Clinical Bottom Line
How could I apply this information?
Infants with hypoplastic left heart syndrome (HLHS) and other types of functional univentricular heart (UVH) are at high risk for delayed motor development during the first year of life. Early therapeutic intervention may be necessary to advance motor development, particularly for those infants with HLHS and UVH who have undergone open-heart surgery. Specifically, extensive family education on the benefits of prone play may be critical once the infant is medically cleared to be positioned prone. In addition, direct intervention to promote motor development may be necessary due to the complex medical status of the infant and the family's level of comfort in progressing motor skills of an infant who has recently undergone cardiac surgery.
What should I be mindful about when applying this information?
It is unclear what factors were associated with the delayed motor development observed in infants with HLHS and UVH. All 23 infants with HLHS and 5 of 13 infants with UVH underwent 2 cardiac surgeries, yet Alberta Infant Motor Scale subtests were only provided for the HLHS and UVH infant groups as a whole. Therefore, it is unclear whether motor development was delayed only for the infants who underwent cardiac surgery or also for some infants who did not undergo surgical intervention. In addition, 6 infants with HLHS and 4 infants with UVH received physical therapy intervention during the course of the study; however, it is unclear whether these infants continued to demonstrate delayed development at the 12-month assessment and why a greater number of infants were not referred for therapeutic intervention. Infants with HLHS and those with UVH demonstrate delayed motor development, particularly in prone and standing skills; however, further research is necessary to clarify the factors associated with motor delay.
Barbara Sargent PT, PhD, PCS
University of Southern California, Los Angeles
Leesha Augustine, PT, DPT
Children's Hospital of Orange County, Orange, California