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DelRosso LM, Artinian H, Mogavero MP, Bruni O, Witmans M, Tablizo MA, Sobremonte-King M, Ferri R. Polysomnographically Defined Restless Sleep Disorder and Periodic Limb Movements during Sleep in Children Born Prematurely. CHILDREN (BASEL, SWITZERLAND) 2024; 11:658. [PMID: 38929237 PMCID: PMC11202265 DOI: 10.3390/children11060658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/26/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Children born prematurely (<37 weeks' gestation) are at increased risk of perinatal complications, comorbidities, and iron deficiency. Iron deficiency is associated with restless legs syndrome and periodic limb movement disorder. In this study, we assessed the prevalence of restless sleep disorder (RSD) and elevated periodic limb movements during sleep (PLMS) in children born prematurely who underwent polysomnography. METHODS A retrospective chart review of sleep studies was conducted in children aged 1-18 years (median age 4 years) with a history of premature birth. Children with genetic syndrome, airway surgery, or tracheostomy were excluded. Three groups were compared: children with PLMS index >5, children with RSD, and children with neither elevated PLMS index nor RSD. RESULTS During the study, 2577 sleep studies were reviewed. Ninety-two studies fit our criteria and were included in the analysis. The median age at birth was 31 weeks, and the interquartile range (IQR) was 27-34 weeks. A total of 32 (34.8%) children were referred for restless sleep and 55 (59.8%) for snoring. After polysomnography, 18% were found to have a PLMS index >5/h, and 14% fit the criteria for restless sleep disorder (RSD). There were no statistically significant differences in PSG parameters among the children with RSD, PLMS, and the remaining group, except for lower obstructive apnea/hypopnea index (Kruskal-Wallis ANOVA 8.621, p = 0.0135) in the RSD group (median 0.7, IQR 0.3-0.9) than in the PLMS (median 1.7, IQR 0.7-3.5) or the non-RSD/non-PLMS (median 2.0, IQR 0.8-4.5) groups. CONCLUSIONS There was an elevated frequency of RSD and elevated PLMS in our cohort of children born prematurely. Children born prematurely are at higher risk of iron deficiency which can be a contributor factor to sleep -related movement disorders. These results add new knowledge regarding the prevalence of RSD and PLMS in these children.
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Affiliation(s)
- Lourdes M. DelRosso
- University of California San Francisco, 155 N. Fresno St, Fresno, CA 93701, USA (M.A.T.)
- Seattle Childrens Hospital, Seattle, WA 98105, USA;
| | - Hovig Artinian
- University of California San Francisco, 155 N. Fresno St, Fresno, CA 93701, USA (M.A.T.)
| | - Maria P. Mogavero
- Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, 20127 Milan, Italy;
- Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, 00185 Rome, Italy;
| | - Manisha Witmans
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Mary Anne Tablizo
- University of California San Francisco, 155 N. Fresno St, Fresno, CA 93701, USA (M.A.T.)
- Department of Pediatrics, Division of Pediatric Pulmonary and Sleep Medicine, Stanford University, Palo Alto, CA 94305, USA
| | | | - Raffaele Ferri
- Sleep Research Centre, Department of Neurology IC, Oasi Research Institute-IRCCS, 94018 Troina, Italy;
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Komisarek O, Malak R, Kwiatkowski J, Wiecheć K, Szczapa T, Kasperkowicz J, Matthews-Kozanecka M, Matthews-Brzozowska T, Wójcik M, Samborski W, Mojs E. The Evaluation of Facial Muscles by Surface Electromyography in Very Preterm Infants. Biomedicines 2022; 10:biomedicines10112921. [PMID: 36428488 PMCID: PMC9687131 DOI: 10.3390/biomedicines10112921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/11/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND It is reported that 40% of preterm infants have problems with eating. Neonatal feeding disorders may be one of the factors increasing neonatal mortality. The aim of our study was to evaluate the muscles involved in suckling and swallowing in premature newborns using surface electromyography (sEMG). We would like to objectively describe the tension of muscles engaged in feeding in order to properly plan the therapy. Another aim was to compare sEMG measurements to gestational age, birth weight, and umbilical blood pH to show which parameters put children at risk of feeding problems. METHODS Sixteen preterm neonates with gestational age less than 32 weeks, birth weight less than 1500 g, and oral feeding difficulties were analyzed for muscle response and electrical activity of nerves using sEMG (surface electromyography). RESULTS We found a negative correlation indicating that preterm infants with a younger gestational age had higher suprahyoid muscle tension, and a positive correlation was found between pH value and suprahyoid muscles. The lower the pH value, the lower the tension in the suprahyoid muscles. CONCLUSIONS sEMG may be a helpful diagnostic tool in the evaluation of the masticatory system of premature infants. Due to the abnormal tone of the muscles responsible for swallowing, it is advisable to rehabilitate as early as possible.
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Affiliation(s)
- Oskar Komisarek
- Department of Plastic, Reconstructive and Aesthetic Surgery, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-821 Bydgoszcz, Poland
- Correspondence: (O.K.); (R.M.)
| | - Roksana Malak
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznań, Poland
- Correspondence: (O.K.); (R.M.)
| | - Jacek Kwiatkowski
- Students Scientific Society of Maxillofacial Orthopaedics and Orthodontics, University of Medical Sciences, 60-812 Poznań, Poland
| | - Katarzyna Wiecheć
- Department of Clinical Psychology, Poznań University of Medical Sciences, 60-812 Poznań, Poland
| | - Tomasz Szczapa
- Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, II Department of Neonatology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Joanna Kasperkowicz
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznań, Poland
| | - Maja Matthews-Kozanecka
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 60-806 Poznań, Poland
| | - Teresa Matthews-Brzozowska
- Department of Orthodontics and Masticatory System Dysfunction, Poznan University of Medical Sciences, 60-812 Poznań, Poland
| | - Małgorzata Wójcik
- Department of Physiotherapy, Faculty of Physical Culture in Gorzów Wielkopolski, Poznan University of Physical Education, Estkowskiego 13, 66-400 Gorzów Wielkopolski, Poland
| | - Włodzimierz Samborski
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznań, Poland
| | - Ewa Mojs
- Department of Clinical Psychology, Poznań University of Medical Sciences, 60-812 Poznań, Poland
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Thomas J, Armstrong-Heimsoth A, Laurent RS. The Head Control Scale: Development, inter-rater reliability, and utility. J Pediatr Rehabil Med 2019; 12:295-303. [PMID: 31476179 DOI: 10.3233/prm-180574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE This study introduces a new scale for the assessment of head control called the Head Control Scale (HCS). The purpose of this study was to establish interrater reliability of the HCS and to determine its usefulness in a clinical setting. METHODS The HCS assesses head control in four positions (prone, supine, pull to sit, and supported sitting) on a 0-4 rating scale. The authors used both a focus group and pilot testing to refine the scale to its final version, which was then used to assess interrater reliability. Twenty-six therapists used the HCS to evaluate head control of five subjects of varying ages and abilities who were videotaped spending 30-40 seconds in each position. Participants also completed a post-rating survey. RESULTS Fleiss's weighted kappa coefficient is excellent for the prone (0.82), pull to sit (0.83), and sitting (0.88) positions as well as for the scale overall (kappa = 0.91). It can be described as fair to good for supine (kappa = 0.68). CONCLUSIONS The HCS has high interrater reliability and users report it to be a needed tool, applicable to clinical practice, and easy to use. IMPLICATIONS The results of this study indicate that the HCS has great potential for clinical use.
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Affiliation(s)
- Jodi Thomas
- School of Physical Therapy, Institute of Health Sciences-Dallas, Texas Woman's University, Dallas, TX, USA
| | | | - Roy St Laurent
- Department of Mathematics and Statistics, Northern Arizona University, Flagstaff, AZ, USA
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Araújo ATDC, Eickmann SH, Coutinho SB. Fatores associados ao atraso do desenvolvimento motor de crianças prematuras internadas em unidade de neonatologia. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2013. [DOI: 10.1590/s1519-38292013000200005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVOS: verificar a frequência do atraso do desenvolvimento motor em crianças prematuras internadas em unidade neonatal e identificar os fatores associados. MÉTODOS: estudo descritivo e analítico, realizado na Unidade Neonatal de uma maternidade de alto risco em Recife, Brasil. Avaliou-se o desenvolvimento motor, através do Test of Infant Motor Performance, de 98 crianças nascidas pré-termo com idade pós-conceptual mínima de 34 semanas, durante a internação, entre janeiro e julho de 2009. Analisaram-se associações entre variáveis maternas, neonatais e assistenciais com desenvolvimento motor. RESULTADOS: a média de idade pós-conceptual na avaliação foi de 37 semanas e 39,8% das crianças apresentaram desenvolvimento motor alterado (atípico ou suspeito). Fatores significativamente associados ao desenvolvimento motor alterado foram: menor peso ao nascer; maior idade na avaliação; maior número de consultas pré-natais; ocorrência de hipóxia e displasia broncopulmonar; maior tempo de permanência na unidade de terapia intensiva e unidade neonatal. Houve tendência significante a um pior desenvolvimento motor com uso de oxigenoterapia e ventilação mecânica prolongadas. CONCLUSÕES: crianças prematuras internadas podem apresentar atraso precoce do desenvolvimento motor, de forma grave ou limítrofe. Peso ao nascer, morbidades neonatais e assistência recebida na unidade neonatal foram os fatores que mais influenciaram o desfecho. Esses resultados justificam o início de estratégias preventivas e estimulação ainda no período de internação.
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Abstract
BACKGROUND Daily experiences are thought to play an important role in motor development during infancy. There are limited studies on the effect of postural and movement experiences on head control. OBJECTIVE The purpose of this study was to quantify the effects of postural and movement experiences on head control through a comprehensive set of measurements beginning when infants were 1 month old. DESIGN This was a prospective, longitudinal, 2-cohort study. METHODS Twenty-two full-term infants who were healthy were randomly assigned to either a training group or a control group. Infants were observed every other week from 1 to 4 months of age. Head control was assessed using a standardized developmental assessment tool, the Test of Infant Motor Performance (TIMP), as well as behavioral coding and kinematics of infants' head postures and movements in a supported sitting position. Caregivers performed at least 20 minutes of daily postural and movement activities (training group), or social interaction (control group) for 4 weeks. RESULTS The training group had higher TIMP scores on head control-related items during the training period and after training stopped compared with the control group. Starting from the during training phase, the training group infants had their heads in a vertical and midline position longer compared with the control group infants. After training stopped, the training group infants actively moved their heads forward more often and for larger distances. LIMITATIONS The experiences outside daily training were not monitored, and the results may be specific to the experimental setup for infants with typical development. CONCLUSIONS Young infants are able to take advantage of postural and movement experiences to rapidly advance their head control as early as 4 to 6 weeks of postnatal life. Infant positioning, caregiver handling, and caregiver-infant interactions were likely contributing factors. This database of comprehensive measures may be useful in future trials focused on head control in infants with special needs.
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Caçola P, Bobbio TG. Baixo peso ao nascer e alterações no desenvolvimento motor: a realidade atual. REVISTA PAULISTA DE PEDIATRIA 2010. [DOI: 10.1590/s0103-05822010000100012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Realizar uma revisão da literatura sobre fatores que influenciam o déficit de desenvolvimento motor em crianças com baixo peso ao nascer. FONTES DE DADOS: Estudos com crianças com baixo peso ao nascer, publicados no período de 1984 a 2008 nas bases de dados Medline e SciELO, usando as palavras chaves "baixo peso ao nascer" e " desenvolvimento motor", na língua inglesa. SÍNTESE DE DADOS: Embora diferenças no desenvolvimento entre crianças nascidas a termo e pré-termo sejam observadas com certa frequência, o seu entendimento ainda é um grande desafio para profissionais da saúde. O uso de diferentes testes e escores dificulta o diagnóstico, o manejo e a previsão dos déficits de desenvolvimento. Resultados heterogêneos são relatados dependendo do método de avaliação, idade e população estudada. Como é esperado que crianças com baixo peso ao nascer tenham risco para problemas cognitivos, motores e comportamentais, estudos abordando práticas de intervenção precoce seriam esperados; entretanto, isso não é observado. CONCLUSÕES: Devido à relação entre desenvolvimento motor e os outros domínios de desenvolvimento, é importante que o achado da alteração motora seja usado como uma variável diagnóstica e que os resultados encontrados sejam padronizados para melhor entendimento dos déficits que crianças com baixo peso ao nascer possam desenvolver
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Rose SE, Hatzigeorgiou X, Strudwick MW, Durbridge G, Davies PS, Colditz PB. Altered white matter diffusion anisotropy in normal and preterm infants at term-equivalent age. Magn Reson Med 2008; 60:761-7. [DOI: 10.1002/mrm.21689] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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