Features of Physical and Motor Development of Children with Congenital Heart Diseases

Abstract

INTRODUCTION: Children with congenital heart diseases (CHD) have certain peculiarities of development determined by the pathology of the cardiovascular system. The type, severity of CHD, the age of correction of the disorder and a number of other factors have a direct impact on the severity of its non-cardiologic complications, such as disorders in physical and motor development attributable to specific conditions of formation of the nervous system in children with CHD.

AIM: To systematize the currently available data on the peculiarities of physical and motor development of children with CHD and their underlying factors, to justify the importance of a more in-depth examination of children at all stages of their development and of the need to correct the identified disorders starting from the moment of their diagnosis.

The review presents the data on the incidence and peculiarities of deviations in motor development of children with CHD at different age periods; describes factors predisposing to their development, as well as the possibilities of diagnosis and correction of such disorders. Besides, information is provided on the development of the balance function that is also impaired in this cohort of patients. Since the physical and motor development of children are closely interrelated and related to the development of the nervous and muscular systems, and the muscle strength and balance are integral components of some motor skills, each of these parameters is considered in a separate section of the article. Acyanotic heart diseases are more commonly associated with disorders in the weight gain, and cyanotic ones — with retardation of children in growth and body mass. Another manifestation of retardation of physical development of children with CHD is deficit of muscle mass development reflected in the research-confirmed reduction of muscle strength in this category of patients. Disorders in fine and/or large motor skills are noted in one to two thirds of children with CHD from an early age to adulthood. Disorders in the motor sphere in childhood entail physical inactivity, psychological and cognitive problems, difficulties in socialization significantly reducing the quality of life.

CONCLUSION: Children with CHD are characterized by peculiarities of the physical and motor development, which have a significant impact on the child’s life. Therefore, currently of paramount importance is not only examination of the cardiovascular system of children with CHD, but also their physical and motor development, as well as timely identification of deviations in the physical and motor development and their targeted rehabilitation.

Keywords

congenital heart diseases / children / motor development / physical development / large motor skills / fine motor skills / balance / muscle strength / rehabilitation

References

[1] Liu Y, Chen S, Zühlke L, et al. Global birth prevalence of congenital heart defects 1970–2017: Updated systematic review and meta-analysis of 260 studies. Int J Epidemiol. 2019;48(2):455–63. doi: 10.1093/ije/dyz009

[2] Liu Y., Chen S., Zühlke L., et al. Global birth prevalence of congenital heart defects 1970–2017: Updated systematic review and meta-analysis of 260 studies // Int. J. Epidemiol. 2019. Vol. 48, No. 2. P. 455–463. doi: 10.1093/ije/dyz009

[3] Sprong MCA, van Brussel M, de Vries LS, et al. Longitudinal Motor-Developmental Outcomes in Infants with a Critical Congenital Heart Defect. Children (Basel). 2022;9(4):570. doi: 10.3390/children9040570

[4] Sprong M.C.A., van Brussel M., de Vries L.S., et al. Longitudinal Motor-Developmental Outcomes in Infants with a Critical Congenital Heart Defect // Children (Basel). 2022. Vol. 9, No. 4. P. 570. doi: 10.3390/children9040570

[5] Marino BS, Lipkin PH, Newburger JW, et al. Neurodevelopmental outcomes in children with congenital heart disease: Evaluation and management a scientific statement from the American Heart Association. Circulation. 2012;126(9):1143–72. doi: 10.1161/CIR.0b013e318265ee8a

[6] Marino B.S., Lipkin P.H., Newburger J.W., et al. Neurodevelopmental outcomes in children with congenital heart disease: Evaluation and management a scientific statement from the American Heart Association // Circulation. 2012. Vol. 126, No. 9. P. 1143–1472. doi: 10.1161/CIR.0b013e318265ee8a

[7] Holm I, Fredriksen PM, Fosdahl MA, et al. Impaired motor competence in school-aged children with complex congenital heart disease. Arch Pediatr Adolesc Med. 2007;161(10):945–50. doi: 10.1001/archpedi.161.10.945

[8] Holm I., Fredriksen P.M., Fosdahl M.A., et al. Impaired motor competence in school-aged children with complex congenital heart disease // Arch. Pediatr. Adolesc. Med. 2007. Vol. 161, No. 10. P. 945–950. doi: 10.1001/archpedi.161.10.945

[9] Nasiruzzamarrt A, Hussain M, Baki M, et al. Growth and Developmental Status of Children with Congenital Heart Disease. Bangladesh Med J. 2014;40(2):54–7. doi: 10.3329/bmj.v40i2.18512

[10] Nasiruzzamarrt A., Hussain M., Baki M., et al. Growth and Developmental Status of Children with Congenital Heart Disease // Bangladesh Med. J. 2014. Vol. 40, No. 2. P. 54–57. doi: 10.3329/bmj.v40i2.18512

[11] Maya S, Gunawijaya E, Yantie NVPK, et al. Growth, development, and quality of life in children with congenital heart disease. Open Access Maced J Med Sci. 2020;8(B):613–8. Available at: https://oamjms.eu/index.php/mjms/article/view/4047. Accessed: 2023 April 09. doi: 10.3889/oamjms.2020.4047

[12] Maya S., Gunawijaya E., Yantie N.V.P.K., et al. Growth, development, and quality of life in children with congenital heart disease // Open Access Maced J Med Sci. 2020. Vol. 8, No. B. P. 613–618. Available at: https://oamjms.eu/index.php/mjms/article/view/4047. Accessed: 2023 April 09. doi: 10.3889/oamjms.2020.4047

[13] Chien C–H, Lee T–Y, Lin M–T. Factors affecting motor development of toddlers who received cardiac corrective procedures during infancy. Early Hum Dev. 2021;158:105392. doi: 10.1016/j.earlhumdev.2021.105392

[14] Chien C.–H., Lee T.–Y., Lin M.–T. Factors affecting motor development of toddlers who received cardiac corrective procedures during infancy // Early Hum. Dev. 2021. Vol. 158. P. 105392. doi: 10.1016/j.earlhumdev. 2021.105392

[15] Latal B. Neurodevelopmental Outcomes of the Child with Congenital Heart Disease. Clin Perinatol. 2016;43(1):173–85. doi: 10.1016/j.clp.2015.11.012

[16] Latal B. Neurodevelopmental Outcomes of the Child with Congenital Heart Disease // Clin. Perinatol. 2016. Vol. 43, No. 1. P. 173–185. doi: 10.1016/j.clp.2015.11.012

[17] Benn J. The Prognosis of Patent Ductus Arteriosus. Br Heart J. 1947;9(4): 283–91. doi: 10.1136/hrt.9.4.283

[18] Benn J. The Prognosis of Patent Ductus Arteriosus // Br. Heart J. 1947. Vol. 9, No. 4. P. 283–291. doi: 10.1136/hrt.9.4.283

[19] Campbell M, Reynolds G. The physical and mental development of children with congenital heart disease. Arch Dis Child. 1949;24(120):294–302. doi: 10.1136/adc.24.120.294

[20] Campbell M., Reynolds G. The physical and mental development of children with congenital heart disease // Arch. Dis. Child. 1949. Vol. 24, No. 120. P. 294–302. doi: 10.1136/adc.24.120.294

[21] Taussig H. Congenital Malformations of the Heart. 2nd ed. London: Press and Oxford University Press; 1960.

[22] Chen C–W, Li C–Y, Wang J–K. Growth and development of children with congenital heart disease. Journal of Advanced Nursing. 2004;47(3):260–9. doi: 10.1111/j.1365-2648.2004.03090.x

[23] Chen C.–W., Li C.–Y., Wang J.–K. Growth and development of children with congenital heart disease // J. Adv. Nurs. 2004. Vol. 47, No. 3. P. 260–269. doi: 10.1111/j.1365-2648.2004.03090.x

[24] Rêgo C de S, Pinho CPS. Muscle strength in children and adolescents hospitalized with congenital heart disease. Nutr Clin Diet Hosp. 2020;40(4): 70–6. doi: 10.12873/404pinho

[25] Rêgo C. de S., Pinho C.P.S. Muscle strength in children and adolescents hospitalized with congenital heart disease // Nutr. Clin. Diet. Hosp. 2020. Vol. 40, No. 4. P. 70–76. doi: 10.12873/404pinho

[26] Meyer M, Wang Y, Brudy L, et al. Impaired grip strength in children with congenital heart disease. Arch Dis Child. 2022;107(1):47–51. doi: 10.1136/archdischild-2020-319955

[27] Meyer M., Wang Y., Brudy L., et al. Impaired grip strength in children with congenital heart disease // Arch. Dis. Child. 2022. Vol. 107, No. 1. P. 47–51. doi: 10.1136/archdischild-2020-319955

[28] Huisenga D, La Bastide-Van Gemert S, Van Bergen A, et al. Developmental outcomes after early surgery for complex congenital heart disease: a systematic review and meta-analysis. Dev Med Child Neurol. 2021;63(1):29–46. doi: 10.1111/dmcn.14512

[29] Huisenga D., La Bastide-Van Gemert S., Van Bergen A., et al. Developmental outcomes after early surgery for complex congenital heart disease: a systematic review and meta-analysis // Dev. Med. Child Neurol. 2021. Vol. 63, No. 1. P. 29–46. doi: 10.1111/dmcn.14512

[30] Niedermeyer C da C, Shizukuishi MLY, Schaan CW, et al. Peripheral and respiratory muscle strength in children and adolescents with CHD: Systematic review and meta-analysis. Cardiol Young. 2022;32(11):1728–41. doi: 10.1017/S1047951122003092

[31] Niedermeyer C. da C., Shizukuishi M.L.Y., Schaan C.W., et al. Peripheral and respiratory muscle strength in children and adolescents with CHD: Systematic review and meta-analysis // Cardiol. Young. 2022. Vol. 32, No. 11. P. 1728–1741. doi: 10.1017/S1047951122003092

[32] Bolduc M–E, Dionne E, Gagnon I, et al. Motor Impairment in Children With Congenital Heart Defects: A Systematic Review. Pediatrics. 2020; 146(6):20200083. doi: 10.1542/peds.2020-00833

[33] Bolduc M.–E., Dionne E., Gagnon I., et al. Motor Impairment in Children With Congenital Heart Defects: A Systematic Review // Pediatrics. 2020. Vol. 146, No. 6. P. 20200083. doi: 10.1542/peds.2020-0083

[34] Fourdain S, Simard M–N, Dagenais L, et al. Gross Motor Development of Children with Congenital Heart Disease Receiving Early Systematic Surveillance and Individualized Intervention: Brief Report. Dev Neurorehabil. 2021;24(1):56–62. doi: 10.1080/17518423.2020.1711541

[35] Fourdain S., Simard M.–N., Dagenais L., et al. Gross Motor Development of Children with Congenital Heart Disease Receiving Early Systematic Surveillance and Individualized Intervention: Brief Report // Dev. Neurorehabil. 2021. Vol. 24, No. 1. P. 56–62. doi: 10.1080/17518423.2020.1711541

[36] Messerli–Bürgy N, Kakebeeke TH, Meyer AH, et al. Walking onset: a poor predictor for motor and cognitive skills in healthy preschool children. BMC Pediatr. 2021;21(1):367. doi: 10.1186/s12887-021-02828-4

[37] Messerli–Bürgy N., Kakebeeke T.H., Meyer A.H., et al. Walking onset: a poor predictor for motor and cognitive skills in healthy preschool children // BMC Pediatr. 2021. Vol. 21, No. 1. P. 367. doi: 10.1186/s12887-021-02828-4

[38] Naef N, Liamlahi R, Beck I, et al. Neurodevelopmental Profiles of Children with Congenital Heart Disease at School Age. J Pediatr. 2017;188:75–81. doi: 10.1016/j.jpeds.2017.05.073

[39] Naef N., Liamlahi R., Beck I., et al. Neurodevelopmental Profiles of Children with Congenital Heart Disease at School Age // J. Pediatr. 2017. Vol. 188. P. 75–81. doi: 10.1016/j.jpeds.2017.05.073

[40] Dordel S, Bjarnason–Wehrens E, Lawrenz B, et al. Efficiency of psychomotor training of children with (partly-) corrected congenital heart disease. Dtsch Z Sportmed. 1999;50:41–6. (In German).

[41] Dordel S., Bjarnason–Wehrens E., Lawrenz B., et al. Efficiency of psychomotor training of children with (partly-)corrected congenital heart disease // Dtsch. Z. Sportmed. 1999. Vol. 50. P. 41–46.

[42] Hövels–Gürich HH, Seghaye MC, Däbritz S, et al. Cognitive and motor development in preschool and school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg. 1997;114(4):578–85. doi: 10.1016/S0022-5223(97)70047-3

[43] Hövels–Gürich H.H., Seghaye M.C., Däbritz S., et al. Cognitive and motor development in preschool and school-aged children after neonatal arterial switch operation // J. Thorac. Cardiovasc. Surg. 1997. Vol. 114, No. 4. P. 578–585. doi: 10.1016/S0022-5223(97)70047-3

[44] Liamlahi R, von Rhein M, Bührer S, et al. Motor dysfunction and behavioural problems frequently coexist with congenital heart disease in school-age children. Acta Paediatr. 2014;103(7):752–8. doi: 10.1111/apa.12639

[45] Liamlahi R., von Rhein M., Bührer S., et al. Motor dysfunction and behavioural problems frequently coexist with congenital heart disease in school-age children // Acta Paediatr. 2014. Vol. 103, No. 7. P. 752–758. doi: 10.1111/apa.12639

[46] Bjarnason–Wehrens B, Dordel S, Schickendantz S, et al. Motor develop-ment in children with congenital cardiac diseases compared to their healthy peers. Cardiol Young. 2007;17(5):487–98. doi: 10.1017/S1047951107001023

[47] Bjarnason–Wehrens B., Dordel S., Schickendantz S., et al. Motor development in children with congenital cardiac diseases compared to their healthy peers // Cardiol. Young. 2007. Vol. 17, No. 5. P. 487–498. doi: 10.1017/S1047951107001023

[48] Easson K, Dahan–Oliel N, Rohlicek C, et al. A Comparison of Developmental Outcomes of Adolescent Neonatal Intensive Care Unit Survivors Born with a Congenital Heart Defect or Born Preterm. J Pediatr. 2019;207:34–41.e2. doi: 10.1016/j.jpeds.2018.11.002

[49] Easson K., Dahan–Oliel N., Rohlicek C., et al. A Comparison of Developmental Outcomes of Adolescent Neonatal Intensive Care Unit Survivors Born with a Congenital Heart Defect or Born Preterm // J. Pediatr. 2019. Vol. 207. P. 34–41.e2. doi: 10.1016/j.jpeds.2018.11.002

[50] Mussatto KA, Hoffmann RG, Hoffman GM, et al. Risk and prevalence of developmental delay in young children with congenital heart disease. Pediatrics. 2014;133(3):e570–7. doi: 10.1542/peds.2013-23099

[51] Mussatto K.A., Hoffmann R.G., Hoffman G.M., et al. Risk and prevalence of developmental delay in young children with congenital heart disease // Pediatrics. 2014. Vol. 133, No. 3. P. e570–e577. doi: 10.1542/peds.2013-2309

[52] Sprong MCA, Broeders W, van der Net J, et al. Motor Developmental Delay after Cardiac Surgery in Children with a Critical Congenital Heart Defect: A Systematic Literature Review and Meta-analysis. Pediatr Phys Ther. 2021;33(4):186–97. doi: 10.1097/PEP.0000000000000827

[53] Sprong M.C.A., Broeders W., van der Net J., et al. Motor Developmental Delay after Cardiac Surgery in Children with a Critical Congenital Heart Defect: A Systematic Literature Review and Meta-analysis // Pediatr. Phys. Ther. 2021. Vol. 33, No. 4. P. 186–197. doi: 10.1097/PEP.0000000000000827

[54] Stieh J, Kramer HH, Harding P, et al. Gross and fine motor development is impaired in children with cyanotic congenital heart disease. Neuropediatrics. 1999;30(2):77–82. doi: 10.1055/s-2007-973464

[55] Stieh J., Kramer H.H., Harding P., et al. Gross and fine motor development is impaired in children with cyanotic congenital heart disease // Neuropediatrics. 1999. Vol. 30, No. 2. P. 77–82. doi: 10.1055/s-2007-973464

[56] Ricci MF, Fung A, Moddemann D, et al. Comparison of motor outcomes between preschool children with univentricular and biventricular critical heart disease not diagnosed with cerebral palsy or acquired brain injury. Cardiol Young. 2021;31(11):1788–95. doi: 10.1017/S1047951121000895

[57] Ricci M.F., Fung A., Moddemann D., et al. Comparison of motor outcomes between preschool children with univentricular and biventri-cular critical heart disease not diagnosed with cerebral palsy or acquired brain injury // Cardiol. Young. 2021. Vol. 31, No. 11. P. 1788–1795. doi: 10.1017/S1047951121000895

[58] Williams DL, Gelijns AC, Moskowitz AJ, et al. Hypoplastic left heart syndrome: valuing the survival. J Thorac Cardiovasc Surg. 2000; 119(4):720–31. doi: 10.1016/S0022-5223(00)70007-9

[59] Williams D.L., Gelijns A.C., Moskowitz A.J., et al. Hypoplastic left heart syndrome: valuing the survival // J. Thorac. Cardiovasc. Surg. 2000. Vol. 119, No. 4, Pt. 1. P. 720–731. doi: 10.1016/S0022-5223(00)70007-9

[60] Sarajuuri A, Jokinen E, Puosi R, et al. Neurodevelopment in children with hypoplastic left heart syndrome. J Pediatr. 2010;157(3):414–20. doi: 10.1016/j.jpeds.2010.04.027

[61] Sarajuuri A., Jokinen E., Puosi R., et al. Neurodevelopment in children with hypoplastic left heart syndrome // J. Pediatr. 2010. Vol. 157, No. 3. P. 414–420. doi: 10.1016/j.jpeds.2010.04.027

[62] Khalid OM, Harrison TM. Early Neurodevelopmental Outcomes in Children with Hypoplastic Left Heart Syndrome and Related Anomalies After Hybrid Procedure. Pediatr Cardiol. 2019;40(8):1591–8. doi: 10.1007/s00246-019-02191-3

[63] Khalid O.M., Harrison T.M. Early Neurodevelopmental Outcomes in Children with Hypoplastic Left Heart Syndrome and Related Anomalies After Hybrid Procedure // Pediatr. Cardiol. 2019. Vol. 40, No. 8. P. 1591–1598. doi: 10.1007/s00246-019-02191-3

[64] Limperopoulos C, Majnemer A, Shevell MI, et al. Predictors of develop-mental disabilities after open heart surgery in young children with congenital heart defects. J Pediatr. 2002;141(1):51–8. doi: 10.1067/mpd.2002.125227

[65] Limperopoulos C., Majnemer A., Shevell M.I., et al. Predictors of developmental disabilities after open heart surgery in young children with congenital heart defects // J. Pediatr. 2002. Vol. 141, No. 1. P. 51–58. doi: 10.1067/mpd.2002.125227

[66] Majnemer A, Limperopoulos C, Shevell M, et al. Long-term neuromotor outcome at school entry of infants with congenital heart defects requiring open-heart surgery. J Pediatr. 2006;148(1):72–7. doi: 10.1016/j.jpeds.2005.08.036

[67] Majnemer A., Limperopoulos C., Shevell M., et al. Long-term neuromotor outcome at school entry of infants with congenital heart defects requiring open-heart surgery // J. Pediatr. 2006. Vol. 148, No. 1. P. 72–77. doi: 10.1016/j.jpeds.2005.08.036

[68] Von Rhein M, Dimitropoulos A, Valsangiacomo Buechel ER, et al. Risk factors for neurodevelopmental impairments in school-age children after cardiac surgery with full-flow cardiopulmonary bypass. J Thorac Cardiovasc Surg. 2012;144(3):577–83. doi: 10.1016/j.jtcvs.2012.02.005

[69] Von Rhein M., Dimitropoulos A., Valsangiacomo Buechel E.R., et al. Risk factors for neurodevelopmental impairments in school-age children after cardiac surgery with full-flow cardiopulmonary bypass // J. Thorac. Cardio- vasc. Surg. 2012. Vol. 144, No. 3. P. 577–583. doi: 10.1016/j.jtcvs.2012.02.005

[70] Kakebeeke TH, Knaier E, Chaouch A, et al. Neuromotor development in children. Part 4: new norms from 3 to 18 years. Dev Med Child Neurol. 2018;60(8):810–9. doi: 10.1111/dmcn.13793

[71] Kakebeeke T.H., Knaier E., Chaouch A., et al. Neuromotor development in children. Part 4: new norms from 3 to 18 years // Dev. Med. Child Neurol. 2018. Vol. 60, No. 8. P. 810–819. doi: 10.1111/dmcn.13793

[72] Bjarnason–Wehrens B, Schmitz S, Dordel S. Motor Development in Children with Congenital Cardiac Diseases. European Cardiology Review. 2008;4(2):92–6. doi: 10.15420/ecr.2008.4.2.92

[73] Bjarnason–Wehrens B., Schmitz S., Dordel S. Motor Development in Children with Congenital Cardiac Diseases // European Cardiology Review. 2008. Vol. 4, № 2. P. 92–96. doi: 10.15420/ecr.2008.4.2.92

[74] Mari MA, Cascudo MM, Alchieri JC. Congenital heart disease and impacts on child development. Braz J Cardiovasc Surg. 2016;31(1):31–7. doi: 10.5935/1678-9741.20160001

[75] Mari M.A., Cascudo M.M., Alchieri J.C. Congenital heart disease and impacts on child development // Braz. J. Cardiovasc. Surg. 2016. Vol. 31, No. 1. P. 31–37. doi: 10.5935/1678-9741.20160001

[76] Skinner RA, Piek JO. Psychosocial implications of poor motor coordination in children and adolescents. Hum Mov Sci. 2001;20(1–2):73–94. doi: 10.1016/s0167-9457(01)00029-x

[77] Skinner R.A., Piek J.O. Psychosocial implications of poor motor coordination in children and adolescents // Hum. Mov. Sci. 2001. Vol. 20, № 1–2. P. 73–94. doi: 10.1016/s0167-9457(01)00029-x

[78] Ilardi D, Sanz JH, Cassidy AR, et al. Neurodevelopmental evaluation for school-age children with congenital heart disease: recommendations from the cardiac neurodevelopmental outcome collaborative. Cardiol Young. 2020;30(11):1623–36. doi: 10.1017/S1047951120003546

[79] Ilardi D., Sanz J.H., Cassidy A.R., et al. Neurodevelopmental evaluation for school-age children with congenital heart disease: Recommendations from the cardiac neurodevelopmental outcome collaborative // Cardiol. Young. 2020. Vol. 30, No. 11. P. 1623–1636. doi: 10.1017/S1047951120003546

[80] Unverdorben M, Singer H, Tragler M, et al. Impaired coordination in children with congenital heart disease – Only hardly to be explained by medical causes? Herz Kreislauf. 1997;29(6):181–4.

[81] Unverdorben M., Singer H., Tragler M., et al. Impaired coordination in children with congenital heart disease — Only hardly to be explained by medical causes? // Herz Kreislauf. 1997. Vol. 29, No. 6. P. 181–184.

[82] Natterer J, Schneider J, Sekarski N, et al. ORCHID (Outcome Registry for CHIldren with severe congenital heart Disease) a Swiss, nationwide, prospective, population-based, neurodevelopmental paediatric patient registry: framework, regulations and implementation. Swiss Med Wkly. 2022;152:w30217. doi: 10.4414/SMW.2022.w30217

[83] Natterer J., Schneider J., Sekarski N., et al. ORCHID (Outcome Registry for CHIldren with severe congenital heart Disease) a Swiss, nationwide, prospective, population-based, neurodevelopmental paediatric patient registry: framework, regulations and implementation // Swiss Med. Wkly. 2022. Vol. 152. P. w30217. doi: 10.4414/SMW.2022.w30217

RIGHTS & PERMISSIONS

Eco-Vector