The evaluation of motor deficits in children with ulcerative colitis: a cross-sectional study

While the gastrointestinal symptoms of ulcerative colitis (UC) are well-defined, its impact on motor development in children remains poorly understood. We aimed to assess motor proficiency, handgrip strength, and physical activity levels in children with UC and to investigate associations with disease activity. In this cross-sectional study, 49 children with UC aged 8-17 years and 41 age‑ and sex-matched healthy controls were enrolled. Disease activity was assessed using the Pediatric Ulcerative Colitis Activity Index, and laboratory markers including C-reactive protein and erythrocyte sedimentation rate were measured. Motor proficiency was evaluated using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition. Handgrip strength was measured with a dynamometer, and physical activity was assessed via the Physical Activity Questionnaire (PAQ). Group comparisons were adjusted for age, sex, socioeconomic status, and body mass index, with False Discovery Rate correction for multiple testing. Children with UC scored significantly lower on the Total Motor Composite than controls (37.4 vs. 45.1, p < 0.001). Adjusted analyses revealed a specific pattern: fine motor skills were preserved, but significant deficits were found in gross motor domains, including bilateral coordination and strength and agility (all p < 0.001). Handgrip strength differences lost significance after adjustment for body mass index, and no difference was observed in physical activity. Within the UC group, a higher erythrocyte sedimentation rate correlated with lower non-dominant handgrip strength (ρ = - 0.533, p < 0.001) and poorer agility (ρ = - 0.414, p = 0.003). CONCLUSION: Children with UC exhibit significant gross motor deficits, even during clinical remission. These cross-sectional findings indicate that clinically well children may still have impaired motor proficiency compared to healthy peers. However, longitudinal studies are needed to determine whether these deficits predate diagnosis, emerge during active disease, or persist despite remission. WHAT IS KNOWN: • The primary treatment goal in ulcerative colitis with children is the resolution of symptoms and intestinal inflammation. • The potential effects of ulcerative colitis on a child's motor function are not routinely assessed in clinical practice. WHAT IS NEW: • Children with ulcerative colitis have significantly lower overall motor proficiency scores compared to their healthy peers. • Children in clinical remission may still have impaired motor skills, indicating a potential need for comprehensive functional assessment during follow-up.