Cardiorespiratory performance and locomotor function of patients with anorectal malformations

Abstract

The aim of this study was to assess whether adolescents following anorectal malformation repair have a decreased cardiorespiratory performance capacity and impaired motor skills. All eligible children treated for ARMs between 2000 and 2014 were invited to participate in a prospective study consisting of a clinical examination, evaluation of Bowel function and Quality of Life, spirometry, spiroergometry and assessment of the motor activity. The results were compared to a healthy age- and sex-matched control group. There was no statistically significant difference in height, weight, BMI, muscle mass or body fat percentage between the study and the control group. Nine out of 18 patients (50%) had an excellent functional outcome with a normal Bowel Function Score. Spirometry revealed no significant differences between ARM patients and controls, four patients showed a ventilation disorder. Spiroergometry revealed a significantly lower relative performance capacity and the overall rating of the motor activity test showed significantly decreased grades in ARM patients. ARM patients were affected by an impaired cardiopulmonary function and decreased motor abilities. Long-term examinations consisting of routine locomotor function evaluation and spiroergometry are advisable to detect impaired cardiopulmonary function and to prevent a progression of associated complications and related impaired quality of life.

Physical self-concept and ability to swim in patients born with anorectal malformation and Hirschsprung’s disease: a case control study

“…While fecal and urinary incontinence are predictive of the HRQoL in patients with ARM/HD [ 23 ], physical self-concept and perceived physical attractiveness were largely independent of symptom load according to the Rintala score. This finding matches recent studies where lower scores for locomotor function and exercise capacity [ 13 ], as well as pelvic floor muscle defects [ 17 ] were observed without correlation to bowel symptom load. We conclude that physical activity may improve HrQOL in ARM/ HD patients independent of symptom load or presence of an ostomy.…”

“…Cardiorespiratory fitness and muscular strength are positively correlated with the HRQoL in children and adolescents, including physical and psychological well-being and perceived health status [ 12 ]. A recent study evaluating sports performance revealed a significantly lower relative performance capacity in children with ARM in spiroergometry, independent of symptom load [ 13 ]. These results corroborate our own findings of subjectively reduced endurance in our patient cohort, independent of Rintala score.…”

“…In female patients with ARM, defects in the pelvic floor muscles have been reported in all patients, even in lower forms of ARM [ 17 ]. A study assessing motor abilities of children aged 9 to 18 years reveal a significant deficit in all motor skills regarding the lower extremities and deep core muscles (lateral jump, long jump, crunches) [ 13 ]. In our patient cohort, adolescents had subjectively reduced motor function in terms of speed (males and females) and strength (females).…”

A Narrative Review of Patient-Reported Outcome Measures and Their Application in Recent Pediatric Surgical Research: Advancing Knowledge and Offering New Perspectives to the Field

“…Out of 345 articles identified by the database searches, 49 articles met the inclusion criteria. 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 Most concerned esophageal atresia ( n = 17) and Hirschsprung's disease ( n = 14). None of the articles focused on duodenal atresia or omphalocele.…”