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The Alberta Infant Motor Scale as an Outcomes Measure of Gross Motor Abilities after Early Complex Cardiac Surgery

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Abstract

To address the research hypothesis that the Alberta Infant Motor Scale (AIMS) completed following complex cardiac surgery (CCS) is a useful outcomes measure this study determined: (1) AIMS scores at age 8 months after CCS; (2) predictive validity of AIMS at 8 months for Bayley Scales of Infant and Toddler Development-III Gross Motor-scaled scores (GMSS) and diagnosis of cerebral palsy (CP) at 21 months; and (3) predictive demographic and surgical variables of AIMS scores. A prospective cohort study of 250/271 (92.3%) surviving children from Northern Alberta (born 2009–2020) who had CCS at age < 6 months determined AIMS scores at age mean (SD) 8.6 (2.4) and the GMSS at 21.9 (3.8) months. Gross motor delay was defined as AIMS < 5th percentile and GMSS as < 4 (-2SD). Predictions using multiple logistic regressions were expressed as Odds Ratios (OR) and 95% Confidence Interval (CI). Of children, 100/250 (40%) had AIMS < 5th predicting GMSS < 4 (n = 43); sensitivity, specificity, positive, and negative predictive values were 88%, 71%, 40%, and 97%. Hospitalization days were independently associated with AIMS < 5th, OR 1.02 (95% CI 1.007, 1.032; p = 0.005). Excluding hospital days, ventilation days independently predicted AIMS < 5th, OR 1.08 (95% CI 1.038, 1.125, p < 0.001. Gross motor delay determine by AIMS scores of < 5th percentile occurred in 40% of survivors with good prediction of continued delay. Delay determined by AIMS was predicted by longer hospitalization and ventilation; further investigations about the causes are required. AIMS results provide opportunity for early motor intervention.

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Data Availability

The database used for this study is available from the corresponding author upon reasonable request.

Abbreviations

CHD:

Congenital heart defect

CCS:

Complex cardiac surgery

AIMS:

Alberta Infant Motor Scale

GMSS:

The Bayley Scales of Infant and Toddler Development – third edition (Bayley-III), Gross Motor-Scaled Scores

PPV:

Positive predictive value

NPV:

Negative predictive value

SD:

Standard deviation

IQR:

Inter-quartile range

CI:

Confidence interval

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Acknowledgements

We thank Julie Sorensen, Pediatric Physical Therapist, Glenrose Rehabilitation Hospital for her supervision of the assessment of the motor abilities of the children who were part of this study and for her guidance in the interpretation of the scoring and interpretation of the Alberta Infant Motor Scale. We also thank the children and their families for their attendance to the developmental follow-up clinic.

Funding

The Complex Pediatric Therapies Follow-up Program, a multidisciplinary collaboration among Canada’s prairie provinces, has been supported by funding contributions from Alberta Health, Stollery Children’s Hospital, and Women and Children’s Health Research Institute, with ongoing funding by Glenrose Rehabilitation Hospital. The Glenrose Rehabilitation Hospital provided in-kind support for the assessment of the children. This research has been funded by the Stollery Children’s Hospital Foundation through the Women and Children’s Health Research Institute, University of Alberta, Edmonton, Alberta, Canada. This Resident/Clinical Fellow Trainee Research Grant (no grant # was given) was awarded to Dr. R. Baril as part of the completion of her Fellowship in Developmental Pediatrics, University of Alberta. Role of Funder/Sponsor: This funding agency had no role in design and conduct of the study; analysis or interpretation of data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Pediatrics, University of Alberta, Edmonton, Canada

    Rebecca Baril, Ari R. Joffe, John C. Andersen & Charlene M. T. Robertson

  2. Department of Pediatrics, Glenrose Rehabilitation Hospital, Room 242A Glen East, 10230-111 Avenue, Edmonton, AB, T5G 0B7, Canada

    Rebecca Baril, John C. Andersen & Charlene M. T. Robertson

  3. School of Public Health, University of Alberta, Edmonton, Canada

    Sara Khademioureh & Irina A. Dinu

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  1. Rebecca Baril
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  6. Charlene M. T. Robertson
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by CMTR, ARJ, SK, and IAD. JCA gave subject matter expertise. The first draft of the manuscript was written by RB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Charlene M. T. Robertson.

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Baril, R., Joffe, A.R., Andersen, J.C. et al. The Alberta Infant Motor Scale as an Outcomes Measure of Gross Motor Abilities after Early Complex Cardiac Surgery. Pediatr Cardiol (2024). https://doi.org/10.1007/s00246-024-03458-0

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