Motor and functional characteristics in school-age survivors of congenital diaphragmatic hernia: a cross-sectional observational study.

IF 3.9 2区 医学 Q1 PEDIATRICS
Takamasa Mitsumatsu, Yuji Ito, Yukako Muramatsu, Yoshiaki Sato, Tadashi Ito, Sho Narahara, Ryosuke Miura, Hiroyuki Yamamoto, Miharu Ito, Anna Shiraki, Tomohiko Nakata, Tomomi Kotani, Jun Natsume, Masahiro Hayakawa, Yoshiyuki Takahashi, Hiroyuki Kidokoro
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Abstract

Background: Children born with congenital diaphragmatic hernia (CDH) are at risk of poor developmental outcomes. This study aimed to clarify the motor and functional characteristics of school-age CDH survivors and identify perinatal factors associated with motor function deficits.

Methods: Motor function was comprehensively assessed in CDH survivors aged 6-10 years (CDH group, n=24) and in age- and sex-matched controls (n=72). Assessments included physical activity time, grip strength, the five times sit-to-stand test, one-leg standing time, 6 min walking distance and gait ability using a three-dimensional gait analysis. In the CDH group, correlations between perinatal factors and motor function outcomes were analysed.

Results: In the CDH group, all children had isolated CDH. Three were extracorporeal membrane oxygenation (ECMO) treated and 21 were non-ECMO treated. The CDH group exhibited shorter stature, lower weight and reduced physical activity time than the controls. They also showed significantly lower grip strength, longer five times sit-to-stand test time, shorter one-leg standing time and decreased 6 min walking distance. No significant differences were found between the two groups regarding walking speed, step length or Gait Deviation Index. Within the CDH group, a higher observed-to-expected lung area-to-head circumference ratio (o/e LHR) was positively correlated with better grip strength.

Conclusions: School-age survivors of CDH are at risk of impaired motor function. Particularly, grip strength measurement is crucial for those born with a low o/e LHR. Implementing follow-up and intervention programmes focused on improving limb muscle strength, balance, and endurance, and promoting adequate physical activity may enhance motor function.

先天性膈疝学龄幸存者的运动和功能特征:一项横断面观察研究。
背景:先天性膈疝(CDH)患儿存在发育不良的风险。本研究旨在阐明学龄CDH幸存者的运动和功能特征,并确定与运动功能缺陷相关的围产期因素。方法:综合评估6-10岁CDH幸存者(CDH组,n=24)和年龄和性别匹配的对照组(n=72)的运动功能。评估包括体力活动时间、握力、5次坐立测试、单腿站立时间、6分钟步行距离和采用三维步态分析的步态能力。在CDH组中,分析围产期因素与运动功能结局的相关性。结果:CDH组患儿均有孤立性CDH。体外膜氧合(ECMO)治疗3例,非ECMO治疗21例。CDH组表现出比对照组更矮的身材、更低的体重和更少的体力活动时间。他们的握力也明显降低,5次坐立测试时间延长,单腿站立时间缩短,6分钟步行距离缩短。两组在步行速度、步长和步态偏离指数方面没有显著差异。在CDH组中,较高的观察到的肺面积与头围比(o/e LHR)与较好的握力呈正相关。结论:学龄期CDH幸存者存在运动功能受损的风险。特别是,握力测量对于那些出生时0 /e LHR较低的人来说至关重要。实施以改善肢体肌肉力量、平衡和耐力为重点的随访和干预方案,以及促进适当的身体活动,可能会增强运动功能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.00
自引率
4.50%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.
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