Effects of strength training on isometric muscle strength and muscle cross-sectional area in adults with a Fontan circulation: a pilot study
- 1Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- 2Department of Diagnostics and Intervention, Umeå University, Umeå, Sweden
- 3Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
Abstract
Background
Adults with complex congenital heart disease, particularly those with a Fontan circulation, often have impaired muscle strength and reduced muscle mass from early age. Despite these concerns, data regarding the effects of strength training in this population is limited.Aim
To evaluate the impact of a 10-week strength training intervention on muscle strength and muscle cross-sectional area (CSA) in adults with Fontan circulation, compared to age- and sex matched controls.Methods
Nine adults with a Fontan circulation (median age 28.9 [IQR: 23.4-35.0], 4 women) underwent a gym-based strength training program. Isometric muscle strength (elbow flexion, knee extension, grip strength), radial and tibial muscle CSA and density, and habitual physical activity (accelerometer-based and self-reported data) were measured pre- and post-intervention. Within-group changes were analysed using the Wilcoxon signed-rank test; between-group differences were assessed using the Mann Whitney U test.Results
Both patients and controls demonstrated improvements in isometric elbow flexion strength (Patients: +6.2% [IQR: 2.8-17.7], p = 0.02, r = 0.77; Controls: +8.4% [IQR: 2.9-16.0], p = 0.012, r = 0.84) and tibial cross-sectional area (Patients: +5.0% [IQR: 2.7-11.4], p = 0.011, r = 0.85; Controls: +4.0% [IQR: 1.4-7.4], p = 0.018, r = 0.89). No changes were observed in isometric knee extension or grip strength. There were no differences between groups, and no adverse events occurred.Conclusion
This pilot study supports that strength training is safe and effective in improving muscle strength and muscle CSA in adults with a Fontan circulation. Despite the small sample size these findings are reassuring. However, confirmation in larger prospective trials is warranted.Clinicaltrialsgov id
NCT05454254, https://clinicaltrials.gov.
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BibTeX
@article{wikner2026effects,
title = {{Effects of strength training on isometric muscle strength and muscle cross-sectional area in adults with a Fontan circulation: a pilot study}},
author = {Anna Wikner and Frida Bergman and Daniel Rinnström and Karna Johansson and Johan Ljungberg and Bengt Johansson and Camilla Sandberg},
journal = {International journal of cardiology. Congenital heart disease},
year = {2026},
month = sep,
doi = {10.1016/j.ijcchd.2026.100716},
url = {https://europepmc.org/article/PMC/PMC13717887},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effects of strength training on isometric muscle strength and muscle cross-sectional area in adults with a Fontan circulation: a pilot study
AU - Anna Wikner
AU - Frida Bergman
AU - Daniel Rinnström
AU - Karna Johansson
AU - Johan Ljungberg
AU - Bengt Johansson
AU - Camilla Sandberg
PY - 2026
DA - 2026/09/27
JO - International journal of cardiology. Congenital heart disease
DO - 10.1016/j.ijcchd.2026.100716
UR - https://europepmc.org/article/PMC/PMC13717887
AB - Background Adults with complex congenital heart disease, particularly those with a Fontan circulation, often have impaired muscle strength and reduced muscle mass from early age. Despite these concerns, data regarding the effects of strength training in this population is limited.Aim To evaluate the impact of a 10-week strength training intervention on muscle strength and muscle cross-sectional area (CSA) in adults with Fontan circulation, compared to age- and sex matched controls.Methods Nine adults with a Fontan circulation (median age 28.9 [IQR: 23.4-35.0], 4 women) underwent a gym-based strength training program. Isometric muscle strength (elbow flexion, knee extension, grip strength), radial and tibial muscle CSA and density, and habitual physical activity (accelerometer-based and self-reported data) were measured pre- and post-intervention. Within-group changes were analysed using the Wilcoxon signed-rank test; between-group differences were assessed using the Mann Whitney U test.Results Both patients and controls demonstrated improvements in isometric elbow flexion strength (Patients: +6.2% [IQR: 2.8-17.7], p = 0.02, r = 0.77; Controls: +8.4% [IQR: 2.9-16.0], p = 0.012, r = 0.84) and tibial cross-sectional area (Patients: +5.0% [IQR: 2.7-11.4], p = 0.011, r = 0.85; Controls: +4.0% [IQR: 1.4-7.4], p = 0.018, r = 0.89). No changes were observed in isometric knee extension or grip strength. There were no differences between groups, and no adverse events occurred.Conclusion This pilot study supports that strength training is safe and effective in improving muscle strength and muscle CSA in adults with a Fontan circulation. Despite the small sample size these findings are reassuring. However, confirmation in larger prospective trials is warranted.Clinicaltrialsgov id NCT05454254, https://clinicaltrials.gov.
SN - 2666-6685
ER -