Evaluation of cognitive functions, manual dexterity, grip strength, reaction time and balance in children with kidney transplantation

The aim of our study is to determine whether cognitive functions, manual dexterity, handgrip strength, reaction time, and balance are affected in children with chronic kidney transplantation compared to their healthy peers. A total of 30 patients in the kidney transplantation group who were followed up at Istinye University Hospital Bahcesehir Liv Hospital and 30 healthy children as the control group were included and divided into two groups. Cognitive functions of all participants were evaluated with the Stroop Test; gross motor hand skills with the Box and Block Test; fine motor hand skills with the 9-Hole Peg Test; handgrip strength with the Handgrip Strength Test (HGST); reaction time with the Light- Trainer (LTv2, Türkiye) device; and balance with the Pediatric Balance Scale. As a result of all assessments, the demographic characteristics of the kidney transplantation group and the control group were found to be similar (p>0.05). Significant differences were observed in cognitive functions, hand motor skills, and hand reaction time parameters. In cognitive assessment, the Stroop Test showed significantly higher times in the transplantation group for "Black/White Reading" (p<0.001), "Naming the Color of the Squares" (p=0.007), and "Reading Colored Words" (p=0.002), as well as significantly higher error numbers in these sections and in "Naming the Color of Colored Words" (respectively; p=0.029; p=0.002; p=0.048; p=0.001) (p<0.05). In hand motor skills, both in the gross motor test "Box and Block Test" (dominant: p=0.020; non-dominant: p=0.037) and in the fine motor test "9-Hole Peg Test" (dominant: p<0.001; non-dominant: p<0.001), the control group was found to have significantly better performance (p<0.05). No significant differences were found between the groups in handgrip strength for the dominant hand (p=0.336) and non-dominant hand (p=0.348) (p>0.05). In reaction time measurements performed with the Light Trainer device, statistically significant differences were found between the two groups in the "fastest" (p<0.001), "slowest" (p=0.005), and "average" (p=0.018) reaction times of the dominant and non-dominant hands (p<0.05). No significant difference was observed between the groups in balance assessment (p=0.276). Our results show a multidimensional impairment in executive functions, attention, motor coordination, and time-based motor performance in children who have undergone kidney transplantation. These cognitive and motor impairments may lead to various difficulties in daily life, academic success, and social participation. Therefore, it is necessary to integrate neurodevelopmental assessments into the post-transplant clinical follow-up process and to create individualized rehabilitation programs specific to children. Physiotherapy and rehabilitation interventions targeting attention, processing speed, motor coordination, and postural control should be planned at an early stage, and holistic intervention models that include integration into the school environment should be adopted.