Longitudinal assessments of motor performance and musculoskeletal abnormalities in preschool children with esophageal atresia

Abstract

Background: Children with esophageal atresia (EA) may have impaired motor performance and musculoskeletal abnormalities, but when and in whom these abnormalities develop is still unknown.

Aims: To study motor performance and musculoskeletal abnormalities from infancy to pre-school age, and to assess risk factors for poor motor performance at 24 and 48 months.

Study design: Prospective cohort study at 12, 24, and 48 months.

Subjects: Forty-six children with EA.

Outcome measures: Total and subtest scores and percentile ranks describing motor skills were obtained by using the Alberta Infant Motor Scale (AIMS) at 12 months, Peabody Developmental Motor Scale, Second Edition (PDMS-2) at 24 months, and Motor Assessment Battery for Children, Second Edition (MABC-2) at 48 months. Muscle strength was measured by Grippit, and musculoskeletal abnormalities were clinically evaluated according to a standardized protocol.

Results: The total median z-scores for AIMS, PDMS-2, and MABC-2 at group level were -0.571, -0.903, and -0.994 respectively, all significantly lower than in reference populations (p < 0.001). The decrease in motor skills between 12 and 48 months may have biological importance and was significantly more frequent in patients with more neonatal morbidity, anastomotic complications, and reduced muscle strength. The number of patients with musculoskeletal abnormalities increased from 11 % to 59 % between 24 and 48 months, but was not related to motor performance.

Conclusions: Motor performance was low from infancy, reduced longitudinally, and related to neonatal morbidity in children with EA. Musculoskeletal abnormalities increased throughout childhood, but were not related to motor performance.

Keywords: Esophageal atresia; Motor performance; Musculoskeletal abnormalities.