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Impaired grip strength in children with congenital heart disease
Michael Meyer1,2, Yi Wang3, Leon Brudy3,2
1Institute of Preventive Pediatrics, Technical University of Munich, Munich, Germany michael.meyer@tum.de.
Insights
Children with congenital heart disease (CHD) have significantly lower grip strength than healthy peers. Grip strength and health-related physical fitness (HRPF) are distinct measures in pediatric CHD patients.
Area of Science:
- Pediatric Cardiology
- Exercise Physiology
- Rehabilitation Medicine
Background:
- Reduced grip strength is documented in adults with congenital heart disease (CHD).
- Understanding grip strength and physical fitness in pediatric populations with CHD is crucial for long-term health management.
Purpose of the Study:
- To compare grip strength in children with CHD against healthy controls.
- To investigate the association between grip strength and health-related physical fitness (HRPF) in pediatric CHD patients.
Main Methods:
- Grip strength and HRPF were assessed in 569 children with CHD and 2551 healthy controls.
- Grip strength was measured as the maximum of three hand repetitions.
- HRPF was evaluated using the FITNESSGRAM battery and converted to z-scores.
Main Results:
- Children with CHD exhibited significantly lower grip strength (20.8 kg) compared to controls (24.5 kg) after adjusting for covariates.
- Grip strength varied across CHD complexity, with total cavopulmonary connection and complex CHD showing the lowest values.
- HRPF was also reduced in children with CHD (z-score: -0.46) and showed a weak association with grip strength (r=0.21).
Conclusions:
- Grip strength is demonstrably reduced in children with congenital heart disease.
- Grip strength and HRPF represent distinct physiological domains in pediatric CHD.
- Separate assessment of grip strength and HRPF is recommended for comprehensive evaluation in children with CHD.
Objectives:
Grip strength is known to be reduced in adults with congenital heart disease (CHD). This study compared grip strength in paediatric patients with CHD with healthy controls and determined a possible association between grip strength and health-related physical fitness (HRPF).
Methods:
Grip strength and HRPF were assessed in 569 children (12.4 years, 95% CI 12.16 to 12.72; 238 girls) with various CHD and compared with 2551 healthy controls (11.4 years, 95% CI 11.3 to 11.5; 1424 girls). Grip strength was determined as the maximum value of three repetitions with each hand. HRPF was tested by five motor tasks (FITNESSGRAM) and converted into an SD score (z-score).
Results:
After adjusting for age, sex and weight, children with CHD showed significantly lower grip strength compared with healthy controls (CHD: 20.8 kg, 95% CI 20.4 to 21.2; controls: 24.5 kg, 95% CI 24.3 to 24.8). CHD subgroup analysis also revealed significantly lower grip strength than the controls, with the lowest values in patients with total cavopulmonary connection (19.1, 95% CI 18.0 to 20.2). Children with complex CHD showed the lowest values with 19.8 kg (95% CI 19.2 to 20.4), those with moderate 20.7 kg (95% CI 19.9 to 21.4) and those with simple 22.5 kg (95% CI 21.6 to 23.3), respectively. HRPF was also lower (z-score: -0.46, 95% CI -0.49 to -0.35) compared with healthy controls and poorly associated with grip strength (r=0.21).
Conclusions:
Grip strength is already reduced in children with CHD and poorly associated with HRPF. This suggests that grip strength and HRPF are different domains and have to be assessed separately.
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