Impaired motor competence in school-aged children with complex congenital heart disease.

OBJECTIVE To explore the extent and type of motor problems in children with complex congenital heart disease (CHD) compared with schoolchildren without any documented heart failure. DESIGN Cohort study. SETTING Biomechanical Laboratory, Rikshospitalet-Radiumhospitalet Medical Centre. PARTICIPANTS One hundred twenty children aged 7 to 12 years with complex CHD and 387 healthy schoolchildren in the same age range (control group). INTERVENTIONS All children with CHD were surgically treated with multiple corrections within the first year of life. MAIN OUTCOME MEASURES Movement Assessment Battery for Children, grip strength, quadriceps muscle strength, and balance. RESULTS Compared with the control group, children with CHD had a risk of having any degree of impaired motor competence of 5.8 (95% confidence interval, 3.8-8.8). The risk for having severe motor problems was 11.0 (95% confidence interval, 5.4-22.5). There were highly significant differences between the groups for manual dexterity, ball skills, grip strength, quadriceps muscle strength, and static and dynamic balance (P<.001). CONCLUSIONS Children with CHD have a risk of severe motor problems 11-fold that of schoolchildren without any known heart failure. This suggests that primary health care providers should screen the motor competence in children with CHD at an early age to initiate therapeutic actions for children who show incipient motor problems. Optimal rehabilitative, social, and environmental support may improve the children's motor competence and prevent future health problems.