title: Early postoperative physical therapy for improving short-term gross motor outcome in infants with cyanotic and acyanotic congenital heart disease.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: Sumihito
authors.initials: S
authors.lastname: Haseba
authors.affiliation: b Course of Physical Therapy, School of Health Sciences, Faculty of Medicine , Kagoshima University , Kagoshima , Japan.
authors.forename: Harutoshi
authors.initials: H
authors.lastname: Sakakima
authors.affiliation: 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.
authors.forename: Syuhei
authors.initials: S
authors.lastname: Nakao
authors.affiliation: a Division of Rehabilitation , Kagoshima University Hospital , Kagoshima , Japan.
authors.forename: Misaki
authors.initials: M
authors.lastname: Ohira
authors.affiliation: a Division of Rehabilitation , Kagoshima University Hospital , Kagoshima , Japan.
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Yanagi
authors.affiliation: c Department of Cardiovascular and Gastroenterological Surgery, Graduate School of Medical and Dental Sciences , Kagoshima University , Kagoshima , Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imoto
authors.affiliation: a Division of Rehabilitation , Kagoshima University Hospital , Kagoshima , Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yoshida
authors.affiliation: a Division of Rehabilitation , Kagoshima University Hospital , Kagoshima , Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Shimodozono
mesh_terms: D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D000068079:Motor Disorders / Q000209:etiology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D011182:Postoperative Care; D020127:Recovery of Function; D012189:Retrospective Studies
keywords: Paediatrics; congenital heart disease; cyanotic and acyanotic heart disease; gross motor ability; postoperative rehabilitation