Haseba Sumihito, Sakakima Harutoshi, Nakao Syuhei, Ohira Misaki, Yanagi Shigefumi, Imoto Yutaka, Yoshida Akira, Shimodozono Megumi
a Division of Rehabilitation , Kagoshima University Hospital , Kagoshima , Japan.
b Course of Physical Therapy, School of Health Sciences, Faculty of Medicine , Kagoshima University , Kagoshima , Japan.
Disabil Rehabil. 2018 Jul;40(14):1694-1701. doi: 10.1080/09638288.2017.1309582. Epub 2017 Apr 7.
We analysed the gross motor recovery of infants and toddlers with cyanotic and acyanotic congenital heart disease (CHD) who received early postoperative physical therapy to see whether there was any difference in the duration to recovery.
This study retrospectively evaluated the influence of early physical therapy on postoperative gross motor outcomes of patients with CHD. The gross motor ability of patients with cyanotic (n = 25, average age: 376.4 days) and acyanotic (n = 26, average age: 164.5 days) CHD was evaluated using our newly developed nine-grade mobility assessment scale.
Physical therapy was started at an average of five days after surgery, during which each patient's gross motor ability was significantly decreased compared with the preoperative level. Patients (who received early postoperative physical therapy) with cyanotic (88.0%) and acyanotic CHD (96.2%) showed improved preoperative mobility grades by the time of hospital discharge. However, patients with cyanotic CHD had a significantly prolonged recovery period compared to those with acyanotic CHD (p < .01). The postoperative recovery period to preoperative mobility grade was significantly correlated with pre-, intra-, and postoperative factors.
Our findings suggested that infants with cyanotic CHD are likely at a greater risk of gross motor delays, the recovery of which might differ between infants with cyanotic and acyanotic CHD after cardiac surgery. Early postoperative physical therapy promotes gross motor recovery. Implications of Rehabilitation Infants and toddlers with cyanotic congenital heart disease are likely at greater risk of gross motor delays and have a prolonged recovery period of gross motor ability compared to those with acyanotic congenital heart disease. Early postoperative physical therapy for patients with congenital heart disease after cardiac surgery promoted gross motor recovery. The postoperative recovery period to preoperative mobility grade was affected by pre-, intra-, and postoperative factors. Rehabilitation experts should consider the risk of gross motor delays of patients with congenital heart disease after cardiac surgery and the early postoperative physical therapy to promote their gross motor recovery.
我们分析了接受早期术后物理治疗的患有青紫型和非青紫型先天性心脏病（CHD）的婴幼儿的大运动恢复情况，以观察恢复时间是否存在差异。
本研究回顾性评估了早期物理治疗对CHD患者术后大运动结局的影响。使用我们新开发的九级活动能力评估量表对青紫型CHD患者（n = 25，平均年龄：376.4天）和非青紫型CHD患者（n = 26，平均年龄：164.5天）的大运动能力进行评估。
物理治疗平均在术后五天开始，在此期间，每位患者的大运动能力与术前水平相比均显著下降。患有青紫型CHD（88.0%）和非青紫型CHD（96.2%）的患者（接受早期术后物理治疗）在出院时术前活动能力等级有所改善。然而，与非青紫型CHD患者相比，青紫型CHD患者的恢复期明显延长（p < 0.01）。术后恢复到术前活动能力等级的时间与术前、术中和术后因素显著相关。
我们的研究结果表明，青紫型CHD婴儿出现大运动发育迟缓的风险可能更大，心脏手术后，青紫型和非青紫型CHD婴儿的大运动恢复情况可能有所不同。早期术后物理治疗可促进大运动恢复。康复意义 与非青紫型先天性心脏病患儿相比，青紫型先天性心脏病婴幼儿出现大运动发育迟缓的风险可能更大，大运动能力的恢复期更长。心脏手术后对先天性心脏病患者进行早期术后物理治疗可促进大运动恢复。术后恢复到术前活动能力等级的时间受术前、术中和术后因素影响。康复专家应考虑心脏手术后先天性心脏病患者出现大运动发育迟缓的风险以及早期术后物理治疗以促进其大运动恢复。
