Motor development in children with congenital cardiac diseases compared to their healthy peers

Abstract

Their perceptual and motor experiences determine the physical and motor development of children, and impact also on their emotional, psychosocial, and cognitive development. Our aim, therefore, was to evaluate motor development in children with congenitally malformed hearts compared to their healthy peers. We compared 194 children, with a mean age of 10.0 years, and standard deviation of 2.7 years, representing the entire spectrum of congenital cardiac disease, to a control group of 455 healthy children, having a mean age 9.6 years, with standard deviation of 2.17 years. The bodily coordination test for children was used to examine motor development. Of the children with congenitally malformed hearts, 26.8% showed moderate, and 31.9% had severe disturbances of motor development, compared to 16.5% and 5.5% of the control group, the p-value for these differences being less than 0.001. The mean motor quotient adjusted for age and gender was lower in the children with congenitally malformed hearts than in their healthy peers, at 79.6, with standard deviation of 18.9 as opposed to 96.6, with standard deviation of 15, this difference having a p-value of less than 0.001. Depending on the presence, and/or the degree, of residual sequels, the children with congenitally malformed hearts were divided into two subgroups, with either no or mild residual sequels, or with significant sequels. The mean motor quotient was lower in those with significant residual sequels, at 75, with standard deviation of 19.3, as opposed to 83, with standard deviation of 17.9, the p-value for this difference being less than 0.01. In both subgroups, the mean motor quotient was lower, with a p-value of less than 0.01, than in the control group. Our findings show that children with congenitally malformed hearts have deficits in their motor development, these being found in the presence of no or mild sequels, as well as with significant residual sequels. Parental overprotection may contribute to these findings.

Children After Fontan have Strength and Body Composition Similar to Healthy Peers and Can Successfully Participate in Daily Moderate-to-Vigorous Physical Activity

“…Reported morbidities for patients after Fontan include deficits in motor development [3], inattention and hyperactivity [30], internalizing problems (depression, anxiety) and aggression [17], and hypoactive lifestyles [29]. The benefits of physically active lifestyles [13,15] are known to ameliorate many of the morbidities commonly experienced by patients after Fontan.…”

Psychomotor Slowness in School-Age Children With Congenital Heart Disease

“…In addition to anatomic/hemodynamic risk factors, reduced physical activity may compromise the motor development of children with CHD (Bjarnason-Wehrens et al, 2007). Due to the heart disease medical restrictions may be imposed, exercise tolerance may be limited, and hospitalizations may cause periods of inactivity.…”

“…Moreover, the illness may cause the parents to be anxious and overprotective toward the child (Samango-Sprouse & Suddaby, 1997), as a result of which they may limit its engagement in physical activity. Restrictions of physical activity, whether imposed by their cardiologist or their parents, may impede the motor development of children with CHD (Bjarnason-Wehrens et al, 2007). The motor slowness observed in these children may thus be due to a lack of sufficient practice.…”

A home-based exercise program for children with congenital heart disease following interventional cardiac catheterization: study protocol for a randomized controlled trial

“…Studies have demonstrated that abnormal hemodynamics during fetal gestation and hypoxia in utero might play an important role in the risk of long-term adverse neurological outcomes in children with critical CHD [9, 10]. A distinctive pattern of neurodevelopmental and behavioral impairments has been noticed over the years; these are characterized by delayed motor development, cognitive impairments, and other abnormal growth [11, 12]. Many school-aged survivors adapt poorly to their school life because of low physical activity levels and poor academic performance, and these problems may persist into young adulthood, leading to a low quality of life for these children and their families [13].…”

“…Studies demonstrate that cardiac problems are not the only reason responsible for development delays [11, 14–16]; overprotection of parents or main caregivers is also a factor. Parents are the most concerned caregivers for their children, and overprotection of children with CHD has been observed with most parents and teachers.…”