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Akin MA, Balci NC, Demirsoz M. Revolutionizing Neonatal Care: A Comprehensive Assessment of Neuromotor Development in At-Risk Infants Using the Novel Neonatal Infant Motor Assessment Scale (NIMAS) Test Battery. CHILDREN (BASEL, SWITZERLAND) 2024; 11:445. [PMID: 38671662 PMCID: PMC11048848 DOI: 10.3390/children11040445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 03/29/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
We developed a new neonatal neuromotor test battery, the Neonatal Infant Motor Assessment Scale (NIMAS), to perform a detailed neuromotor and holistic assessment of at-risk infants in the neonatal period. METHODS A total of 68 infants (28-41 Gestational weeks) hospitalised in the Neonatal Intensive Care Unit were included in the study. The NIMAS is a scale consisting of Automatic Motor Area, Functional Motor Area and sociodemographic form. The Dubowitz Neurological Examination and the Amiel-Tison Neurological Assessment Tests were also applied to evaluate the construct validity of the test. RESULTS The mean gestational age at birth was 34.62 ± 3.07 weeks and birth weight was 2305.66 ± 738.95. Fifty-one (75%) of the babies were premature and 17 (25%) were term babies. The KMO value to test the adequacy of the distribution for factor analysis was found to be at a very good level. Barlett's test result was 2198.389 (p < 0.05). The amount of variance obtained as 44.76% in the study was at a sufficient level. The factor loads of the questions in the automatic motor domain dimension varied between 0.523 and 0.694 and the factor loads of the questions in the functional motor domain dimension varied between 0.619 and 0.772. Since Cronbach's alpha was above 0.70, the reliability was adequate. Inter-rater scale agreement in the automatic motor domain was 81.1%; scale agreement in the functional motor domFain was 92.9%; and the NIMAS total score agreement was 93.4%. These agreements were statistically significant (p < 0.05). Total correlation above 0.20 indicates that the item is important for the question. According to the results obtained, total correlation values were between 0.258 and 0.720. CONCLUSIONS The NIMAS is the first test battery to assess the "Functional Motor Area" and this questionnaire, based on the results of the analyses, is a valid, reliable and clinically usable measurement tool for the infant at-risk at the neonatal period.
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Affiliation(s)
- Mustafa Ali Akin
- Department of Neonatology, Faculty of Medicine, Ondokuz Mayis University, Samsun 55139, Turkey;
| | - Nilay Comuk Balci
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ondokuz Mayis University, Samsun 55139, Turkey
| | - Mert Demirsoz
- Department of Biostatistics, Selcuk University, Konya 42130, Turkey;
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Smith LM, Harrison TM. Neurodevelopment in the Congenital Heart Disease Population as Framed by the Life Course Health Development Framework. J Cardiovasc Nurs 2024; 39:160-169. [PMID: 36752754 PMCID: PMC10406968 DOI: 10.1097/jcn.0000000000000977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Adverse neurodevelopment is a common comorbidity associated with congenital heart disease (CHD). The consequences of adverse neurodevelopment are seen across the life course. The cause of adverse neurodevelopment is multifactorial, and use of a life course perspective can assist with understanding and enhancing neurodevelopment in individuals with CHD. PURPOSE The purposes of this article are to (1) apply the Life Course Health Development framework to neurodevelopment in the population with CHD and (2) discuss how exposure to the pediatric cardiac intensive care unit (PCICU) environment during infancy is a point of intervention for improving neurodevelopmental outcomes. CONCLUSION Individuals with CHD are at an increased risk for adverse neurodevelopment across the life course. The PCICU environment is a point of intervention for improving neurodevelopmental outcomes. Stress can lead to changes in brain structure and function that are associated with negative outcomes in terms of outward behavioral and functional capacity, and the PCICU environment is a source of stressful stimuli. Infancy is a period of rapid brain growth, and the brain is more susceptible to stress during this period of the life course, putting infants receiving care in the PCICU at an increased risk of adverse neurodevelopment. CLINICAL IMPLICATIONS Interventions to support optimal neurodevelopment should focus on the PCICU environment during infancy. Developmentally supportive care models should be explored as a means of modifying the PCICU environment. In addition, more research is needed on the relationship between the PCICU and neurodevelopment. The conceptual model introduced can serve as a starting point for this research.
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Beaugrand M, Jaramillo V, Markovic A, Huber R, Kohler M, Schoch SF, Kurth S. Lack of association between behavioral development and simplified topographical markers of the sleep EEG in infancy. Neurobiol Sleep Circadian Rhythms 2023; 15:100098. [PMID: 37424705 PMCID: PMC10329166 DOI: 10.1016/j.nbscr.2023.100098] [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: 03/22/2023] [Revised: 06/07/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
The sleep EEG mirrors neuronal connectivity, especially during development when the brain undergoes substantial rewiring. As children grow, the slow-wave activity (SWA; 0.75-4.25 Hz) spatial distribution in their sleep EEG changes along a posterior-to-anterior gradient. Topographical SWA markers have been linked to critical neurobehavioral functions, such as motor skills, in school-aged children. However, the relationship between topographical markers in infancy and later behavioral outcomes is still unclear. This study aims to explore reliable indicators of neurodevelopment in infants by analyzing their sleep EEG patterns. Thirty-one 6-month-old infants (15 female) underwent high-density EEG recordings during nighttime sleep. We defined markers based on the topographical distribution of SWA and theta activity, including central/occipital and frontal/occipital ratios and an index derived from local EEG power variability. Linear models were applied to test whether markers relate to concurrent, later, or retrospective behavioral scores, assessed by the parent-reported Ages & Stages Questionnaire at ages 3, 6, 12, and 24 months. Results indicate that the topographical markers of the sleep EEG power in infants were not significantly linked to behavioral development at any age. Further research, such as longitudinal sleep EEG in newborns, is needed to better understand the relationship between these markers and behavioral development and assess their predictive value for individual differences.
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Affiliation(s)
| | - Valeria Jaramillo
- University of Surrey, School of Psychology, Guildford, United Kingdom
| | - Andjela Markovic
- University of Fribourg, Department of Psychology, Fribourg, Switzerland
- University Hospital Zurich, Department of Pulmonology, Zurich, Switzerland
| | - Reto Huber
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, Switzerland
| | - Malcolm Kohler
- University Hospital Zurich, Department of Pulmonology, Zurich, Switzerland
- Center of Competence Sleep & Health Zurich, University of Zurich, Zurich, Switzerland
| | - Sarah F. Schoch
- University Hospital Zurich, Department of Pulmonology, Zurich, Switzerland
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Salome Kurth
- University of Fribourg, Department of Psychology, Fribourg, Switzerland
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Deng W, Anastasopoulos S, deRegnier RA, Pouppirt N, Barlow AK, Patrick C, O’Brien MK, Babula S, Sukal-Moulton T, Peyton C, Morgan C, Rogers JA, Lieber RL, Jayaraman A. Protocol for a randomized controlled trial to evaluate a year-long (NICU-to-home) evidence-based, high dose physical therapy intervention in infants at risk of neuromotor delay. PLoS One 2023; 18:e0291408. [PMID: 37725613 PMCID: PMC10508609 DOI: 10.1371/journal.pone.0291408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023] Open
Abstract
INTRODUCTION Developmental disabilities and neuromotor delay adversely affect long-term neuromuscular function and quality of life. Current evidence suggests that early therapeutic intervention reduces the severity of motor delay by harnessing neuroplastic potential during infancy. To date, most early therapeutic intervention trials are of limited duration and do not begin soon after birth and thus do not take full advantage of early neuroplasticity. The Corbett Ryan-Northwestern-Shirley Ryan AbilityLab-Lurie Children's Infant Early Detection, Intervention and Prevention Project (Project Corbett Ryan) is a multi-site longitudinal randomized controlled trial to evaluate the efficacy of an evidence-based physical therapy intervention initiated in the neonatal intensive care unit (NICU) and continuing to 12 months of age (corrected when applicable). The study integrates five key principles: active learning, environmental enrichment, caregiver engagement, a strengths-based approach, and high dosage (ClinicalTrials.gov identifier NCT05568264). METHODS We will recruit 192 infants at risk for neuromotor delay who were admitted to the NICU. Infants will be randomized to either a standard-of-care group or an intervention group; infants in both groups will have access to standard-of-care services. The intervention is initiated in the NICU and continues in the infant's home until 12 months of age. Participants will receive twice-weekly physical therapy sessions and caregiver-guided daily activities, assigned by the therapist, targeting collaboratively identified goals. We will use various standardized clinical assessments (General Movement Assessment; Bayley Scales of Infant and Toddler Development, 4th Edition (Bayley-4); Test of Infant Motor Performance; Pediatric Quality of Life Inventory Family Impact Module; Alberta Infant Motor Scale; Neurological, Sensory, Motor, Developmental Assessment; Hammersmith Infant Neurological Examination) as well as novel technology-based tools (wearable sensors, video-based pose estimation) to evaluate neuromotor status and development throughout the course of the study. The primary outcome is the Bayley-4 motor score at 12 months; we will compare scores in infants receiving the intervention vs. standard-of-care therapy.
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Affiliation(s)
- Weiyang Deng
- Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
| | | | - Raye-Ann deRegnier
- Division of Neonatology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States of America
- Department of Pediatrics (Neonatology), Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Nicole Pouppirt
- Division of Neonatology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States of America
- Department of Pediatrics (Neonatology), Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Ann K. Barlow
- Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
| | - Cheryl Patrick
- Division of Rehabilitative Services, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States of America
| | - Megan K. O’Brien
- Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern Medicine, Chicago, IL, United States of America
| | - Sarah Babula
- Pathways.org, Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
| | - Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Colleen Peyton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - John A. Rogers
- Department of Biomedical Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, Illinois, United States of America
- Departments of Materials Science and Engineering, Chemistry, Mechanical Engineering, Electrical Engineering and Computer Science, Northwestern University, Evanston, Illinois, United States of America
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Richard L. Lieber
- Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
- Department of Biomedical Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, Illinois, United States of America
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- Jessie Brown Jr., Hines V.A. Medical Center, Hines, Illinois, United States of America
| | - Arun Jayaraman
- Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern Medicine, Chicago, IL, United States of America
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
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Ravarian A, Rahmani N, Soleimani F, Sajedi F, Noroozi M, Campbell SK, Mohseni-Bandpei MA. Test of infant motor performance: Cross-cultural adaptation, validity and reliability in Persian infants. Early Hum Dev 2023; 184:105831. [PMID: 37536018 DOI: 10.1016/j.earlhumdev.2023.105831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND The Test of Infant Motor Performance (TIMP) is an appropriate tool used to measure infant motor performance in many countries and due to the importance of the TIMP in the early diagnosis of infants with developmental delay, the production of a reliable translation of the TIMP in Iran is necessary. AIMS This study was designed to evaluate the validity and reliability of the Persian version of the TIMP and cross-cultural adaptation of the TIMP to Persian. METHOD Twenty- two experts were involved in translation, cross-cultural adaptation, validity and reliability. 170 Persian premature infants with post menstrual age (PMA) 34-42 weeks were tested to evaluate inter-rater and intra-rater reliability, test-retest and discriminative validity of the Persian version of the TIMP. RESULTS The content validity and face validity of the items of the Persian version of the TIMP were confirmed by a 10-expert panel and 10 therapists. High intra- and inter-rater reliability (ICC = 0.98, Kappa = 0.93), test-retest reliability (ICC = 0.98) and internal consistency (α = 0.82) were detected for the Persian version of the TIMP. Discriminative validity confirmed that the TIMP could distinguish groups of infants born with a low birth weight (p ˂ 0.001) and infants born small for gestational age (p = 0.002). CONCLUSIONS High validity and reliability are reported for the Persian version of the TIMP and this test was demonstrated to be differentiate among groups of infants who are at risk of motor delay.
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Affiliation(s)
- Aida Ravarian
- Pediatric Neurorehabilitation Research Center, Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Nahid Rahmani
- Department of Physical Therapy, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farin Soleimani
- Pediatric Neurorehabilitation Research Center, University of Social Welfare & Rehabilitation Sciences (USWR), Tehran, Iran
| | - Firoozeh Sajedi
- Pediatric Neurorehabilitation, Research Center, Clinical Sciences Department, University of Social Welfare & Rehabilitation Sciences (USWR), Tehran, Iran
| | - Mehdi Noroozi
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
| | - Suzann K Campbell
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.
| | - Mohammad A Mohseni-Bandpei
- Department of Physical Therapy, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; University Institute of Physical Therapy, Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan.
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Haffner DN, Sankovic A. A Neurologist's Guide to Neonatal Neurodevelopmental Assessments and Preterm Brain Injury. Semin Pediatr Neurol 2022; 42:100974. [PMID: 35868724 DOI: 10.1016/j.spen.2022.100974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/14/2022] [Accepted: 04/14/2022] [Indexed: 11/19/2022]
Abstract
Despite advances in medical care and improved survival of extremely preterm infants, rates of neurodevelopmental impairment remain high. Outcomes are significantly improved with early intervention, but infants must be appropriately identified to facilitate services. Neuroimaging provides important information regarding neurodevelopmental outcomes but prognosticating and communicating risk remains challenging. Standardized neonatal neurodevelopmental assessments provide supplemental information to aid in the identification of high-risk infants and counseling for their families.
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Affiliation(s)
- Darrah N Haffner
- Division of Pediatric Neurology, Nationwide Children's Hospital and the Ohio State University, 700 Children's Dr Columbus, 43205 OH, United States.
| | - Alexandra Sankovic
- Division of Pediatric Neurology, Nationwide Children's Hospital and the Ohio State University, 700 Children's Dr Columbus, 43205 OH, United States
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