Abstract
ABSTRACT Purpose: This retrospective study aims to describe the gross motor development of children aged 4 to 24 months with congenital heart disease (CHD) enrolled in a systematic developmental follow-up program and to describe the frequency of physical therapy sessions they received between 4 and 8 months of age. Methods: Twenty-nine infants with CHD underwent motor evaluations using the AIMS at 4 months, and the Bayley-III at 12 and 24 months. Results: Based on AIMS, 79% of 4-month-old infants had a gross motor delay and required physical therapy. Among these, 56.5% received one to two physical therapy sessions, and 43.5% received three to six sessions. Infants who benefited from regular interventions tended to show a better improvement in motor scores from 12 to 24 months. Conclusion: This study highlights the importance of early motor screening in infants with CHD and suggests a potential benefit of early physical therapy in at-risk children. Abbreviations: CHD: Congenital heart disease; AIMS: Alberta Infant Motor Scales; Bayley-III: Bayley Scales of Infant and Toddler Development, Third edition; Bayley-III/GM: Gross Motor section of the Bayley Scales of Infant and Toddler Development, Third edition
Highlights
74% of children received early intervention services from the US regional early intervention programmes or private services, which raised the possibility of a potential benefit of early intervention on motor development
Participants All infants with congenital heart disease (CHD) who were referred at birth to the Clinique d’Investigation Neurocardiaque (CINC) of the Sainte-Justine University Hospital Centre, in Montreal, Canada, from March 2013 to June 2016, and who underwent motor evaluations at the ages of 4, 12 and 24 months were considered to be included in this study
A total of thirty (N = 30) infants were included in this pilot study: six (n = 6) infants in the no-intervention group, thirteen (n = 13) in the occasional intervention group, and eleven (n = 11) in the regular intervention group
Summary
Children with congenital heart disease (CHD) requiring early cardiac surgery experience a broad spectrum of neurodevelopmental disorders characterized by a combination of mild to moderate motor, cognitive, and language impairments.[1–10] During infancy, gross motor delays typically appear as the primary manifestations of altered neurodevelopment.[2,4,5,9,11] Longitudinal studies investigating motor development in children with CHD revealed a delay in the acquisition of gross motor skills as early as the age of 2 months.[4,5,9,11] In most of these studies, gross motor developpment was persistently delayed up to the age of 2 years.[5,9,11] At an older age, 39% and 42% of 5year-old and school-aged children with CHD, respectively, were shown to experience persistent gross motor deficits.[12,13] In contrast, some studies revealed an improvement in motor development during infancy.[5,9] In particular, Mussatto and colleagues reported better motor scores in older CHD children without genetic syndrome, resulting in motor performances similar to those of typically developing infants at the age of 12 months and older.[4]. We previously reported significant motor improvement after early intervention in one of our patients with CHD.[14] research is still needed to document the motor development of cohorts of infants enrolled in such structured surveillance programmes and to estidoi:10.20944/preprints201908.0248.v1 mate the effects of early physical therapy when provided.
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