of time your child spends on sitting- down activities each day – for example, watching TV, being on the computer, or using games consoles. ❤❤ Praise and reward your child for being active. Be positive about their achievements, big or small, and reward them for persistence and taking part. ❤❤ If your child enjoys sport, that is fine, but if they don’t it really doesn’t matter. Just find another way to keep them active doing something they enjoy. ❤❤ Any activity is better than none at all! ❤❤ Encourage the whole family to be more active and set a good example yourself. Try walking to school or to the shop and use the car less. ❤❤ Go for family walks, go to the park, and play games with your children. 40 41 What to do if someone has a cardiac arrest If the person seems to be unconscious ❤❤ Check for danger: Approach with care, making sure that you, the person and anybody nearby are safe. ❤❤ Check for response: To find out if the person is conscious, gently shake him or her, and shout loudly, ‘Are you all right?’ ❤❤ If there is no response, shout for help. You will need to assess the casualty and take suitable action. Remember ABC – Airway, Breathing, CPR. If you have been taught adult basic life support and have no specific knowledge of resuscitating children, use the adult sequence given on page 44. 43 A Airway Open the person’s airway by tilting their head back and lifting their chin. C CPR Action: Cardiopulmonary resuscitation (CPR) 1 Chest compressions Start chest compressions. ❤❤ Place the heel of one hand in the centre of the person’s chest. This means on the lower half of their breastbone. ❤❤ Place the heel of your other hand on top of the first hand B and interlock your fingers. Breathing Check Look, listen and feel for signs of normal breathing. Only do this for up to 10 seconds. If you’re not sure if their breathing is normal, act as if it is not normal. Action: Get help If the person is unconscious and is not breathing normally, phone 999 for an ambulance. Send someone else to do this if you can, and ask them to come back and tell you they have done it. If you’re alone, go and phone 999 and then return to the person immediately. When asking for help, ask for an automated external defibrillator (AED) if one is available. 44 ❤❤ Make sure that you are not applying pressure over the person’s ribs or upper abdomen or the bottom end of the breastbone. Press down firmly and smoothly 30 times at a depth of about 5- 6 centimetres. Do this at a rate of 100-120 times a minute. That’s about two each second. For children you must compress the chest by at least one-third of its depth. Use either one or two hands to achieve the right amount of compression. 45 2 Rescue breaths After 30 compressions, open the airway again by tilting the head back and lifting the chin, and give two breaths to the person. These are called rescue breaths. The two breaths should not take more than 5 seconds. To do this, pinch the person’s nostrils closed using your index finger and thumb. Take a normal breath and blow steadily into the person’s mouth, making sure that no air can leak out, and watching for their chest to rise. Take about one second to make their chest rise as in normal breathing. This is an effective rescue breath. 3 Continue CPR Keep doing the 30 chest compressions followed by 2 rescue breaths until: ❤❤ the ambulance crew arrives and takes over, or ❤❤ the person starts to show signs of regaining consciousness such as coughing, opening their eyes, speaking or moving purposefully and starts to breathe normally, or ❤❤ you become exhausted. If you have not been trained to do CPR, or if you’re not able or not willing to give rescue breaths Keeping the person’s head tilted and chin lifted, take your mouth away from the person and watch for their chest to fall as air comes out. Give chest compressions only, as described in step 1 on page 45. Keep doing the chest compressions – at a rate of 100-120 times a minute – until: Take another normal breath and blow into the person’s mouth again, to give a second effective rescue breath. Then, without delay, return your hands to the correct position on the breastbone and give a further 30 chest compressions and then 2 rescue breaths. ❤❤ the ambulance crew arrives and takes over, or ❤❤ the child or young person starts to show signs of regaining consciousness such as coughing, opening their eyes, speaking or moving purposefully and starts to breathe normally, or ❤❤ you become exhausted. 46 47 Note If you have been trained to do so, you can make the following changes to the adult sequence to make it more suitable for use in children: ❤❤ Give 5 initial rescue breaths before starting chest compressions. ❤❤ If you are on your own, perform CPR for 1 minute before going for help. ❤❤ Compress the chest by one-third of its depth. For a child over 1 year, use either one or two hands as necessary to achieve the right amount of compression. For an infant under 1 year, use two fingers. 48 About the British Heart Foundation For more information The British Heart Foundation (BHF) is the nation’s heart charity, saving lives through pioneering research, patient care and vital information. British Heart Foundation bhf.org.uk For general information about heart disease. What you can do for us We rely on donations of time and money to continue our life-saving work. If you would like to make a donation, please: ❤❤ call our donation hotline on 0300 330 3322 ❤❤ visit bhf.org.uk/donate, or ❤❤ post it to us at the address on the back cover. For other ways to support our work, see bhf.org.uk/supportus 50 Heart health yheart.net/meet The BHF’s website for young people with heart conditions. Website for over-11s: yheart.net Website for under-11s: cbhf.net Children’s Heart Federation 0808 808 5000 www.chfed.org.uk The leading children’s heart charity and umbrella body for voluntary organisations, working to meet the needs of children and young people with heart conditions and their families. Grown Up Congenital Heart Patients Association www.guch.org.uk Supports young people and adults born with heart conditions. 51 BHF publications BHF card An ‘ID card’ for young people with heart conditions. It can be used in situations where a young person needs to prove they have a heart condition and to show what type of heart condition they have. This can help teachers and physical activity leaders to have a better understanding of what type of physical activity the person can and cannot do, although they will still need to know about the person’s individual abilities and limitations. The card also gives information on what to do in the case of an emergency. The card can only be issued by your child’s cardiac specialist. For more information see bhf.org.uk/bhfcard Leaflets for young people with heart conditions The following leaflets are designed to enable young people to understand more about their heart condition as they start to take more responsibility for their own health: ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ 52 Aortic stenosis Coarctation of the aorta Hypoplastic left heart syndrome Implantable cardioverter defibrillators Large ventricular septal defect Long QT syndrome Pacemakers Pulmonary atresia Pulmonary stenosis Tetralogy of Fallot Transposition of the great arteries Tricuspid atresia. Understanding your child’s heart Each booklet in this series explains a congenital heart condition and the benefits and risks of its treatment. The booklets are intended for parents of babies and children with congenital heart conditions, and their family and friends. They give support and guidance on how to cope with a child’s heart condition and information on where to go for more support. The booklets in the series are: ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ ❤❤ Aortic stenosis Coarctation of the aorta Double-inlet ventricle Hypoplastic left heart syndrome Large ventricular septal defect Pulmonary atresia Pulmonary stenosis Single ventricle circulation Tetralogy of Fallot Transposition of the great arteries Tricuspid atresia. 53 Encouraging your child to be more active Publications Get Kids on the Go BHF National Centre for Physical Activity and Health This booklet includes tips and tools for encouraging children to be active. Pocket Play Pack BHF National Centre for Physical Activity and Health A small z-card with lots of activity ideas for children. For free copies of these resources: ❤ call the BHF Orderline on 0870 600 6566 ❤ email [email protected] or ❤ visit bhf.org.uk/publications Acknowledgements This booklet was written by: ❤ Lynne Kendall, Clinical Specialist Physiotherapist, Leeds General Infirmary, and ❤ Jo Quirk, Congenital Nurse Specialist, Leeds General Infirmary. Our thanks go to the following organisations and people for their support and professional expertise in helping to produce this booklet. ❤ Children’s Heart Federation ❤ Nick Bromell, University Teacher of Physical Education, Loughborough University ❤ Dr Kate English, Consultant Adult Congenital Cardiologist, Leeds General Infirmary ❤ Dr Phil Gates, Exercise Physiologist, Peninsula Medical School, Exeter University ❤ Dr John Thomson, Consultant Congenital Cardiologist, Active Places www.activeplaces.com A website that allows you to search for sports facilities anywhere in England. Leeds General Infirmary. Edited by Wordworks. BHF National Centre for Physical Activity and Health (BHFNC) bhfactive.org.uk Funded by the British Heart Foundation, the BHFNC develops resources to support professionals in promoting physical activity. The BHFNC has also produced a number of resources on physical activity for parents and carers and for children and young people. 54 55 bhf.org.uk Heart Helpline 0300 330 3311 bhf.org.uk Information & support on anything heart-related. Phone lines open 9am to 5pm Monday to Friday. Similar cost to 01 or 02 numbers. © British Heart Foundation 2011, registered charity in England and Wales (225971) and Scotland (SC039426) Print code: G524 2011 is the British Heart Foundation’s 50th birthday. Since 1961, we have been the nation’s heart charity, dedicated to saving lives through pioneering research, patient care, campaigning for change and by providing vital information. But we urgently need your help. We rely on your donations of time and money to continue our life-saving work. Because together we can beat heart disease. British Heart Foundation Greater London House 180 Hampstead Road London NW1 7AW T 020 7554 0000 F 020 7554 0100
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