Long-term gross motor proficiency deficits among children post posterior fossa brain tumor removal vs. traumatic brain injury: a cross-sectional study

Abstract

Abstract Background Acquired brain injury (ABI) is classified into traumatic brain injury (TBI) and ABI-PF. In ABI-PF, almost half of pediatric brain tumors arise in the posterior fossa (PF). Assessment of motor proficiency is commonly conducted with the Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT2). This study assessed: 1) gross motor performance deficits in children with TBI and ABI on account of tumor in the PF (ABI-PF) using two different assessment methods (two-standard deviation and age equivalent methods); 2) BOT2 ability to discriminate between children with TBI and ABI-PF; and 3) factors associated with motor ability. Methods Participated in this study were children with TBI (n = 50) and ABI-PF (n = 30) (mean age = 11.34 ± 3.55 years). Participants were tested on BOT2 Upper-Limb Coordination, Balance, Strength, Running Speed and Agility, and Bilateral-Coordination subtests. Motor performance deficits were established using BOT2 two-standard deviation and age-equivalent methods. Differences in the prevalence of children with/without motor performance deficits were evaluated using a chi-square test. Between-group differences (TBI vs. ABI-PF) in BOT2 were assessed via independent t-tests. The ability of the BOT2 to distinguish between the two study groups was established using receiver operating characteristic curves. Results Motor deficits in the ABI-PF group were higher than in the TBI group. More specifically, according to the two-standard deviation method, motor deficits in the ABI-PF group ranged from 20% (bilateral coordination) to 66.66% (balance), whereas in the TBI group 8% (strength) to 16% (balance). The age-equivalent method revealed higher rates of motor deficits. In the TBI group, 40% (Upper Limb Coordination) to 66.0 (Bilateral Coordination) of the children presented motor function that is ≥ 36 months below their chronological age. In the ABI-PF group, 46.66% (Bilateral Coordination) to 76.66% (Balance) of the children presented such motor deficits. BOT2 discriminated between the two etiology groups. Several significant associations were observed between age and motor function. Conclusions Motor deficits post-pediatric ABI are prevalent. In comparison to the TBI group, deficits are greater in the ABI-PF group. Moreover, compared to the two-standard deviation method, the extent of motor deficiency is greater in the age-equivalent method. Finally, age is associated with several motor function deficits.