Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-18T07:35:21.642Z Has data issue: false hasContentIssue false
  • English
  • Français

Motor skills of 5-year-old children who underwent early cardiac surgery

Published online by Cambridge University Press:  05 June 2015

Suzanne H. Long Open the ORCID record for Suzanne H. Long [Opens in a new window] ,
Beverley J. Eldridge ,
Susan R. Harris  and
Michael M. H. Cheung
Suzanne H. Long*
Affiliation:
Heart Research Group, Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia
Beverley J. Eldridge
Affiliation:
Department of Physiotherapy, Royal Children’s Hospital, Melbourne, Australia Department of Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
Susan R. Harris
Affiliation:
Department of Physical Therapy, University of British Columbia, Vancouver, Canada
Michael M. H. Cheung
Affiliation:
Heart Research Group, Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia Department of Cardiology, Royal Children’s Hospital, Melbourne, Australia Department of Paediatrics, University of Melbourne, Melbourne, Australia
*
Correspondence to: S. H. Long, PhD, Heart Research Group, Murdoch Children’s Research Institute, South Level 6, 50 Flemington Road, Parkville, VIC 3052, Australia. Tel: +61 3 8341 6200; Fax: +61 3 9348 1391; E-mail: suzanne.long@mcri.edu.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Aims

To describe the motor proficiency of 5-year-old children who underwent early infant cardiac surgery and had atypical infant gross motor development. To identify risk factors for motor dysfunction at 5 years of age.

Methods

A total of 33 children (80.5% participation rate) were re-assessed by a physiotherapist blinded to the diagnosis and previous clinical course, using standardised motor assessment tools.

Results

Motor proficiency was categorised as below average or well below average in 41% of the study patients. Approximately 30% of the cohort had balance deficits. Motor abilities at 4 months and 2 years of age were associated with motor proficiency at age 5; however, atypical motor development in infancy was not predictive of below-average or well below-average scores at age 5. Risk factors associated with motor ability at age 5 included respiratory support and intensive care length of stay in the 1st year of life, asymmetrical crawling in infancy, and cyanotic CHD at age 5.

Conclusions

Despite differences from other reported studies in terms of cohort diagnoses and age at surgery, the rate of motor dysfunction was similar, with rates much higher than expected in typical children. Further assessment is needed in later childhood to determine the significance of these findings.

Keywords

CHDmotor skillsBruininks–Oseretsky Test of Motor Proficiencysecond edition
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 4 , April 2016 , pp. 650 - 657
Check for updates
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Bellinger, DC, Wypij, D, Rivkin, MJ, et al. Adolescents with d-transposition of the great arteries corrected with the arterial switch procedure: neuropsychological assessment and structural brain imaging. Circulation 2011; 124: 1361–1369.Google Scholar
2. Schaefer, C, von Rhein, M, Knirsch, W, et al. Neurodevelopmental outcome, psychological adjustment, and quality of life in adolescents with congenital heart disease. Dev Med Child Neurol 2013; 55: 1143–1149.Google Scholar
3. Majnemer, A, Limperopoulos, C, Shevell, M, Rosenblatt, B, Rohlicek, C, Tchervenkov, C. Long-term neuromotor outcome at school entry of infants with congenital heart defects requiring open-heart surgery. J Pediatr 2006; 148: 72–77.Google Scholar
4. Hovels-Gurich, HH, Seghaye, MC, Dabritz, S, Messmer, BJ, von Bernuth, G. Cognitive and motor development in preschool and school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg 1997; 114: 578–585.Google Scholar
5. Goldberg, CS, Schwartz, EM, Brunberg, JA, et al. Neurodevelopmental outcome of patients after the fontan operation: a comparison between children with hypoplastic left heart syndrome and other functional single ventricle lesions. J Pediatr 2000; 137: 646–652.Google Scholar
6. Snookes, SH, Gunn, JK, Eldridge, BJ, et al. A systematic review of motor and cognitive outcomes after early surgery for congenital heart disease. Pediatrics 2010; 125: e818–e827.Google Scholar
7. Bellinger, DC, Wypij, D, Kuban, KC, et al. Developmental and neurological status of children at 4 years of age after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. Circulation 1999; 100: 526–532.Google Scholar
8. Long, SH, Harris, SR, Eldridge, BJ, Galea, MP. Gross motor development is delayed following early cardiac surgery. Cardiol Young 2012; 22: 574–582.CrossRefGoogle ScholarPubMed
9. Long, SH, Galea, MP, Eldridge, BJ, Harris, SR. Performance of 2-year-old children after early surgery for congenital heart disease on the Bayley Scales of Infant and Toddler Development, Third Edition. Early Hum Dev 2012; 88: 603–607.Google Scholar
10. Bruininks, RH, Bruininks, BD. Bruininks-Oseretsky Test of Motor Proficiency Brief Form, 2nd edn. Pearson, San Antonio, TX, 2010.Google Scholar
11. Bruininks, RH, Bruininks, BD. Bruininks-Oseretsky Test of Motor Proficiency, 2nd edn. Pearson, San Antonio, TX, 2005.Google Scholar
12. Gagnon, I, Swaine, B, Forget, R. Exploring the comparability of the Sensory Organization Test and the Pediatric Clinical Test of Sensory Interaction for Balance in Children. Phys Occup Ther Pediatr 2006; 26: 23–41.Google Scholar
13. Clarkson, HM, Gilewich, GB. Musculoskeletal Assessment: Joint Range of Motion and Manual Muscle Strength. Williams & Wilkins, Baltimore, MD, 1989.Google Scholar
14. Roberts, G, Howard, K, Spittle, AJ, Brown, NC, Anderson, PJ, Doyle, LW. Rates of early intervention services in very preterm children with developmental disabilities at age 2 years. J Paediatr Child Health 2008; 44: 276–280.CrossRefGoogle ScholarPubMed
15. Richardson, PK, Atwater, SW, Crowe, TK, Deitz, JC. Performance of preschoolers on the Pediatric Clinical Test of Sensory Interaction for Balance. Am J Occup Ther 1992; 46: 793–800.Google Scholar
16. Anderson, PJ, De Luca, CR, Hutchinson, E, Roberts, G, Doyle, LW, Victorian Infant Collaborative Group. Underestimation of developmental delay by the new Bayley-III Scale. Arch Pediatr Adolesc Med 2010; 164: 352–356.Google Scholar
17. Acton, BV, Biggs, WSG, Creighton, DE, et al. Overestimating neurodevelopment using the Bayley-III after early complex cardiac surgery. Pediatrics 2011; 128: e794–e800.Google Scholar
18. Westcott, SL, Lowes, LP, Richardson, PK. Evaluation of postural stability in children: current theories and assessment tools. Phys Ther 1997; 77: 629–645.Google Scholar
19. Donofrio, MT, Duplessis, AJ, Limperopoulos, C. Impact of congenital heart disease on fetal brain development and injury. Curr Opin Pediatr 2011; 23: 502–511.Google Scholar
20. Casselbrant, ML, Mandel, EM. Balance disorders in children. Neurol Clin 2005; 23: 807–829.Google Scholar
21. Amianto, F, Bergui, G, Abbate-Daga, G, Bellicanta, A, Munno, D, Fassino, S. Growing up with a congenital heart disease: neuro-cognitive, psychopathological and quality of life outcomes. Panminerva Med 2011; 53: 109–127.Google Scholar
22. Bottos, M, Dalla Barba, B, Stefani, D, Pettena, G, Tonin, C, D’Este, A. Locomotor strategies preceding independent walking: prospective study of neurological and language development in 424 cases. Dev Med Child Neurol 1989; 31: 25–34.Google Scholar
23. Adolph, KE, Vereijken, B, Denny, MA. Learning to crawl. Child Dev 1998; 69: 1299–1312.CrossRefGoogle ScholarPubMed
24. de Groot, L, Hopkins, B, Touwen, B. Motor asymmetries in preterm infants at 18 weeks corrected age and outcomes at 1 year. Early Hum Dev 1997; 48: 35–46.Google Scholar
25. Teitelbaum, O, Benton, T, Shah, PK, Prince, A, Kelly, JL, Teitelbaum, P. Eshkol-Wachman movement notation in diagnosis: the early detection of Asperger’s syndrome. Proc Natl Acad Sci U S A 2004; 101: 11909–11914.Google Scholar
26. Teitelbaum, P, Teitelbaum, O, Nye, J, Fryman, J, Maurer, RG. Movement analysis in infancy may be useful for early diagnosis of autism. Proc Natl Acad Sci USA 1998; 95: 13982–13987.CrossRefGoogle ScholarPubMed