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Cross-sectional study of motor development among children after the Fontan procedure

Published online by Cambridge University Press:  24 January 2012

Patricia E. Longmuir ,
Laura Banks  and
Brian W. McCrindle
Patricia E. Longmuir*
Affiliation:
Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada Department of Physical Therapy, University of Toronto, Toronto, Canada
Laura Banks
Affiliation:
Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada
Brian W. McCrindle
Affiliation:
Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada Departments of Pediatrics and Nutritional Sciences, University of Toronto, Toronto, Canada
*
Correspondence to: Dr P. Longmuir, Healthy Active Living and Obesity Research Unit, Children's Hospital of Eastern Ontario, 401 Smyth Road Ottawa, Ontario, Canada K1H 8L1. Tel: +613 738 3908; Fax: +613 738 4800; E-mail: plongmuir@cheo.on.ca
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Abstract

Objectives

To determine the gross motor skills of school-aged children after the Fontan procedure and compare the locomotor and object control skills with normative data.

Study design

This study followed a cross-sectional design.

Setting

This study was based on hospital outpatient visit, with accelerometry conducted at home.

Patients

This study included 55 patients, including 22 girls in the age group of 6–10 years, 5.1 years after Fontan.

Main outcome measures

Test of Gross Motor Development – Version 2, daily activity by accelerometer, medical history review, child and parent perceptions of activity.

Results

Being involved in active team sports increased locomotor percentile score by 10.3 points (CI: 4.4, 16.1). Preference for weekend outdoor activities (6.9, CI: 2.0, 11.8), performing at least 30 minutes of moderate-to-vigorous physical activity daily (24.5, CI: 7.3, 41.8), and reporting that parents seldom criticise the child's physical activity (21.8, CI: 8.9, 34.8) were also associated with higher locomotor percentile scores (p < 0.01). Object control percentile scores were higher (p < 0.03) with involvement in formal instruction (5.9, CI: 1.1, 10.6) and being restricted to “activities within comfortable limits” (27.6, CI: 7.7, 47.5). Older chronological age (r = 0.28), a more complicated medical history (r = 0.36), and older age at Fontan (r = 0.28) were associated with greater skill delay (p < 0.04).

Conclusions

Children after Fontan attain basic motor skills at a later age than their peers, and deficits continue for more complex skills as age increases, suggesting a need for longitudinal monitoring of gross motor skill development through the elementary school years. Future research might investigate whether a gross motor skill rehabilitation programme can provide these children with the motor skills needed to successfully participate in a physically active lifestyle with peers.

Keywords

Motor skillFontanphysical activitychildren
Type
Original Article
Information
Cardiology in the Young , Volume 22 , Issue 4 , August 2012 , pp. 443 - 450
Copyright
Copyright © Cambridge University Press 2012

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