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MIGHTEE: Motivational Interaction Group Heart Transplant Exercise and Education, A Pilot Study

Statement of Problem

Orthotopic heart transplant (OHT) is the definitive therapy for children with cardiac disease; approximately 400 pediatric OHT are performed each year in the U.S. But survival after transplant is limited, and research shows that patient quality of life after transplant is less than their healthy peers

A child’s transplanted heart usually works well, pumping blood as well as most healthy hearts, and the American Heart Association (AHA) recommends no specific exercise-related restrictions for heart transplant recipients. However, children with transplanted hearts have impaired exercise performance and do not exercise as much as their peers. This is concerning, as impaired exercise tolerance is associated with reduced survival, diminished health-related quality of life, and depression and anxiety. Therefore, identifying interventions that positively impact physical activity and promote transplant longevity, like individualized exercise programs, should be a priority for post-transplant care.

However, pediatric cardiac rehabilitation programs are limited and distance to rehabilitation centers may be a barrier to receiving services. Those from racial minority backgrounds and with lower socioeconomic status are also associated with less exercise, increased sedentary behaviors, more unhealthy eating patterns, and higher rates of obesity, underscoring the presence of additional barriers to post-transplant physical health for some of our most vulnerable patients.

These findings emphasize the need to develop accessible, effective interventions to help children after transplant develop a culture of activity. 


MIGHTEE: Motivational Interaction Group Heart Transplant Exercise and Education, A Pilot Study


The virtual component of this intervention could also address barriers families may face to accessing pediatric cardiac rehabilitation programs.

Next Steps

We hope that this project will offer novel information about the ways in which collaborative methods, wearable technology and virtual platforms can be used to improve the care of pediatric heart transplant recipients. We anticipate that the approach described in this study will increase the accessibility of cardiac rehabilitation programs to traditionally underrepresented patient populations, and will provide the foundation for larger-scale, multi-center studies of heart transplant recipients. 

Our ultimate goal is that this methodology can be extended to enhance the care provided to children with a wide range of diseases, both cardiac and otherwise, leveraging the known benefits of physical activity to improve outcomes and quality of life.

This project page was last updated in November 2021. 

Suggested Citation

Children's Hospital of Philadelphia, PolicyLab. MIGHTEE: Motivational Interaction Group Heart Transplant Exercise and Education, A Pilot Study [Online]. Available at: [Accessed: plug in date accessed here].