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Motor Impairment in Children With Congenital Heart Defects: A Systematic Review
Marie-Eve Bolduc1,2, Eliane Dionne1,2, Isabelle Gagnon1
1School of Physical and Occupational Therapy.
Insights
Infants with congenital heart defects (CHDs) face a high risk of motor impairments throughout childhood. Early and ongoing motor skill assessments are crucial for these children.
Area of Science:
- Pediatric Cardiology
- Developmental Pediatrics
- Neuroscience
Background:
- Improved survival rates for newborns with congenital heart defects (CHDs) have shifted focus to long-term neurodevelopmental outcomes.
- Motor difficulties are a significant concern impacting the quality of life for individuals with CHDs.
Purpose of the Study:
- To systematically review the prevalence and extent of motor difficulties in infants, children, and adolescents with CHDs requiring open-heart surgery.
- To synthesize existing research on motor skill impairments in pediatric CHD populations.
Main Methods:
- A systematic review of original studies published between 1997 and 2019.
- Searched Embase, Medline, and CINAHL for studies assessing gross and/or fine motor skills in children with CHDs who underwent open-heart surgery.
- Extracted prevalence data and standardized motor assessment scores, categorized by age.
Main Results:
- Forty-six studies were included, revealing mild to severe motor impairments (<-1 SD) ranging from 12.3% to 68.6% across childhood.
- Severe motor impairments (<-2 SDs) ranged from 0% to 60.0%, appearing more prevalent in younger children.
- The prevalence of mild to severe motor impairments remained relatively constant, while severe impairments were higher in younger age groups.
Conclusions:
- Infants with CHDs have an elevated risk of motor impairments from infancy through adolescence.
- Systematic screening and evaluation of motor skills are essential for children with CHDs throughout their developmental years.
- These findings underscore the need for integrated care addressing both cardiac and neurodevelopmental aspects in pediatric CHD management.
Context:
With improvements in survival rates in newborns with congenital heart defects (CHDs), focus has now shifted toward enhancing neurodevelopmental outcomes across their life span.
Objective:
To systematically review the prevalence and extent of motor difficulties in infants, children, and adolescents with CHD requiring open-heart surgery.
Data Sources:
Data sources included Embase, Medline and the Cumulative Index to Nursing and Allied Health Literature.
Study Selection:
Original studies published between 1997 and 2019 examining gross and/or fine motor skills in children born with a CHD requiring open-heart surgery were selected.
Data Extraction:
The prevalence of motor impairments and mean scores on standardized motor assessments were extracted. Findings were grouped in 5 categories on the basis of the age of the children.
Results:
Forty-six original studies were included in this systematic review. The prevalence of mild to severe motor impairments (scores <-1 SD below normative data or controls) across childhood ranged from 12.3% to 68.6%, and prevalence ranged from 0% to 60.0% for severe motor impairments (<-2 SDs). Although our results suggest that the overall prevalence of motor impairments <-1 SD remains rather constant across childhood and adolescence, severe motor impairments (<-2 SDs) appear to be more prevalent in younger children.
Limitations:
Variability in sampling and methodology between the reviewed studies is the most important limitation of this review.
Conclusions:
The results of this review highlight that infants with CHD have an increased risk of motor impairments across infancy, childhood, and adolescence. These findings stress the importance of systematic screening or evaluation of motor skills across childhood and adolescence in children with CHD.
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