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Impacto das cardiopatias congénitas nas habilidades motoras fundamentais e capacidade funcional de crianças dos 6 aos 9 anos
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Introdução: As crianças têm uma necessidade básica de atividade física. Frequentemente, a doença cardíaca significa uma limitação da experiência percetiva e motora da criança afetada. Há relativamente poucos estudos centrados no desenvolvimento motor das crianças com doenças cardíacas congénitas (CC). O nosso objetivo é avaliar o impacto das CC nas capacidades motoras fundamentais das crianças dos 6 aos 9 anos de idade. Métodos: Foram incluídas crianças com CC, de ambos os sexos, com idades compreendidas entre os 6 e os 9 anos. Os critérios de exclusão tiveram em conta a presença de outros fatores de risco de perturbação do desenvolvimento motor, alterações visuais ou auditivas, presença de malformações extracardíacas ou síndromes que pudessem interferir com as variáveis do estudo. Os participantes foram divididos em 3 grupos, de acordo com a doença subjacente e o estado cirúrgico: CC acianótica simples corrigida (grupo I); CC acianótica complexa corrigida ou CC cianótica corrigida (grupo II); CC cianótica complexa não corrigida, ou seja, após cirurgia paliativa (grupo III). A avaliação incluiu o teste da marcha dos 6 minutos; uma entrevista com as crianças e os seus pais para recolher dados clínicos, demográficos e de hábitos de vida; e no final foi aplicado o teste de proficiência motora de Bruininks-Oseretsky, 2ª Edição. Resultados: Foram recrutados quarenta e quatro participantes, 23 do sexo masculino e 21 do sexo feminino. O grupo I incluiu 15 crianças, o grupo II 13, e o grupo III 16. No Score Composto de Proficiência Motora, o Grupo I apresentou uma pontuação correspondente ao percentil 48 (34,51-61,76), o Grupo II apresentou uma pontuação correspondente ao percentil 25 (10,06-40,25); finalmente, os participantes do Grupo III apresentaram uma pontuação correspondente ao percentil 5 (2,54-7,32), muito abaixo da média para a sua idade e sexo. As diferenças estatisticamente significativas entre os três grupos foram documentadas para os diferentes sub-testes avaliados. Foi documentada uma correlação entre a Proficiência Motora e os resultados do TC6, sendo o impacto maior quanto mais complexa for a doença. Conclusões: Este estudo documenta que as crianças com cardiopatias congénitas complexas ou paliativas apresentam uma competência motora reduzida, com limitações nas competências motoras finas e brutas. Estas limitações, baseadas nas competências adquiridas desde a primeira infância, apresentam um efeito negativo adicional sobre a aptidão física e a força muscular dos indivíduos. Estes resultados apontam para a necessidade de uma intervenção precoce no desenvolvimento destes pacientes.
Introduction: Children have a basic need for physical activity. Frequently, heart disease means a limitation of the affected child's perceptual and motor experience. There are relatively few studies focusing on the motor development of children with congenital heart disease (CHD). We aim to assess the impact of CHD on the fundamental motor skills of children aged 6 to 9 years. Methods: Children with CHD, of both sexes, aged 6 to 9 years were included. Exclusion criteria were presence of other risk factors for motor development disorder, visual or auditory alterations, presence of extra-cardiac malformations or syndromes that could interfere with the study variables. The participants were divided into 3 groups according to the underlying disease and surgical status: corrected simple acyanotic CHD (group I); corrected cyanotic or complex acyanotic CHD (group II); uncorrected complex cyanotic CHD, i.e., after palliative surgery (group III). The assessment included the 6-Minutes’ Walk-test; an interview with the children and their parents to collect clinical, demographic and life habits data; and at the end the Bruininks-Oseretsky motor proficiency test, 2nd Edition, was applied. Results: Forty-four participants were recruited, 24 males and 20 females. Group I included 15 children, group II 13, and group III 16. In the Composite Motor Proficiency Score, Group I presented a score corresponding to the 48th percentile (34.51-61.76), Group II presented a score corresponding to the 25th percentile (10.06-40.25); finally, the participants in Group III present a score corresponding to the 5th percentile (2.54- 7.32), much below the average for their age. Statistically significant differences between the three groups were documented for the different subtests assessed. A correlation was documented between Motor Proficiency and the results of the 6MWT, the impact being greater the more complex the disease. Conclusions: This study documents that children with complex or palliated CHD present reduced motor competence, with limitations in fine and gross motor skills. These limitations, based on skills acquired since early childhood, present an additional negative effect on the physical fitness and muscle strength of individuals. These results point to the need for early intervention in the development of these patients.
Introduction: Children have a basic need for physical activity. Frequently, heart disease means a limitation of the affected child's perceptual and motor experience. There are relatively few studies focusing on the motor development of children with congenital heart disease (CHD). We aim to assess the impact of CHD on the fundamental motor skills of children aged 6 to 9 years. Methods: Children with CHD, of both sexes, aged 6 to 9 years were included. Exclusion criteria were presence of other risk factors for motor development disorder, visual or auditory alterations, presence of extra-cardiac malformations or syndromes that could interfere with the study variables. The participants were divided into 3 groups according to the underlying disease and surgical status: corrected simple acyanotic CHD (group I); corrected cyanotic or complex acyanotic CHD (group II); uncorrected complex cyanotic CHD, i.e., after palliative surgery (group III). The assessment included the 6-Minutes’ Walk-test; an interview with the children and their parents to collect clinical, demographic and life habits data; and at the end the Bruininks-Oseretsky motor proficiency test, 2nd Edition, was applied. Results: Forty-four participants were recruited, 24 males and 20 females. Group I included 15 children, group II 13, and group III 16. In the Composite Motor Proficiency Score, Group I presented a score corresponding to the 48th percentile (34.51-61.76), Group II presented a score corresponding to the 25th percentile (10.06-40.25); finally, the participants in Group III present a score corresponding to the 5th percentile (2.54- 7.32), much below the average for their age. Statistically significant differences between the three groups were documented for the different subtests assessed. A correlation was documented between Motor Proficiency and the results of the 6MWT, the impact being greater the more complex the disease. Conclusions: This study documents that children with complex or palliated CHD present reduced motor competence, with limitations in fine and gross motor skills. These limitations, based on skills acquired since early childhood, present an additional negative effect on the physical fitness and muscle strength of individuals. These results point to the need for early intervention in the development of these patients.
Descrição
Tese de mestrado, Reabilitação Cardiovascular, Universidade de Lisboa, Faculdade de Medicina, 2022
Palavras-chave
Cardiopatias congénitas Destreza motora Criança Reabilitação cardíaca Teses de mestrado - 2022