Motor Proficiency and Generalized Self-Efficacy towards Physical Activity in Children with Intestinal Failure

Objective: Survival rates of children with intestinal failure have increased, however associated co-morbidities may impact long-term motor developmental outcomes. This study evaluates motor proficiency and generalized self-efficacy towards physical activity (PA) in children age 6–12 years with intestinal failure. Methods: Observational, cross-sectional study of children followed in a multi-disciplinary intestinal rehabilitation program. Motor proficiency was assessed using the Bruininks-Oseretsky Test of Motor Proficiency-2 Short Form (BOT-2 SF) and the Scales of Independent Behavior (parent-proxy report). Children completed the Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity (CSAPPA) and a PA questionnaire. Relevant demographic and medical variables were correlated with assessment results. Results: Thirty children (18 males), median age 7 years (IQR 6, 9) with gestational age 35 weeks (IQR 32, 39) and birth weight 2.13 kilograms (IQR 1.68, 2.77). Thirteen (43%) were dependent on parenteral nutrition. Fifteen (50%) scored below average on the BOT-2 SF. Lower BOT-2 SF scores were significantly associated with lower CSAPPA scores (r = 0.480, p = 0.01), with a common barrier to PA being the presence of a central line or enterostomy tube. Gestational age, height z-scores, length of hospital admissions and number of septic events were all significantly correlated with lower scores in motor proficiency. Number of septic events and total parenteral nutrition days were significant predictors of lower BOT-2 SF scores, when adjusting for birth weight. Conclusions: Multiple medical variables related to intestinal failure may impact motor proficiency and PA self-efficacy. Developmental follow-up is important to optimize motor skill development and promote PA participation. Address correspondence and reprint requests to Stephanie So, Department of Rehabilitation Services, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G 1X8, Canada (e-mail: stephanie.so@sickkids.ca). Received 24 October, 2017 Accepted 2 July, 2018 Funding Acknowledgements: OT/PT Paediatric Network, Toronto, Ontario Individual Acknowledgements: Kristen Pitzul and Karolina Urban for statistical support. Dr. John Hay for research support. University Acknowledgements: This research was completed in partial fulfillment of the requirements for an MSc.PT degree at the University of Toronto. Conflicts of interest: None of the authors have a conflict of interest to declare for this study. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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