Longmuir Patricia E, Banks Laura, McCrindle Brian W
Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Ontario, Canada.
Cardiol Young. 2012 Aug;22(4):443-50. doi: 10.1017/S104795111100206X. Epub 2012 Jan 24.
To determine the gross motor skills of school-aged children after the Fontan procedure and compare the locomotor and object control skills with normative data. Study design This study followed a cross-sectional design.
This study was based on hospital outpatient visit, with accelerometry conducted at home. Patients This study included 55 patients, including 22 girls in the age group of 6-10 years, 5.1 years after Fontan. Main outcome measures Test of Gross Motor Development - Version 2, daily activity by accelerometer, medical history review, child and parent perceptions of activity.
Being involved in active team sports increased locomotor percentile score by 10.3 points (CI: 4.4, 16.1). Preference for weekend outdoor activities (6.9, CI: 2.0, 11.8), performing at least 30 minutes of moderate-to-vigorous physical activity daily (24.5, CI: 7.3, 41.8), and reporting that parents seldom criticise the child's physical activity (21.8, CI: 8.9, 34.8) were also associated with higher locomotor percentile scores (p < 0.01). Object control percentile scores were higher (p < 0.03) with involvement in formal instruction (5.9, CI: 1.1, 10.6) and being restricted to "activities within comfortable limits" (27.6, CI: 7.7, 47.5). Older chronological age (r = 0.28), a more complicated medical history (r = 0.36), and older age at Fontan (r = 0.28) were associated with greater skill delay (p < 0.04).
Children after Fontan attain basic motor skills at a later age than their peers, and deficits continue for more complex skills as age increases, suggesting a need for longitudinal monitoring of gross motor skill development through the elementary school years. Future research might investigate whether a gross motor skill rehabilitation programme can provide these children with the motor skills needed to successfully participate in a physically active lifestyle with peers.
确定接受Fontan手术的学龄儿童的大运动技能，并将其运动和物体控制技能与标准数据进行比较。研究设计 本研究采用横断面设计。
本研究基于医院门诊就诊，并在家中进行加速度测量。患者 本研究纳入了55名患者，其中包括22名6至10岁的女孩，在接受Fontan手术后5.1年。主要结局指标 大运动发展测试 - 第2版、通过加速度计测量的日常活动、病史回顾、儿童和家长对活动的看法。
参与积极的团队运动使运动百分位数得分提高了10.3分（置信区间：4.4, 16.1）。偏好周末户外活动（6.9，置信区间：2.0, 11.8）、每天至少进行30分钟的中度至剧烈体育活动（24.5，置信区间：7.3, 41.8）以及报告家长很少批评孩子的体育活动（21.8，置信区间：8.9, 34.8）也与较高的运动百分位数得分相关（p < 0.01）。参与正规指导（5.9，置信区间：1.1, 10.6）和仅限于“在舒适范围内的活动”（27.6，置信区间：7.7, 47.5）时，物体控制百分位数得分更高（p < 0.03）。实际年龄较大（r = 0.28）、病史更复杂（r = 0.36）以及Fontan手术时年龄较大（r = 0.28）与技能延迟更大相关（p < 0.04）。
接受Fontan手术的儿童比同龄人获得基本运动技能的年龄更晚，并且随着年龄增长，更复杂技能的缺陷持续存在，这表明需要在小学阶段对大运动技能发展进行纵向监测。未来的研究可能会调查大运动技能康复计划是否能够为这些儿童提供成功与同龄人一起参与积极体育生活方式所需的运动技能。
