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Motor and visuomotor function in 10-year-old children with congenital heart disease: association with behaviour

Published online by Cambridge University Press:  13 October 2021

Joana Teixeira
Child Development Center, University Children’s Hospital, Zurich, Switzerland
Jon Caflisch
Child Development Center, University Children’s Hospital, Zurich, Switzerland
Aziz Chaouch
Division of Biostatistics, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
Ingrid Beck
Child Development Center, University Children’s Hospital, Zurich, Switzerland
Maria Feldmann
Child Development Center, University Children’s Hospital, Zurich, Switzerland
Susanne Polentarutti
Child Development Center, University Children’s Hospital, Zurich, Switzerland
Christian Balmer
Department of Cardiology, University Children’s Hospital, Zurich, Switzerland
Beatrice Latal*
Child Development Center, University Children’s Hospital, Zurich, Switzerland Children’s Research Center, University Children’s Hospital, Zurich, Switzerland
Author for correspondence: B. Latal, MD, Child Development Center, University Children’s Hospital Zurich, Steinwiesstrasse 75, CH-8032Zurich, Switzerland. Tel: +41 44 266 79 24; Fax +41 44 266 71 64. E-mail:



Children with CHD are at increased risk for neurodevelopmental impairments. There is little information on long-term motor function and its association with behaviour.


To assess motor function and behaviour in a cohort of 10-year-old children with CHD after cardiopulmonary bypass surgery.


Motor performance and movement quality were examined in 129 children with CHD using the Zurich Neuromotor Assessment providing four timed and one qualitative component, and a total timed motor score was created based on the four timed components. The Beery Test of Visual–Motor Integration and the Strengths and Difficulties Questionnaire were administered.


All Zurich Neuromotor Assessment motor tasks were below normative values (all p ≤ 0.001), and the prevalence of poor motor performance (≤10th percentile) ranged from 22.2% to 61.3% in the different components. Visuomotor integration and motor coordination were poorer compared to norms (all p ≤ 0.001). 14% of all analysed children had motor therapy at the age of 10 years. Children with a total motor score ≤10th percentile showed more internalising (p = 0.002) and externalising (p = 0.028) behavioural problems.


School-aged children with CHD show impairments in a variety of motor domains which are related to behavioural problems. Our findings emphasise that motor problems can persist into school-age and require detailed assessment and support.

Original Article
© The Author(s), 2021. Published by Cambridge University Press

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