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Bosserman J, Kelkar S, LeBlond KD, Cassidy J, McCarty DB. Postural Control Measurements to Predict Future Motor Impairment in Preterm Infants: A Systematic Review. Diagnostics (Basel) 2023; 13:3473. [PMID: 37998609 PMCID: PMC10670104 DOI: 10.3390/diagnostics13223473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023] Open
Abstract
Preterm infants are more likely to demonstrate developmental delays than fullterm infants. Postural measurement tools may be effective in measuring the center of pressure (COP) and asymmetry, as well as predicting future motor impairment. The objective of this systematic review was to evaluate existing evidence regarding use of pressure mats or force plates for measuring COP and asymmetry in preterm infants, to determine how measures differ between preterm and fullterm infants and if these tools appropriately predict future motor impairment. The consulted databases included PubMed, Embase, Scopus, and CINAHL. The quality of the literature and the risk of bias were assessed utilizing the ROB2: revised Cochrane risk-of bias tool. Nine manuscripts met the criteria for review. The postural control tools included were FSA UltraThin seat mat, Conformat Pressure-Sensitive mat, Play and Neuro-Developmental Assessment, and standard force plates. Studies demonstrated that all tools were capable of COP assessment in preterm infants and support the association between the observation of reduced postural complexity prior to the observation of midline head control as an indicator of future motor delay. Postural measurement tools provide quick and objective measures of postural control and asymmetry. Based on the degree of impairment, these tools may provide an alternative to standardized assessments that may be taxing to the preterm infant, inaccessible to therapists, or not sensitive enough to capture motor delays.
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Affiliation(s)
- Jennifer Bosserman
- Physical Medicine and Rehabilitation, Johns Hopkins Hospital, Baltimore, MD 21205, USA;
| | - Sonia Kelkar
- Department of Health Sciences, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA
| | - Kristen D. LeBlond
- Physical Therapy and Occupational Therapy, Duke Health, Durham, NC 27705, USA
| | - Jessica Cassidy
- Department of Health Sciences, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA
| | - Dana B. McCarty
- Department of Health Sciences, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA
- North Carolina Children’s Hospital, Chapel Hill, NC 27599, USA
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2
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Nakanomori A, Miyabayashi H, Tanaka Y, Maedomari T, Mukai C, Saito K, Okahashi A, Nagano N, Morioka I. Changes in Cranial Shape and Developmental Quotient at 6 Months of Age in Preterm Infants. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050855. [PMID: 37238403 DOI: 10.3390/children10050855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Abstract
The purpose of this study was to investigate changes in cranial shape among preterm neonates aged 1-6 months and the relationship between developmental quotient (DQ) and cranial shape at 6 months of age. Preterm infants who were hospitalized in our hospital were prospectively followed for 6 months. The cephalic index (CI) and cranial vault asymmetry index (CVAI) were evaluated at 1 (T1), 3 (T2), and 6 months (T3) of age and compared with those of the full-term infants. The relationship between CI or CVAI and DQ at T3 was analyzed using the Enjoji Scale of Infant Analytical Development. A total of 26 participants born at 34.7 ± 1.9 weeks of gestation were included. The CI increased with age (T1: 77.2%, T2: 82.9%, T3: 85.4%, p < 0.01). The prevalence of dolichocephaly at T3 did not significantly differ from that in full-term infants (15.4% vs. 4.5%, p = 0.08). CVAI did not significantly differ between preterm and full-term infants. The DQ showed no significant correlation with either the CI or CVAI (correlation coefficients: 0.23 for CI, -0.01; CVAI). Dolichocephaly improved over time in preterm infants and no relationship between cranial shape and development was observed in preterm infants at 6 months of age.
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Affiliation(s)
- Aya Nakanomori
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo 173-8610, Japan
- Department of Pediatrics, Kasukabe Medical Center, Saitama 344-8588, Japan
| | - Hiroshi Miyabayashi
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo 173-8610, Japan
- Department of Pediatrics, Kasukabe Medical Center, Saitama 344-8588, Japan
| | - Yukari Tanaka
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo 173-8610, Japan
- Department of Pediatrics, Kasukabe Medical Center, Saitama 344-8588, Japan
| | - Taishin Maedomari
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo 173-8610, Japan
- Department of Pediatrics, Kasukabe Medical Center, Saitama 344-8588, Japan
| | - Chihiro Mukai
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo 173-8610, Japan
- Department of Pediatrics, Kasukabe Medical Center, Saitama 344-8588, Japan
| | - Katsuya Saito
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo 173-8610, Japan
- Department of Pediatrics, Kasukabe Medical Center, Saitama 344-8588, Japan
| | - Aya Okahashi
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Nobuhiko Nagano
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Ichiro Morioka
- Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo 173-8610, Japan
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3
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Bagagiolo D, Priolo CG, Favre EM, Pangallo A, Didio A, Sbarbaro M, Borro T, Daccò S, Manzoni P, Farina D. A Randomized Controlled Trial of Osteopathic Manipulative Therapy to Reduce Cranial Asymmetries in Young Infants with Nonsynostotic Plagiocephaly. Am J Perinatol 2022; 39:S52-S62. [PMID: 36451623 DOI: 10.1055/s-0042-1758723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
OBJECTIVE This study aimed to compare the efficacy of osteopathic manipulative therapy (OMTh) versus light touch therapy (LTT) in reducing cranial asymmetries in infants with nonsynostotic plagiocephaly (NSP). STUDY DESIGN A prospective, parallel-group, single-center, LTT-controlled randomized clinical trial was conducted in the Department of Neonatology of Sant'Anna Hospital in Turin, Italy, from September 6, 2016 to February 20, 2020. We enrolled infants of 1 to 6 months of age with NSP, who were then randomly assigned to the study group (repositioning therapy plus six sessions of OMTh) or the control group (repositioning therapy plus six sessions of LTT). The outcome was the reduction of the oblique diameter difference index (ODDI) score <104%, which was assessed at the end of the intervention protocol (at 3 months) and at 1 year of age. RESULTS A total of 96 infants were randomized, 48 in the OMTh group and 48 in the LTT group, with mean ages of 3.1 versus 3.2 months, and baseline ODDI score of 110.2 versus 108.7%. In the OMTh group, a significant reduction of the ODDI score <104%, compared with the LTT group, was observed in the intension-to-treat (ITT) and per-protocol (PP) analyses. The ITT analysis revealed an ODDI score <104% in the OMTh group at 3 months (risk difference: 0.41; 95% confidence interval [CI]: 0.25-0.53; p < 0.001) and at the follow-up at 1 year of age (risk difference: 0.47; 95% CI: 0.31-0.64; p < 0.001). The PP analysis at 3 months reported a risk difference of 0.44 (95% CI: 0.27-0.60; p < 0.001), and at 1 year of age, a risk difference of 0.54 (95% CI: 0.36-0.72; p < 0.001). CONCLUSION In infants with NSP, a course of six OMTh sessions significantly reduced cranial asymmetries at both the 3-month and 1-year follow-up assessments, compared with LTT. This study is registered with ClinicalTrial.gov (identifier: NCT03970395; www. CLINICALTRIALS gov ). KEY POINTS · OMTh plus repositioning therapy significantly decreased the risk and severity of NSP compared with LTT.. · OMTh reduced mild and moderate cranial asymmetries.. · The role of OMTh in severe cranial asymmetries should be investigated in a multicenter trial..
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Affiliation(s)
- Donatella Bagagiolo
- Department of Research, Scuola Superiore di Osteopatia Italiana, Turin, Italy
| | - Claudio G Priolo
- Division of Neonatology and NICU, Sant'Anna Hospital, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy
| | - Elena M Favre
- Department of Research, Scuola Superiore di Osteopatia Italiana, Turin, Italy
| | - Antonella Pangallo
- Department of Research, Scuola Superiore di Osteopatia Italiana, Turin, Italy
| | - Alessia Didio
- Department of Research, Scuola Superiore di Osteopatia Italiana, Turin, Italy
| | - Marco Sbarbaro
- Department of Research, Scuola Superiore di Osteopatia Italiana, Turin, Italy
| | - Tiziana Borro
- Division of Neonatology and NICU, Sant'Anna Hospital, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy
| | - Silvia Daccò
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Albese con Cassano, Como, Italy
| | - Paolo Manzoni
- Division of Neonatology and NICU, Sant'Anna Hospital, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy.,Division of Pediatrics and Neonatology, Department of Maternal, Neonatal, and Infant Medicine, Nuovo Ospedale Degli Infermi, Ponderano, Italy
| | - Daniele Farina
- Division of Neonatology and NICU, Sant'Anna Hospital, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy
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Wilczyński J, Sowińska A, Mierzwa-Molenda M. Physiotherapy as a Specific and Purposeful Form of Physical Activity in Children with Idiopathic Body Asymmetry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15008. [PMID: 36429727 PMCID: PMC9690881 DOI: 10.3390/ijerph192215008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/06/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
The aim of the study was to determine the relationship between idiopathic asymmetry in infants and body posture in children at an early school age. The study included 45 girls aged nine. The Diers Formetric III 4D device was used to assess body posture, which allows photogrammetric registration of the back surface using the raster stereography process. For the purposes of the re-search project, the examination was performed via DiCAM using the "Average measurement" mode. Despite physiotherapy, these children had more postural defects later on compared to the control group due to asymmetry. They mainly concerned pelvic skewness, scoliosis angle, deviation from the vertical line and lateral deviation, as well as surface rotation. Positive correlations were observed between direction of asymmetry and pelvic skewness (r = 0.40), and between the location of asymmetry and the location of curvature (r = 0.39). Significant negative correlations were also found between the age of treatment initiation and trunk length (r = -0.42). There was also a negative correlation between the number of physiotherapeutic appointments and deviation from the vertical line, which means that along with an increase in the number of physiotherapeutic visits, the value of deviation from the vertical line decreased (p = -0.40). For scoliosis angle, the most important predictor was the direction of asymmetry (p = 0.05). For the location of the curvature, the most important predictor was the direction of asymmetry (p = 0.04), as well as the number of physiotherapeutic appointments (p = 0.04). Additionally, regression analysis allowed us to show that the number of physiotherapeutic visits (p = 0.03) was the most important predictor of curvature direction. The applied physiotherapy probably contributed to the occurrence of a smaller number of postural defects in these children at a later age. Physiotherapy as a specific and targeted form of physical activity among infants with idiopathic asymmetry should play a very important role in the prevention of body posture defects.
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Affiliation(s)
| | - Anita Sowińska
- Correspondence: (J.W.); (A.S.); Tel.: +48-603-703-926 (J.W.)
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Eliks M, Sowińska A, Gajewska E. The Polish Version of the Alberta Infant Motor Scale: Cultural Adaptation and Validation. Front Neurol 2022; 13:949720. [PMID: 35968314 PMCID: PMC9366671 DOI: 10.3389/fneur.2022.949720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
The Alberta Infant Motor Scale (AIMS) is a diagnostic tool for the assessment of the motor performance of infants from the time of birth, to the period of independent walking (0-18 months). This study aims to derive a Polish version of the AIMS through its cultural adaptation and validation. The study included 145 infants aged 0-18 months, who were divided into four further age groups: 0-3 months, 4-7 months, 8-11 months, and older than 12 months. The validation was based on an analysis of intrarater and interrater reliability values, as well as concurrent validity, using the gross motor scale of Peabody Developmental Motor Scales-2 (PDMS-2). The total Intraclass Correlation Coefficient (ICC) for intrarater reliability was 0.99 (ICC range in positions was 0.87-0.99, in subgroups was 0.91-0.99), while in particular positions, the ICC ranges were as follows: prone 0.97-0.99, supine 0.94-0.99, sitting 0.95-0.99, and standing: 0.63-0.99. The total ICC for interrater reliability was 0.99 (ICC range in positions was 0.98-0.99, in subgroups was 0.91-0.99), while in particular positions, the ICC ranges were as follows: prone 0.95-0.99, supine 0.93-0.96, sitting 0.93-0.98, standing 0.91-0.98. Only the standing position was analyzed for the subgroup of participants over 12 months old. The Spearman correlation between the Polish version of the AIMS and the gross motor scale of PDMS-2 was significant in the total population (r = 0.97, p < 0.0001) and in subgroups (r = 0.79-0.85, p < 0.0001). The results of our study confirm that the Polish version of the AIMS is reliable for infants aged 0-18 months and can be applied to this population for clinical and scientific purposes. Trial Registry ClinicalTrials.gov ID NCT05264064, URL https://clinicaltrials.gov/ ct2/show/NCT05264064.
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Affiliation(s)
- Małgorzata Eliks
- Chair and Clinic of the Developmental Neurology, Poznan University of Medical Sciences, Poznań, Poland,Doctoral School of Poznań University of Medical Sciences, Poznań, Poland,*Correspondence: Małgorzata Eliks
| | - Anna Sowińska
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznań, Poland
| | - Ewa Gajewska
- Chair and Clinic of the Developmental Neurology, Poznan University of Medical Sciences, Poznań, Poland
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6
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Yun EJ, Kim TI. Development and effectiveness of an educational program on developmental positioning for neonatal intensive care unit nurses in South Korea: a quasi-experimental study. CHILD HEALTH NURSING RESEARCH 2022; 28:70-81. [PMID: 35172082 PMCID: PMC8858784 DOI: 10.4094/chnr.2022.28.1.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/03/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose This study aimed to develop and evaluate the effectiveness of an educational program on developmental positioning (EPDP) for nurses in neonatal intensive care units (NICUs). Methods The study utilized a non-equivalent control group pretestposttest design. Sixty NICU nurses were recruited from two university hospitals in Daejeon, South Korea. The EPDP consisted of a 7-week program: 3 weeks of education and practice, followed by 4 weeks of encouragement messages using social networking services. Developmental positioning (DP) posters and DP aids were also provided during the intervention period. The intervention group (n=30) received the EPDP, but not the control group. The data were analyzed using the x2 test, the Fisher exact test, the independent t-test, and repeated-measures analysis of variance. Results Participants' knowledge (t=7.49, p<.001), attitudes (t=1.99, p=.001), self-efficacy (t=2.99, p=.004), performance of DP (t=2.98, p=.004) and Infant Positioning Assessment Tool (IPAT) scores (F=29.50, p<.001) were significantly higher in the intervention group than in the control group. Conclusion The EPDP can be an effective and useful program for improving the performance of DP among NICU nurses by increasing their knowledge, attitudes, and self-efficacy of DP. However, further research involving various NICU settings is needed to gather more empirical evidence.
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Affiliation(s)
- Eun-Ju Yun
- Lecturer, Department of Nursing, Daejeon University, Daejeon, Korea
| | - Tae-Im Kim
- Professor, Department of Nursing, Daejeon University, Daejeon, Korea
- Corresponding author Tae-Im Kim Department of Nursing, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon 34520, Korea TEL: +82-42-280-2654 FAX: +82-42-280-2785 E-MAIL:
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Santander P, Quast A, Hubbert J, Juenemann L, Horn S, Hensel KO, Meyer-Marcotty P, Dieks JK. Stereophotogrammetric head shape assessment in neonates is feasible and can identify distinct differences between term-born and very preterm infants at term equivalent age. Sci Rep 2021; 11:21155. [PMID: 34707196 PMCID: PMC8551176 DOI: 10.1038/s41598-021-00680-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/14/2021] [Indexed: 11/17/2022] Open
Abstract
The development of head shape and volume may reflect neurodevelopmental outcome and therefore is of paramount importance in neonatal care. Here, we compare head morphology in 25 very preterm infants with a birth weight of below 1500 g and / or a gestational age (GA) before 32 completed weeks to 25 term infants with a GA of 37–42 weeks at term equivalent age (TEA) and identify possible risk factors for non-synostotic head shape deformities. For three-dimensional head assessments, a portable stereophotogrammetric device was used. The most common and distinct head shape deformity in preterm infants was dolichocephaly. Severity of dolichocephaly correlated with GA and body weight at TEA but not with other factors such as neonatal morbidity, sex or total duration of respiratory support. Head circumference (HC) and cranial volume (CV) were not significantly different between the preterm and term infant group. Digitally measured HC and the CV significantly correlated even in infants with head shape deformities. Our study shows that stereophotogrammetric head assessment is feasible in all preterm and term infants and provides valuable information on volumetry and comprehensive head shape characteristics. In a small sample of preterm infants, body weight at TEA was identified as a specific risk factor for the development of dolichocephaly.
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Affiliation(s)
- Petra Santander
- Department of Orthodontics, University Medical Center, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Anja Quast
- Department of Orthodontics, University Medical Center, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Johanna Hubbert
- Department of Orthodontics, University Medical Center, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Laura Juenemann
- Department of Orthodontics, University Medical Center, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Sebastian Horn
- Department of Pediatric Cardiology, Neonatology and Intensive Care Medicine, University Medical Center, Georg-August University Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Kai O Hensel
- Department of Pediatric Cardiology, Neonatology and Intensive Care Medicine, University Medical Center, Georg-August University Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Philipp Meyer-Marcotty
- Department of Orthodontics, University Medical Center, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Jana-Katharina Dieks
- Department of Pediatric Cardiology, Neonatology and Intensive Care Medicine, University Medical Center, Georg-August University Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
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8
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Uchio Y, Shima N, Nakamura K, Ikai T, Nitta O. Effects of continued positioning pillow use until a corrected age of six months on cranial deformation and neurodevelopment in preterm infants: A prospective case-control study. Early Hum Dev 2020; 148:105137. [PMID: 32682000 DOI: 10.1016/j.earlhumdev.2020.105137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/06/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Preterm infants have a high risk of cranial deformity resulting from external pressures. Such deformity is associated with delayed neurodevelopment. AIMS We aimed to clarify the effects of continuous use of positioning pillows on cranial deformity and neurodevelopment in preterm infants. METHODS This prospective case-control study was conducted between November 2018 and August 2019. The continuous use of a pillow was initiated after discharge from the neonatal intensive care unit, up to a corrected age of six months. Preterm infants weighing less than 1800 g without neurological abnormalities were included in the study. Patients were divided into two groups: non-pillow group (NP-group) and pillow group (P-group). The primary outcome was the Bayley Scales of Infant Development III (BSID-III) score. We compared asymmetrical cranial deformity and the BSID-III scores in the two groups at a corrected age of six months using the Fisher's exact test and unpaired t-test, respectively. RESULTS There were 19 preterm infants (mean gestational age 32.5 ± 1.9 weeks, birth weight 1461.3 ± 244.7) eligible during the study period. The P-group (n = 11) showed asymmetrical cranial deformity at six months less frequently than the NP-group (n = 8) (p = 0.001, Fisher's exact test). Infants in the P-group had significantly higher scores on the BSID-III cognitive scales (95.0 ± 8.4 vs. 86.9 ± 2.6; p = 0.02, unpaired t-test) and fine motor scores on the motor scales (8.6 ± 2.2 vs. 6.6 ± 0.7, p = 0.02, unpaired t-test). CONCLUSIONS Continuous pillow use in preterm infants is effective in reducing cranial deformity and improved cognitive and fine motor skills. TRIAL REGISTRATION UMIN Clinical Trials Registry, trial no. UMIN000034400 (http://www.umin.ac.jp/ctr/index.htm).
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Affiliation(s)
- Yuu Uchio
- Department of Rehabilitation, Tokyo Women's Medical University, Tokyo, Japan; Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan; Department of Rehabilitation, Faculty of Health Sciences, University of Tokyo Health Sciences, Tokyo, Japan.
| | - Naoko Shima
- Department of Rehabilitation, Tokyo Women's Medical University, Tokyo, Japan
| | - Kaho Nakamura
- Department of Rehabilitation, Tokyo Women's Medical University, Tokyo, Japan
| | - Tetsuo Ikai
- Department of Rehabilitation Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Osamu Nitta
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
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9
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Launonen AM, Aarnivala H, Kyteas P, Vuollo V, Heikkinen T, Kau CH, Pirttiniemi P, Harila V, Valkama AM. A 3D Follow-Up Study of Cranial Asymmetry from Early Infancy to Toddler Age after Preterm versus Term Birth. J Clin Med 2019; 8:jcm8101665. [PMID: 31614700 PMCID: PMC6832468 DOI: 10.3390/jcm8101665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/05/2019] [Accepted: 10/08/2019] [Indexed: 11/16/2022] Open
Abstract
Preterm infants are at higher risk for both symmetrical and asymmetrical head molding. This study involved 3D stereophotogrammetry to assess the cranial growth, molding, and incidence of deformational plagiocephaly (DP) in preterm children compared to term born children. Thirty-four preterm infants and 34 term born controls were enrolled in this study from Oulu University Hospital, Finland. Three-dimensional head images were obtained at the age of 2–4 months (T1), 5–7 months (T2), 11–13 months (T3), and 2.5–3 years (T4) from the term equivalent age (TEA). There was no statistically significant difference in oblique cranial length ratio (OCLR), cephalic index (CI), or weighted asymmetry score (wAS) between the two groups. Occipital flattening, defined by flatness score (FS) was statistically significantly greater in the preterm group than in the term group at T1–T4 (p < 0.05). In both groups, OCLR improved gradually over time. There were no instances, in either group, of severe DP and no moderate DP after T2. Results indicate that DP affects preterm and full-term children almost equally during the first three years of life, and cranial asymmetry resolves at a similar rate in both preterm and term groups after three months of corrected age. Preterm infants present with more occipital flattening than full-term children.
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Affiliation(s)
- Anniina M Launonen
- Department of Oral Development and Orthodontics, Oulu University Hospital, Oulu, Finland.
- Department of Oral Development and Orthodontics, Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.
- Medical Research Center Oulu, Oulu, Finland.
| | - Henri Aarnivala
- Medical Research Center Oulu, Oulu, Finland.
- Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.
- PEDEGO Research Group, University of Oulu, Oulu, Finland.
| | - Panagiotis Kyteas
- Department of Orthodontics, University of Alabama, Birmingham, AL 35294-0007, USA.
| | - Ville Vuollo
- Department of Oral Development and Orthodontics, Oulu University Hospital, Oulu, Finland.
- Department of Oral Development and Orthodontics, Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.
- Medical Research Center Oulu, Oulu, Finland.
| | - Tuomo Heikkinen
- Department of Oral Development and Orthodontics, Oulu University Hospital, Oulu, Finland.
- Department of Oral Development and Orthodontics, Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.
- Medical Research Center Oulu, Oulu, Finland.
| | - Chung H Kau
- Department of Orthodontics, University of Alabama, Birmingham, AL 35294-0007, USA.
| | - Pertti Pirttiniemi
- Department of Oral Development and Orthodontics, Oulu University Hospital, Oulu, Finland.
- Department of Oral Development and Orthodontics, Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.
- Medical Research Center Oulu, Oulu, Finland.
| | - Virpi Harila
- Department of Oral Development and Orthodontics, Oulu University Hospital, Oulu, Finland.
- Department of Oral Development and Orthodontics, Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.
- Medical Research Center Oulu, Oulu, Finland.
| | - A Marita Valkama
- Medical Research Center Oulu, Oulu, Finland.
- Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.
- PEDEGO Research Group, University of Oulu, Oulu, Finland.
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10
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Willis S, Hsiao R, Holland RA, Lee K, Pitetti K. Measuring for nonsynostotic head deformities in preterm infants during NICU management: A pilot study. Early Hum Dev 2019; 131:56-62. [PMID: 30856488 DOI: 10.1016/j.earlhumdev.2019.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/24/2019] [Accepted: 03/04/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Research has focused on the presence of nonsynostotic head deformities (NHD: plagiocephaly, dolichocephaly, brachycephaly) in preterm infants at discharge and within the first year after discharge. However, there is limited data on NHD in preterm neonates during neonatal intensive care unit (NICU) stay. AIM To acquire quantitative data on head shapes among preterm neonates during NICU hospital stay. STUDY DESIGN Investigators performed weekly head measurements on 68 premature infants starting within two weeks of birth or when medically stable until discharge. Infants recruited for the study were born at <34 weeks gestational age. OUTCOME MEASURES Cranial index (CI) and cranial vault asymmetry index (CVAI) were calculated from Ballert cranial caliper measurements during the infants stay (27 to 40 weeks postmenstrual age) in the NICU/Special Care Nursery (SCN) setting. Inter-rater retest reliability was determined for CI and CVAI. RESULTS Throughout the measurement period, CI consistently demonstrated dolichocephaly (CI < 0.76), and CVAI fluctuated above and below the range indicating plagiocephaly (CVAI ≥ 3.5%). Good to acceptable levels of test-retest reliability was demonstrated; prevalence of dolichocephaly and plagiocephaly at discharge was 82% and 36%, respectively; and mean head dimension measurement time for different combinations of bed types and support systems ranged from 1.1 to 1.9 min. CONCLUSIONS Following the progression of CI and CVAI during the NICU stay using the cranial caliper method is reliable, and a substantial presence of NHD was reported.
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Affiliation(s)
- Sarah Willis
- Department of Neonatology, Wesley Medical Center, 550 N. Hillside St., Wichita, KS 67214, USA
| | - Robert Hsiao
- Department of Neonatology, Wesley Medical Center, 550 N. Hillside St., Wichita, KS 67214, USA
| | - Ruth A Holland
- Department of Neonatology, Wesley Medical Center, 550 N. Hillside St., Wichita, KS 67214, USA.
| | - Kelly Lee
- Department of Neonatology, Wesley Medical Center, 550 N. Hillside St., Wichita, KS 67214, USA.
| | - Ken Pitetti
- Department of Physical Therapy, Wichita State University, 213 N. Mead St, Wichita, KS 67202, USA.
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Body Posture Asymmetry in Prematurely Born Children at Six Years of Age. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9302520. [PMID: 29181408 PMCID: PMC5664194 DOI: 10.1155/2017/9302520] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 09/13/2017] [Indexed: 11/24/2022]
Abstract
Aims The purpose of the study was to assess body posture asymmetries in the standing and sitting position in prematurely born children at six years of age. Study Design and Subjects We measured trunk symmetry in coronal plane. The study was carried out in a group of 101 children, aged 6-7 years, mean age of 6.63, including 50 preterm children born at gestational age <32 weeks (preterm group) and 51 full-term children (control group). Outcome Measures Trunk symmetry in coronal plane was measured using photogrammetric technique with Mora 4G CQ Elektronik. The subjects were examined in standing and sitting position. Statistical analyses were carried out using Shapiro-Wilk W-test, Student's t-test, Mann–Whitney U test, and Pearson's chi-squared test. Statistical significance was assumed at p < 0.05. Results No significant differences were found between the groups in the asymmetries identified in the relevant anthropometric points, relative to the position assumed during the examination or to the subjects' sex. Conclusions There are no significant differences in body posture in the coronal plane, between preterm children and full-term children. Premature birth does not have adverse effects related to body posture asymmetry in preterm children at the age of six.
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Abstract
BACKGROUND More than 95% of higher-order multiples are born preterm and more than 90% are low birth weight, making this group of infants especially vulnerable to sudden infant death syndrome (SIDS). Emerging evidence suggests that families with twins face challenges adhering to the American Academy of Pediatrics (AAP) recommendations to reduce SIDS risks. Adherence to the AAP recommendations in families with higher-order multiples has not been described. PURPOSE This study describes SIDS risk reduction infant care practices for higher-order multiples during the first year of life. METHODS Mothers caring for higher-order multiple-birth infants were recruited from an online support group. An online survey was used to assess infant care practices when the infants were first brought home from the hospital as well as at the time of the survey. RESULTS Ten mothers of triplets and 4 mothers of quadruplets responded. Less than 80% of the mothers practiced "back to sleep" immediately postdischarge. Supine sleep positioning decreased over time, particularly during daytime naps. Only 50% of the infants shared the parents' bedroom and approximately 30% bed-shared with their siblings. Sleep-time pacifier use was low. IMPLICATIONS FOR PRACTICE Safe sleep education must include specific questions regarding home sleeping arrangements, encouragement of breast milk feedings, supine positioning, and pacifier use at every sleep for higher-order multiple infants well before discharge in order for parents to plan a safe sleep environment at home. IMPLICATIONS FOR RESEARCH Prospective studies to identify barriers and facilitators can inform future strategies supporting adherence to safe sleep practices for higher-order multiple infants.
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Fabre-Grenet M, Garcia-Méric P, Bernard-Niel V, Guagliardo V, Cortaredona S, Aymeric-Ponsonnet M. [Effects of deformational plagiocephaly during the first 12 months on the psychomotor development of prematurely born infants]. Arch Pediatr 2017; 24:802-810. [PMID: 28754278 DOI: 10.1016/j.arcped.2017.01.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 12/21/2016] [Accepted: 01/03/2017] [Indexed: 10/19/2022]
Abstract
AIMS The link between deformational plagiocephaly and psychomotor development is a recurrent question in medical publications. Main publications concentrate on term infants, but there is a lack of data on the impact of deformational plagiocephaly on the long-term neurodevelopment of premature infants. We attempted to establish a possible relation between deformational plagiocephaly during the 1st year of life and the psychomotor score at 4 years in prematurely born infants. Other risk factors potentially impacting the psychomotor score were also studied. MATERIAL AND METHODS A retrospective study of the files of the children followed by the "Naître et Devenir Région PACA Ouest Corse Sud" healthcare network and included in the database allowed us to select a cohort of 594 infants born prematurely at under 33 weeks of gestational age. These children were developmentally evaluated during the 1st year of life and at 4 years or age using the "EVAL Mater" test. The "Naître et Devenir" network is following up infants born prematurely at under 33 weeks of gestation in the West Provence Alpes Côte d'Azur and South Corsica region, from discharge to 7 years. A group of 170 specially trained pediatricians follow these infants developmentally at term, 3, 6, 9, 12, 18, and 24 months of corrected age and 3, 4 5, 6, and 7 years. Data are collected in a specially designed database. RESULTS There was no significant link between deformational plagiocephaly during the 1st year of life and a pathological psychomotor score at age 4, but some risk factors were demonstrated: male gender, birth at under 28 weeks of gestational age, weight at birth under 1000g, having a Latal and Ferriero neuromotor score equal to or greater than 2 at 3 months of corrected age, and to a lesser extent having a prescription for physiotherapy during the 1st year. CONCLUSION The research on deformational plagiocephaly in the full-term infant suggests a relation between deformational plagiocephaly and developmental delay predominantly on the motor side, with an increased rate of special needs services at school age. The question is raised of whether deformational plagiocephaly is the cause of the delay or an early sign of cerebral anomaly with an early motor delay in full-term infants. The results suggest that deformational plagiocephaly in the prematurely born infant may not be related to neurodevelopmental delay but simply to the extended time spent in the supine position because of the early birth associated with physiological hypotonia and axial extension. Other risk factors such as male gender, birth before 28 weeks of gestation, weight less than 1000g, a Latal and Ferriero neuromotor score greater than 2 at 3 months of corrected age, and having a prescription for physiotherapy during the 1st year of life are strongly related to delayed psychomotor development at age 4.
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Affiliation(s)
- M Fabre-Grenet
- Réseau Naître et Devenir, 24, rue Brandis, 13005 Marseille, France; CAMSP Nord, CHU Nord, pavillon mère-enfant, chemin des Bourrelly, 13915 Marseille cedex 15, France.
| | - P Garcia-Méric
- Réseau Naître et Devenir, 24, rue Brandis, 13005 Marseille, France; Département de médecine et réanimation néonatale, CHU la Conception, 147, boulevard Baille, 13005 Marseille, France
| | - V Bernard-Niel
- Réseau Naître et Devenir, 24, rue Brandis, 13005 Marseille, France
| | - V Guagliardo
- UMR 912 SESSTIM, Inserm/IRD, université d'Aix-Marseille (AMU), 15, boulevard Leï-Roure, 13009 Marseille, France
| | - S Cortaredona
- UMR 912 SESSTIM, Inserm/IRD, université d'Aix-Marseille (AMU), 15, boulevard Leï-Roure, 13009 Marseille, France
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Park JY, Kim HJ, Lee S, Jung SG. Aesthetic Correction of Severe Facial Asymmetry in a Deformational Plagiocephaly Patient: A Case Report and Literature Review. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2017. [DOI: 10.14730/aaps.2017.23.3.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jae Yeon Park
- Department of Plastic and Reconstructive Surgery, National Medical Center, Seoul, Korea
| | - Hyo Joong Kim
- Department of Plastic and Reconstructive Surgery, National Medical Center, Seoul, Korea
| | - Seil Lee
- Department of Plastic and Reconstructive Surgery, National Medical Center, Seoul, Korea
| | - Sung Gyun Jung
- Department of Plastic and Reconstructive Surgery, National Medical Center, Seoul, Korea
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Abstract
BACKGROUND The high prevalence of prematurity and low birth-weight places twin infants at increased risk for sudden unexpected infant death (SUID) and/or sudden infant death syndrome (SIDS). Risk for these SUID and SIDS is affected by a combination of nonmodifiable intrinsic risk factors and modifiable extrinsic stressors including infant care practices related to sleep. Although adherence to the full scope of American Academy of Pediatrics (AAP) 2011 recommendations is intended to decrease risk, these recommendations are aimed at singleton infants and may require tailoring for families with multiple infants. PURPOSE The study describes infant care practices reported by mothers of twins in the first 6 months postpartum. METHODS Mothers caring for twin infants (N = 35) were surveyed online both longitudinally (at 2, 8, 16, and 24 weeks after infant hospital discharge) and cross-sectionally. AAP recommendations (2011) guided survey content. RESULTS The degree of adherence to AAP recommendations varied over time. For example, mothers of twins reported 100% adherence to placing twins supine for sleep initially, but many reported putting babies on their stomachs for naps as twins became older. Sharing a parent's bedroom decreased over time as did frequency of crib sharing. Fewer than half of mothers offered a pacifier most or all of the time for sleep. IMPLICATIONS FOR PRACTICE Opportunities exist for development of an educational program geared specifically for postpartum parents of twins. IMPLICATIONS FOR RESEARCH Barriers affecting adherence to AAP recommendations and effectiveness of educational programs addressing needs of this unique population need further exploration.
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Dunsirn S, Smyser C, Liao S, Inder T, Pineda R. Defining the nature and implications of head turn preference in the preterm infant. Early Hum Dev 2016; 96:53-60. [PMID: 27064959 PMCID: PMC4867076 DOI: 10.1016/j.earlhumdev.2016.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 02/03/2016] [Accepted: 02/09/2016] [Indexed: 11/16/2022]
Abstract
AIM To determine the relationship of head turn preference in the preterm infant to: 1) perinatal medical factors, 2) neonatal neurobehavior, and/or 3) infant neurodevelopmental outcomes. METHODS Seventy preterm infants born ≤30weeks gestation were enrolled at birth. Detailed information regarding neonatal intensive care unit (NICU) medical course was compiled for each infant. Neurobehavioral testing was performed during NICU hospitalization. Head turn preference was quantified at term equivalent age using a newly developed scale. Infants returned at age two years for standardized developmental testing. RESULTS All infants demonstrated a head turning preference, with most preferring the right side (n=51, 77%). Fifty-five infants (79%) had moderate to severe head turn preference. Head turn preference was associated with 1) medical severity (hours of inotrope use, p=0.02; oxygen requirement at 36weeks postmenstrual age, p=0.03), 2) worse neurobehavioral performance (decreased self-regulation, p=0.007; more sub-optimal reflexes p=0.006), and 3) worse developmental outcome at age two years (poorer fine motor, p=0.02). INTERPRETATION Medical factors in the NICU appear to be associated with the development of a head turn preference. Increased severity of head turn preference may be a marker for poor developmental outcome. Early identification may inform therapeutic interventions designed to minimize symptoms and optimize neurodevelopmental outcome.
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Affiliation(s)
- Sonya Dunsirn
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States,Corresponding author at: OTD, OTR/L Washington University School of Medicine Program in Occupational Therapy, 4444 Forest Park Parkway, St Louis, MO 63116, United States
| | - Christopher Smyser
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States,Department of Radiology, Washington University School of Medicine, St. Louis, MO, United States,Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States
| | - Steve Liao
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
| | - Terrie Inder
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Roberta Pineda
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, United States,Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States
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Impact of torticollis associated with plagiocephaly on infants' motor development. J Craniofac Surg 2015; 26:151-6. [PMID: 25569394 DOI: 10.1097/scs.0000000000001402] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study investigated whether torticollis (congenital or acquired) in infants with plagiocephaly affects the achievement of specific gross motor milestones. METHODS A total of 175 infants affected by plagiocephaly with or without torticollis were recruited and included in this prospective trial. Anthropometric and clinical variables were recorded at baseline. The infants were included in a physiotherapy treatment program, and they were monthly assessed until hospital discharge. RESULTS Significant differences (P < 0.05) were observed in the achievement of rolling over, crawling, and standing skills depending on the specific profile (plagiocephaly and plagiocephaly with congenital or acquired torticollis). After adjusting for the severity of the plagiocephaly and the age at referral, the torticollis was significantly (P < 0.05) associated with crawling and standing skills. CONCLUSIONS The findings suggest that the presence or absence of congenital or acquired torticollis is an important factor that affects gross motor development in infants with plagiocephaly.
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Ifflaender S, Rüdiger M, Konstantelos D, Lange U, Burkhardt W. Individual course of cranial symmetry and proportion in preterm infants up to 6 months of corrected age. Early Hum Dev 2014; 90:511-5. [PMID: 24751496 DOI: 10.1016/j.earlhumdev.2014.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 03/25/2014] [Accepted: 03/29/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION A significant proportion of preterm infants have dolichocephaly and/or deformational plagiocephaly (DP) at term equivalent age. However, quantitative data on the clinical course after discharge is limited in these infants. AIMS To quantify the individual course of cranial symmetry and proportion in infants born <32 gestational weeks up to six months of corrected age (CA) and to investigate, whether measurements at discharge predict subsequent cranial deformations. METHODS A total of 56 infants were examined at discharge, three and six months of CA. Cranial proportion and symmetry were quantified using a 3D laser scan method. Classification and prevalence data were obtained using age related reference values. Predictive value of DP at discharge regarding subsequent deformation was evaluated. RESULTS Cranial Vault Asymmetry Index was 3.9% at discharge, 4.5% at three months and 3.7% at six months of CA. Prevalence of DP was 34% at discharge, 46% at three months and 27% at six months. Cranial Index was 71.4% at discharge and constantly increased over the examination period. Prevalence of dolichocephaly was high at discharge (77%) and subsequently decreased. While severe DP at discharge was predictive for a persistent deformation (PPV 0.78), 46% of infants without DP at discharge developed DP by six months of CA. DISCUSSION Despite a high prevalence at discharge, the decreased prevalence of DP and dolichocephaly at six months of CA suggests an optimistic course. However, changes in head shape are hardly predictable for the individual infant. Thus, an accurate quantification should be part of neonatal follow-up programs.
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Affiliation(s)
- Sascha Ifflaender
- Department of Neonatology and Pediatric Intensive Care, Medizinische Fakultät Carl Gustav Carus an der TU Dresden, Germany
| | - Mario Rüdiger
- Department of Neonatology and Pediatric Intensive Care, Medizinische Fakultät Carl Gustav Carus an der TU Dresden, Germany.
| | - Dimitrios Konstantelos
- Department of Neonatology and Pediatric Intensive Care, Medizinische Fakultät Carl Gustav Carus an der TU Dresden, Germany
| | - Ulrike Lange
- Department of Neonatology and Pediatric Intensive Care, Medizinische Fakultät Carl Gustav Carus an der TU Dresden, Germany
| | - Wolfram Burkhardt
- Department of Neonatology and Pediatric Intensive Care, Medizinische Fakultät Carl Gustav Carus an der TU Dresden, Germany
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Syrengelas D, Kalampoki V, Kleisiouni P, Konstantinou D, Siahanidou T. Gross motor development in full-term Greek infants assessed by the Alberta Infant Motor Scale: reference values and socioeconomic impact. Early Hum Dev 2014; 90:353-7. [PMID: 24796209 DOI: 10.1016/j.earlhumdev.2014.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 04/08/2014] [Accepted: 04/12/2014] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The aims of this study were to investigate gross motor development in Greek infants and establish AIMS percentile curves and to examine possible association of AIMS scores with socioeconomic parameters. METHODS Mean AIMS scores of 1068 healthy Greek full-term infants were compared at monthly age level with the respective mean scores of the Canadian normative sample. In a subgroup of 345 study participants, parents provided, via interview, information about family socioeconomic status. Multiple linear regression analysis was performed to evaluate the relationship of infant motor development with socioeconomic parameters. RESULTS Mean AIMS scores did not differ significantly between Greek and Canadian infants in any of the 19 monthly levels of age. In multiple linear regression analysis, the educational level of the mother and also whether the infant was being raised by grandparents/babysitter were significantly associated with gross motor development (p=0.02 and p<0.001, respectively), whereas there was no significant correlation of mean AIMS scores with gender, birth order, maternal age, paternal educational level and family monthly income. CONCLUSIONS Gross motor development of healthy Greek full-term infants, assessed by AIMS during the first 19months of age, follows a similar course to that of the original Canadian sample. Specific socioeconomic factors are associated with the infants' motor development.
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Affiliation(s)
- Dimitrios Syrengelas
- Department of Pediatric Physical Therapy, "Aghia Sophia" Children's Hospital, Athens, Greece.
| | - Vassiliki Kalampoki
- First Department of Pediatrics, Athens University Medical School, Athens, Greece
| | - Paraskevi Kleisiouni
- Department of Pediatric Physical Therapy, "Aghia Sophia" Children's Hospital, Athens, Greece
| | | | - Tania Siahanidou
- First Department of Pediatrics, Athens University Medical School, Athens, Greece
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Cabrera-Martos I, Valenza MC, Benítez-Feliponi A, Robles-Vizcaíno C, Ruiz-Extremera A, Valenza-Demet G. Clinical profile and evolution of infants with deformational plagiocephaly included in a conservative treatment program. Childs Nerv Syst 2013; 29:1893-8. [PMID: 23644628 DOI: 10.1007/s00381-013-2120-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 04/19/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to evaluate the results of a conservative intervention in infants with plagiocephaly according to their specific clinical profile. METHODS Prospective clinical trial in which 104 infants with plagiocephaly accompanied or not by congenital or positional torticollis were referred to Early Care and Monitoring Unit (USAT) of San Cecilio Hospital in Granada, between 2009 and 2012. All the infants, grouped into three categories of severity, were included in the physiotherapy protocol until adequate craniofacial morphology and motor development were achieved. The study included an assessment of parents and infants. Parents were assessed with a questionnaire about the mother's medical history and birth-related issues. The assessment of infants included anthropometric measures, a positional assessment, the observation of the head, the assessment of severity, and motor development. RESULTS Birth characteristics were similar in the total sample but showed different clinical profiles according to treatment aspects. More specifically, infants with severe plagiocephaly were referred to treatment later and spent more time in treatment; use of an orthotic helmet was also more prevalent in this category. There were also significant differences (P < 0.05) in the acquisition of specific gross motor skills depending on the severity of plagiocephaly. CONCLUSION The findings suggest that the physiotherapy protocol presented is effective to correct plagiocephaly. Severity of plagiocephaly is a marker that should be taken into account when designing actions aimed at improving gross motor skill development.
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Affiliation(s)
- I Cabrera-Martos
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Av de Madrid SN, 18071, Granada, Spain
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Nuysink J, Eijsermans MJC, van Haastert IC, Koopman-Esseboom C, Helders PJM, de Vries LS, van der Net J. Clinical course of asymmetric motor performance and deformational plagiocephaly in very preterm infants. J Pediatr 2013; 163:658-65.e1. [PMID: 23706356 DOI: 10.1016/j.jpeds.2013.04.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Revised: 02/20/2013] [Accepted: 04/09/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To describe the clinical courses of positional preference and deformational plagiocephaly up to 6 months corrected age (CA) in infants born at gestational age <30 weeks or birth weight <1000 g, and to explore predictive factors for the persistence of these phenomena. STUDY DESIGN A total of 120 infants were examined 3 times each. The presence of deformational plagiocephaly and a score of 0-6 on an asymmetry performance scale served as outcome measures at 6 months CA. Predictive factors were determined using regression analysis. RESULTS The prevalence of a positional preference of the head was 65.8% (79 of 120) at term-equivalent age (TEA) and 36.7% (44 of 120) at 3 months CA and that of deformational plagiocephaly was 30% (36 of 120) at TEA and 50% (60 of 120) at 3 months CA. At 6 months CA, 15.8% of the infants (19 of 120) scored ≥ 2 of a possible 6 on the asymmetry performance scale and 23.3% (28 of 120) had deformational plagiocephaly. Sleeping in the supine position was predictive of an asymmetric motor performance at 6 months CA. Chronic lung disease and/or slow gross motor maturation at 3 months CA predicted the persistence of deformational plagiocephaly. CONCLUSION Infants born very preterm may develop deformational plagiocephaly. A positional preference of the head at TEA seems to be a normal aspect of these infants' motor repertoire, with limited ability to predict persistence of an asymmetric motor performance. The decreased prevalence of deformational plagiocephaly between 3 and 6 months CA indicates an optimistic course. Infants with a history of chronic lung disease and/or slow gross motor maturation merit timely intervention.
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Affiliation(s)
- Jacqueline Nuysink
- Child Development and Exercise Center, Division of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
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