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Kahraman A, Mutlu A, Livanelioğlu A. General movements in spinal muscular atrophy type 1. Physiother Theory Pract 2024; 40:1249-1255. [PMID: 36611288 DOI: 10.1080/09593985.2023.2164842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/30/2022] [Accepted: 12/30/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE To investigate the motor repertoire of infants diagnosed with spinal muscular atrophy Type I (SMA Type I) without administration of any disease-modifying agent. METHODS Motor Optimality Score-Revised (MOS-R) was calculated from videos recorded between post-term weeks 9-17 for 22 infants with SMA Type I. The MOS-R of infants with SMA Type I was compared with those of 22 infants with cerebral palsy (CP) and 22 infants with typical development. RESULTS Of the infants with SMA Type I, 17 had absent fidgety movements (FMs) and 5 had sporadic FMs. Age adequate movement repertoire was absent, and the variety of movements in infants was very low. Movements were symmetrical but movements of four limbs remained on the surface level. Antigravity movements were very rare. Movement characterization was monotonous, slow speed, and small amplitude. The MOS-R of infants with SMA Type I was lower than those of infants with typical development but similar to those of infants with CP. CONCLUSIONS Infants with SMA Type I had a motor repertoire similar to infants with CP, while they had a poorer motor repertoire than infants with typical development in the fidgety period as evidenced by MOS-R. Central nervous system involvement in these infants with SMA Type I with absent FMs and reduced MOS-R is unknown. Further studies are needed to determine the role of problems in the afferent and efferent pathways of spinal cord and muscle atrophy in the observation of normal FMs.
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Affiliation(s)
- Aysu Kahraman
- Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazarı, Turkey
| | - Akmer Mutlu
- Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazarı, Turkey
| | - Ayşe Livanelioğlu
- Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazarı, Turkey
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Kobayashi O, Maeda T, Ihara K. Early infantile spontaneous movement in very low birthweight infants is associated with sensory characteristics at the corrected age of 3 years. Brain Dev 2024; 46:135-141. [PMID: 37978037 DOI: 10.1016/j.braindev.2023.11.003] [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: 06/16/2023] [Revised: 10/23/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023]
Abstract
AIM To clarify the relationship between early infantile spontaneous movement of very-low-birth-weight infants (VLBWIs) and sensory characteristics in childhood. STUDY DESIGN Prospective cohort study. We investigated the association between the Motor Optimality Score-Revised (MOS-R), a detailed assessment of general movements (GMs) at the corrected age of 9-17 weeks and the Infant/Toddler Sensory Profile Japanese version (ITSP-J) at the corrected age of 3 years. A multiple regression analysis was performed to examine the correlation of ITSP-J and MOS-R with patient clinical background factors. SUBJECTS Fifty-three VLBWIs (median gestational age: 28 weeks, 6 days; median birth weight: 997 g) who were managed at the NICU of Oita University from September 2013 to June 2019. RESULTS A multiple regression analysis revealed that the ITSP-J subscale in the sensory section of visual score was significantly correlated with the age-adequate movement repertoire subscore of MOS-R, and in the sensory section of vestibular score was correlated with the fidgety subscore of MOS-R. For both visual and vestibular section scores, intraventricular hemorrhage (IVH) showed an independent association with the MOS-R subscore. CONCLUSION Spontaneous movement characteristics in early infancy were associated with sensory characteristics in early childhood.
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Affiliation(s)
- Osamu Kobayashi
- Department of Pediatrics, Oita University Faculty of Medicine, Japan
| | - Tomoki Maeda
- Department of Pediatrics, Oita University Faculty of Medicine, Japan.
| | - Kenji Ihara
- Department of Pediatrics, Oita University Faculty of Medicine, Japan
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3
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Ji S, Ma D, Pan L, Wang W, Peng X, Amos JT, Ingabire HN, Li M, Wang Y, Yao D, Ren P. Automated Prediction of Infant Cognitive Development Risk by Video: A Pilot Study. IEEE J Biomed Health Inform 2024; 28:690-701. [PMID: 37053059 DOI: 10.1109/jbhi.2023.3266350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVE Cognition is an essential human function, and its development in infancy is crucial. Traditionally, pediatricians used clinical observation or medical imaging to assess infants' current cognitive development (CD) status. The object of pediatricians' greater concern is however their future outcomes, because high-risk infants can be identified early in life for intervention. However, this opportunity has not yet been realized. Fortunately, some recent studies have shown that the general movement (GM) performance of infants around 3-4 months after birth might reflect their future CD status, which gives us an opportunity to achieve this goal by cameras and artificial intelligence. METHODS First, infants' GM videos were recorded by cameras, from which a series of features reflecting their bilateral movement symmetry (BMS) were extracted. Then, after at least eight months of natural growth, the infants' CD status was evaluated by the Bayley Infant Development Scale, and they were divided into high-risk and low-risk groups. Finally, the BMS features extracted from the early recorded GM videos were fed into the classifiers, using late infant CD risk assessment as the prediction target. RESULTS The area under the curve, recall and precision values reached 0.830, 0.832, and 0.823 for two-group classification, respectively. CONCLUSION This pilot study demonstrates that it is possible to automatically predict the CD of infants around the age of one year based on their GMs recorded early in life. SIGNIFICANCE This study not only helps clinicians better understand infant CD mechanisms, but also provides an economical, portable and non-invasive way to screen infants at high-risk early to facilitate their recovery.
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Celik HI, Yildiz A, Yildiz R, Mutlu A, Soylu R, Gucuyener K, Duyan-Camurdan A, Koc E, Onal EE, Elbasan B. Using the center of pressure movement analysis in evaluating spontaneous movements in infants: a comparative study with general movements assessment. Ital J Pediatr 2023; 49:165. [PMID: 38124131 PMCID: PMC10731817 DOI: 10.1186/s13052-023-01568-8] [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: 02/21/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Researchers have attempted to automate the spontaneous movement assessment and have sought quantitative and objective methods over the past decade. The purpose of the study was to present a quantitative assessment method of spontaneous movement using center-of-pressure (COP) movement analysis. METHODS A total of 101 infants were included in the study. The infants were placed in the supine position on the force plate with the cranial-caudal orientation. In this position, the recording of video and COP movement data were made simultaneously for 3 min. Video recordings were used to observe global and detailed general movement assessment (GMA), and COP time series data were used to obtain quantitative movement parameters. RESULTS According to the global GMA, 13 infants displayed absent fidgety movements (FMs) and 88 infants displayed normal FMs. The binary logistic regression model indicated significant association between global GMA and COP movement parameters (chi-square = 20.817, p < 0.001). The sensitivity, specificity, and overall accuracy of this model were 85% (95% CI: 55-98), 83% (95% CI: 73-90), and 83% (95% CI: 74-90), respectively. The multiple linear regression model showed a significant association between detailed GMA (motor optimality score-revised/MOS-R) and COP movement parameters (F = 10.349, p < 0.001). The MOS-R total score was predicted with a standard error of approximately 1.8 points (6%). CONCLUSIONS The present study demonstrated the possible avenues for using COP movement analysis to objectively detect the absent FMs and MOS-R total score in clinical settings. Although the method presented in this study requires further validation, it may complement observational GMA and be clinically useful for infant screening purposes, particularly in clinical settings where access to expertise in observational GMA is not available.
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Affiliation(s)
- Halil Ibrahim Celik
- Bilge Çocuk Special Education and Rehabilitation Center, Beysukent, Çankaya, s06800, Ankara, Turkey.
| | - Ayse Yildiz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Erzurum Technical University, Erzurum, Turkey
| | - Ramazan Yildiz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Erzurum Technical University, Erzurum, Turkey
| | - Akmer Mutlu
- Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Hacettepe University, Ankara, Turkey
| | - Ruhi Soylu
- Faculty of Medicine, Department of Biophysics, Hacettepe University, Ankara, Turkey
| | - Kivilcim Gucuyener
- Faculty of Medicine, Department of Pediatrics, Section of Pediatric Neurology, Gazi University, Ankara, Turkey
| | - Aysu Duyan-Camurdan
- Faculty of Medicine, Department of Pediatrics, Section of Social Pediatrics, Gazi University, Ankara, Turkey
| | - Esin Koc
- Faculty of Medicine, Department of Pediatrics, Section of Neonatal Medicine, Gazi University, Ankara, Turkey
| | - Eray Esra Onal
- Faculty of Medicine, Department of Pediatrics, Section of Neonatal Medicine, Gazi University, Ankara, Turkey
| | - Bulent Elbasan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
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Sermpon N, Gima H. Relationship between fidgety movement and frequency of movement toward midline: An observational study. Early Hum Dev 2023; 177-178:105718. [PMID: 36801663 DOI: 10.1016/j.earlhumdev.2023.105718] [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: 10/04/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Infants show other movements and posture patterns during the fidgety movement period, including movement toward midline (MTM). Few studies have quantified MTM occurring during the fidgety movement period. AIMS This study aimed to examine the relationship between fidgety movements (FMs) and MTM frequency and occurrence rate per minute, from two video data sets (video attached to Prechtl video manual and accuracy data from Japan). STUDY DESIGN Observational study. SUBJECTS It encompassed 47 videos. Of these, 32 were deemed normal FMs. The study amalgamated FMs that were sporadic, abnormal, or absent into a category of aberrant (n = 15). OUTCOME MEASURES Infant video data were observed. MTM item occurrences were recorded and calculated for occurrence percentage and MTM rate of occurrence per minute. The differences between groups for the upper limbs, lower limbs, and total MTM were statistically analysed. RESULTS Twenty-three infant videos of normal FMs and seven infant videos of aberrant FMs showed MTM. Eight infant videos of aberrant FMs showed no MTM, and only four with absent FMs were included. There was a significant difference in the total MTM rate of occurrence per minute between normal FMs versus aberrant FMs (p = 0.008). CONCLUSIONS This study presented MTM frequency and rate of occurrence per minute in infants who showed FMs during the fidgety movement period. Those who showed absent FMs also demonstrated no MTM. Further study may need a larger sample size of absent FMs and information on later development.
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Affiliation(s)
- Nisasri Sermpon
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Japan; Faculty of Physical Therapy, Mahidol University, Thailand
| | - Hirotaka Gima
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Japan.
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Rodriguez SH, Blair MP, Timtim E, Millman R, Si Z, Wroblewski K, Andrews B, Msall ME, Peyton C. Smartphone application links severity of retinopathy of prematurity to early motor behavior in a cohort of high-risk preterm infants. J AAPOS 2023; 27:12.e1-12.e7. [PMID: 36642242 PMCID: PMC10243477 DOI: 10.1016/j.jaapos.2022.11.018] [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] [Received: 07/16/2022] [Revised: 11/18/2022] [Accepted: 11/25/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE To evaluate the General Movement Assessment (GMA) with the Motor Optimality Score-Revised (MOS-R) as a neurodevelopmental marker in infants with retinopathy of prematurity (ROP). METHODS Infants screened prospectively for ROP were evaluated at 3 months' post-term age using a smartphone application to complete the GMA and MOS-R. Results were analyzed by ROP severity. RESULTS Of 105 enrolled infants, 83 completed the study. Of these, 54 (65%) had any ROP, 32 (39%) had severe ROP, and 13 (16%) had type 1 ROP. The proportion with aberrant GMA was significantly higher in infants with severe ROP (14/32 [44%]) compared with infants who had milder ROP (8/51 [16%]; P = 0.006). Of those with severe ROP, there was no significant difference comparing infants with type 1 ROP treated with bevacizumab (7/13 [54%]) to infants with type 2 ROP without treatment (7/19 [37%]; P = 0.47). Although the presence of any ROP, stage of ROP, and severe ROP each predicted lower MOS-R scores on univariate analyses, only severe bronchopulmonary dysplasia and markers of brain injury remained significant in the multivariate analysis. CONCLUSIONS The GMA was a convenient, short-term method of data collection with low attrition. Although severe ROP initially appeared linked to poor early motor scores, this association is likely confounded by neurological and respiratory complications, which frequently accompany severe ROP.
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Affiliation(s)
| | - Michael P Blair
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois; Retina Consults Ltd, Des Plaines, Illinois
| | - Elise Timtim
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois
| | - Ryan Millman
- Department of Physical Therapy and Human Movement Science, Northwestern University
| | - Zhuangjun Si
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois
| | | | - Bree Andrews
- Department of Pediatrics, Section of Neonatology, University of Chicago
| | - Michael E Msall
- Department of Pediatrics, Section of Developmental and Behavioral Pediatrics and Kennedy Research Center on Neurodevelopmental Disabilities, University of Chicago, Chicago, Illinois
| | - Colleen Peyton
- Department of Physical Therapy and Human Movement Science, Northwestern University
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Marschik-Zhang D, Wang J, Shen X, Zhu X, Gao H, Yang H, Marschik PB. Building Blocks for Deep Phenotyping in Infancy: A Use Case Comparing Spontaneous Neuromotor Functions in Prader-Willi Syndrome and Cerebral Palsy. J Clin Med 2023; 12:784. [PMID: 36769434 PMCID: PMC9917638 DOI: 10.3390/jcm12030784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
With the increasing worldwide application of the Prechtl general movements assessment (GMA) beyond its original field of the early prediction of cerebral palsy (CP), substantial knowledge has been gained on early neuromotor repertoires across a broad spectrum of diagnostic groups. Here, we aimed to profile the neuromotor functions of infants with Prader-Willi syndrome (PWS) and to compare them with two other matched groups. One group included infants with CP; the other included patients who were treated at the same clinic and turned out to have inconspicuous developmental outcomes (IOs). The detailed GMA, i.e., the motor optimality score-revised (MOS-R), was used to prospectively assess the infants' (N = 54) movements. We underwent cross-condition comparisons to characterise both within-group similarities and variations and between-group distinctions and overlaps in infants' neuromotor functions. Although infants in both the PWS and the CP groups scored similarly low on MOS-R, their motor patterns were different. Frog-leg and mantis-hand postures were frequently seen in the PWS group. However, a PWS-specific general movements pattern was not observed. We highlight that pursuing in-depth knowledge within and beyond the motor domain in different groups has the potential to better understand different conditions, improve accurate diagnosis and individualised therapy, and contribute to deep phenotyping for precision medicine.
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Affiliation(s)
- Dajie Marschik-Zhang
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
- Leibniz Science Campus Primate Cognition, 37077 Göttingen, Germany
- iDN—Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria
| | - Jun Wang
- Department of Rehabilitation, Children’s Hospital, Fudan University, Shanghai 201102, China
| | - Xiushu Shen
- Department of Rehabilitation, Children’s Hospital, Fudan University, Shanghai 201102, China
| | - Xiaoyun Zhu
- Department of Rehabilitation, Children’s Hospital, Fudan University, Shanghai 201102, China
| | - Herong Gao
- Department of Rehabilitation, Children’s Hospital, Fudan University, Shanghai 201102, China
| | - Hong Yang
- Department of Rehabilitation, Children’s Hospital, Fudan University, Shanghai 201102, China
| | - Peter B. Marschik
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
- Leibniz Science Campus Primate Cognition, 37077 Göttingen, Germany
- iDN—Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Child and Adolescent Psychiatry, Region Stockholm, Karolinska Institutet & Stockholm Health Care Services, 17176 Stockholm, Sweden
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Peyton C, Millman R, Rodriguez S, Boswell L, Naber M, Spittle A, de Regnier R, Barbosa VM, Sukal-Moulton T. Motor Optimality Scores are significantly lower in a population of high-risk infants than in infants born moderate-late preterm. Early Hum Dev 2022; 174:105684. [PMID: 36209602 PMCID: PMC10243476 DOI: 10.1016/j.earlhumdev.2022.105684] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The Motor Optimality Score-Revised (MOS-R) is a detailed scoring of the General Movement Assessment (GMA), measuring the spontaneous behaviors of infants. Infants born moderate-late preterm are not traditionally followed in high-risk clinics, but have increased risk of neurodevelopmental disability. AIMS Compare MOS-R at 3 months corrected age (CA) in high-risk (HR; very preterm or abnormal neuroimaging) infants to infants born moderate-late preterm (MLP). STUDY DESIGN In this prospective cohort study, parents of enrolled infants created video recordings using an app at 3 months CA. Videos were scored with the General Movement Assessment (GMA) and MOS-R. MOS-R scores were divided into "higher-risk" (≤19) and "lower-risk" (≥20). SUBJECTS 181 infants born MLP or categorized as HR. RESULTS Among enrolled infants, 68 (38 %) were in the MLP group, and 113 infants were in the HR group. The HR group had 3.8 increased odds of having an aberrant GMA score compared to the MLP group (p < 0.01, 95 % CI 1.38-10.52). The HR group had significantly lower MOS-R scores (mean 20) than the MLP group (mean 24; p < 0.001; 95%CI 3.3-7.3). The HR group had 11.2 increased odds of having a higher-risk MOS-R score (95%CI 2.5-47.6, p < 0.001) than MLP group. Infants were most likely to have a lower MOS-R score if they had any of the following: VP shunt placement, periventricular leukomalacia, or bronchopulmonary dysplasia. CONCLUSIONS Aberrant GMA and higher-risk MOS-R scores were more common in infants at high-risk, reflecting history of brain lesions and younger gestational age at birth.
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Affiliation(s)
- Colleen Peyton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA.
| | - Ryan Millman
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA
| | - Sarah Rodriguez
- Department of Ophthalmology and Visual Science, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA
| | - Lynn Boswell
- Ann and Robert H Lurie Children's Hospital, 225 E Chicago Ave, Chicago, IL 60611, USA
| | - Meg Naber
- Loyola University Medical Center, 2160 S. 1st Ave, Maywood, IL 60153, USA
| | - Alicia Spittle
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, VIC 3052, Australia
| | - RayeAnn de Regnier
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA; Ann and Robert H Lurie Children's Hospital, 225 E Chicago Ave, Chicago, IL 60611, USA
| | | | - Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL 60611, USA
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Zhuo H, Xiao J, Tseng WL, Liew Z. Developmental Milestones of Infancy and Associations with Later Childhood Neurodevelopmental Outcomes in the Adolescent Brain Cognitive Development (ABCD) Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101424. [PMID: 36291360 PMCID: PMC9600325 DOI: 10.3390/children9101424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/24/2022]
Abstract
The age at attaining infancy developmental milestones has been associated with later neurodevelopmental outcomes, but evidence from large and diverse samples is lacking. We investigated this by analyzing data of 5360 singleton children aged 9-10 from 17 states in the US enrolled in the Adolescent Brain Cognitive Development (ABCD) study during 2016-2020. Delays in four milestones (first roll over, unaided sitting, unaided walking, and speaking first words) were defined using the 90th percentile of age at attainment reported by children's biological mothers. Childhood neurocognitive function was measured by research assistants using the NIH toolbox, and children reported their behavioral problems using the Brief Problem Monitor. Linear mixed-effects models were employed to investigate the association between delays in single or multiple milestones and childhood neurobehavioral outcomes. Delays in first roll over, unaided sitting, or walking were associated with poorer childhood neurocognitive function, while delay in speaking first words was associated with both poorer neurocognitive function and behavioral problems. Children who had delays in both motor and language milestones had the worst neurocognitive function and behavioral outcomes. Our results suggest that delays in motor and language milestone attainment during infancy are predictive of childhood neurobehavioral outcomes.
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Affiliation(s)
- Haoran Zhuo
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06510, USA
- Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA
| | - Jingyuan Xiao
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06510, USA
- Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA
| | - Wan-Ling Tseng
- Yale Child Study Center, Yale School of Medicine, New Haven, CT 06519, USA
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06510, USA
- Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA
- Correspondence:
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10
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Kwong AKL, Doyle LW, Olsen JE, Eeles AL, Zannino D, Mainzer RM, Cheong JLY, Spittle AJ. Parent-recorded videos of infant spontaneous movement: Comparisons at 3-4 months and relationships with 2-year developmental outcomes in extremely preterm, extremely low birthweight and term-born infants. Paediatr Perinat Epidemiol 2022; 36:673-682. [PMID: 35172019 DOI: 10.1111/ppe.12867] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/11/2022] [Accepted: 01/16/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Infants born extremely preterm (EP, <28-week gestational age) or extremely low birthweight (ELBW, <1000 g) are at risk of developmental delay and cerebral palsy (CP). The General Movements Assessment (GMA) and its extension, the Motor Optimality Score, revised (MOS-R) (assesses movement patterns and posture), may help to identify early delays. OBJECTIVES To compare differences in the MOS-R scored from parent-recorded videos between infants born EP/ELBW and term-born infants, to determine relationships between the MOS-R and 2-year cognitive, language and motor outcomes and if any relationships differ between birth groups and the association of the GMA (fidgety) with CP. METHODS A geographical cohort (EP/ELBW and term-control infants) was assessed using the MOS-R inclusive of the GMA at 3- to 4-month corrected age (CA), and the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) at 2-year CA. Differences in mean total MOS-R between groups, relationships between MOS-R and 2-year outcomes and relationships between GMA (fidgety) and CP in infants born EP/ELBW were estimated using linear/logistic regression. RESULTS Three hundred and twelve infants (147 EP/ELBW; 165 term) had complete MOS-R and Bayley-III assessments. Mean MOS-R was lower in infants born EP/ELBW than controls (mean difference -3.2, 95% confidence interval [CI] -4.2, -2.3). MOS-R was positively related to cognitive (β [regression coefficient] = 0.71, 95% CI 0.27, 1.15), language (β = 0.96, 95% CI 0.38, 1.54) and motor outcomes (β = .89, 95% CI 0.45, 1.34). There was little evidence for interaction effects between birth groups for any outcome. Absent/abnormal fidgety movements were related to CP in children born EP/ELBW (risk ratio 5.91, 95% CI 1.48, 23.7). CONCLUSIONS Infants born EP/ELBW have lower MOS-R than infants born at term. A higher MOS-R is related to better outcomes for 2-year development, with similar relationships in both birth groups. Absent/abnormal fidgety movements are related to CP in EP/ELBW survivors.
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Affiliation(s)
- Amanda K L Kwong
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Physiotherapy, University of Melbourne, Parkville, Victoria, Australia
| | - Lex W Doyle
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
| | - Joy E Olsen
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia
| | - Abbey L Eeles
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Physiotherapy, University of Melbourne, Parkville, Victoria, Australia.,Department of Paediatrics, Monash University, Parkville, Victoria, Australia
| | - Diana Zannino
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Rheanna M Mainzer
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Jeanie L Y Cheong
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
| | - Alicia J Spittle
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Physiotherapy, University of Melbourne, Parkville, Victoria, Australia
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Infants prenatally exposed to SARS-CoV-2 show the absence of fidgety movements and are at higher risk for neurological disorders: A comparative study. PLoS One 2022; 17:e0267575. [PMID: 35507630 PMCID: PMC9067650 DOI: 10.1371/journal.pone.0267575] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/11/2022] [Indexed: 11/19/2022] Open
Abstract
Congenital viral infections are believed to damage the developing neonatal brain. However, whether neonates exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) show manifestations of such damage remains unclear. For neurodevelopment evaluation, general movement assessments have been shown to be effective in identifying early indicators of neurological dysfunction, including the absence of fidgety movements. This study compared the early motor repertoire by general movement assessment at three to five months of age in neonates who were or were not prenatally exposed to SARS-CoV-2 to determine whether infants prenatally exposed to SARS-CoV-2 are at risk of developing neurological disorders. Fifty-six infants, including 28 in the exposed group of mothers without vaccination who had no need for intensive care and likely had SARS-CoV-2 infection close to the time of pregnancy resolution and 28 infants in the nonexposed group, were videotaped to compare their detailed early motor repertoires, in which a motor optimality score-revised (MOS-R) was calculated using Prechtl’s method by using the chi-square or Mann–Whitney U tests. In the exposed group, 3 (11%) infants showed the absence of fidgety movements with a total MOS-R<14 points, and 3 (11%) other infants showed abnormal fidgety movements. Between groups, atypical body symmetry (p = 0.009) and MOS-R values were significantly lower (Z = -3.08, p = 0.002), with a large size effect (Cohen’s d = 0.97). The consequences of this new virus go beyond the health of the pregnant mother, and these consequences in some of the infants in the exposed group are likely not transitory because of the absence of fidgety movements between 3–5 months; thus, these babies are at increased risk of developing a serious neurological disorder.
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Burger M, Einspieler C, Jordaan ER, Unger M, Niehaus DJH. Early motor behavior of infants exposed to maternal mental health disorders - A South African perspective. Early Hum Dev 2022; 168:105572. [PMID: 35461052 DOI: 10.1016/j.earlhumdev.2022.105572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/20/2022] [Accepted: 04/11/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Over the past five decades the bulk of research on exposure to maternal mental health disorders and infant neurodevelopment has been generated in high-income countries. The current study included infants, residing in low-income communities in South Africa, born to mothers with a history of psychiatric disorders. AIM To assess the motor behavior of 10- to 20-week-old infants exposed to maternal mental health disorders, and a subgroup of infants with prenatal psychotropic medication exposure. METHODS The present study is a cross-sectional descriptive study, with a longitudinal subgroup analysis. General Movement Assessment (GMA), including the Motor Optimality Score-Revised (MOS-R), was used at 10-20 weeks corrected age to assess infant motor behavior. RESULTS The study included 112 infants. No significant difference (p = 0.523) was found on the MOS-R between infants exposed to maternal mental health disorders (n = 70) and the comparison group (n = 42). Both the exposed and comparison groups scored within the mildly reduced range on the MOS-R. No significant differences were found in a subgroup of infants with prenatal exposure to multi-class psychotropic medication (n = 17), mono-class psychotropic medication (n = 35) or valproate exposure (n = 10) (p > 0.1). CONCLUSION No association was found between exposure to maternal mental health disorders or exposure to psychotropic medication and infant motor behavior at 10-20 weeks post-term age on the MOS-R. Future research should focus on the contribution of exposure to specific classes and types of psychotropic medication on neurodevelopmental outcome of infants in larger cohorts.
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Affiliation(s)
- Marlette Burger
- Physiotherapy Division, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa.
| | - Christa Einspieler
- Research Unit iDN - Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Esme R Jordaan
- Biostatistics Unit, South African Medical Research Council, Parow, South Africa; Statistics and Population Studies, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - Marianne Unger
- Physiotherapy Division, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa
| | - Dana J H Niehaus
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa
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Active head lifting from supine in infancy in the general population: Red flag or not? Early Hum Dev 2021; 163:105466. [PMID: 34543946 DOI: 10.1016/j.earlhumdev.2021.105466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Previously it had been had reported that active head lifting from supine (AHLS) in high-risk infants was associated with lower cognitive scores in the second year. AHLS was generally accompanied by stereotyped leg movements. AIMS To examine in a standardized way whether AHLS with or without stereotyped leg movements in the general population is associated with prenatal, perinatal, neonatal and socio-economic risk factors or with lower scores on concurrent infant tests. STUDY DESIGN Cross-sectional study SUBJECTS: 1700 infants aged 2-18 months representative of the Dutch population. OUTCOME MEASURES Infant Motor Profile (IMP) and Standardized Infant NeuroDevelopmental Assessment (SINDA). Assessments were video-recorded and included at the youngest ages 3min of behaviour in supine. AHLS and the presence of stereotyped leg movements were recorded. Standardized information on early risk factors was available. RESULTS AHLS occurred at 4-9 months (prevalence per months: 1-14%; highest prevalence at 6 months). It was not associated with early risk factors or scores on infant tests. When AHLS was accompanied by stereotyped leg movements it was associated with a higher prevalence of an IMP-variation score < P15 (Odds Ratio (OR) 2.472 [95%CI 1.017; 6.006]). Stereotyped leg movements irrespective of AHLS were associated with more unfavourable total IMP scores and IMP performance scores (B coefficients -3.212 [-4.065; -2.360], -2.521 [-3.783; -1.259]) and IMP variation and SINDA neurological scores (ORs 5.432 [3.409; 8.655], 3.098 [1.548; 6.202]). CONCLUSIONS The data suggest that AHLS is not a red flag. Rather its co-occurring stereotyped leg movements may signal less favourable neurodevelopment.
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14
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Salavati S, Bos AF, Doyle LW, Anderson PJ, Spittle AJ. Very Preterm Early Motor Repertoire and Neurodevelopmental Outcomes at 8 Years. Pediatrics 2021; 148:peds.2020-049572. [PMID: 34452979 DOI: 10.1542/peds.2020-049572] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Children born very preterm (<32 weeks' gestation) have more neurodevelopmental problems compared with term-born peers. Aberrant fidgety movements (FMs) are associated with adverse motor outcomes in children born very preterm. However, associations of aberrant FMs combined with additional movements and postures to give a motor optimality score-revised (MOS-R) with school-aged cognitive and motor outcomes are unclear. Our aim with this study was to determine those associations. METHODS Of 118 infants born <30 weeks' gestation recruited into a randomized controlled trial of early intervention, 97 had a general movements assessment at 3 months' corrected age and were eligible for this study. Early motor repertoire including FMs and MOS-R were scored from videos of infant's spontaneous movement at 3 months' corrected age. At 8 years' corrected age, cognitive and motor performances were evaluated. Associations of early FMs and MOS-R with outcomes at 8 years were determined using linear regression. RESULTS Seventy-eight (80%) infants with early motor repertoire data had neurodevelopmental assessments at 8 years. A higher MOS-R, and favorable components of the individual subscales of the MOS-R, including the presence of normal FMs, were associated with better performance for general cognition, attention, working memory, executive function and motor function at 8 years; eg, presence of normal FMs was associated with a 21.6 points higher general conceptual ability score (95% confidence interval: 12.8-30.5; P < .001) compared with absent FMs. CONCLUSIONS Favorable early motor repertoire of infants born <30 weeks is strongly associated with improved cognitive and motor performance at 8 years.
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Affiliation(s)
- Sahar Salavati
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Arend F Bos
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Lex W Doyle
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia.,Obstetrics and Gynaecology.,Paediatrics, University of Melbourne, Melbourne, Australia.,Newborn Research, Royal Women's Hospital, Melbourne, Australia
| | - Peter J Anderson
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia.,Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Alicia J Spittle
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia.,Departments of Physiotherapy.,Newborn Research, Royal Women's Hospital, Melbourne, Australia
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Locatelli C, Onnivello S, Antonaros F, Feliciello A, Filoni S, Rossi S, Pulina F, Marcolin C, Vianello R, Toffalini E, Ramacieri G, Martelli A, Procaccini G, Sperti G, Caracausi M, Pelleri MC, Vitale L, Pirazzoli GL, Strippoli P, Cocchi G, Piovesan A, Lanfranchi S. Is the Age of Developmental Milestones a Predictor for Future Development in Down Syndrome? Brain Sci 2021; 11:655. [PMID: 34069813 PMCID: PMC8157296 DOI: 10.3390/brainsci11050655] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/12/2021] [Accepted: 05/14/2021] [Indexed: 01/23/2023] Open
Abstract
Down Syndrome (DS) is the most common genetic alteration responsible for intellectual disability, which refers to deficits in both intellectual and adaptive functioning. According to this, individuals with Down Syndrome (DS) reach developmental milestones (e.g., sitting, walking, and babbling) in the same order as their typically developing peers, but later in life. Since developmental milestones are the first blocks on which development builds, the aims of the current study are to: (i) expand the knowledge of developmental milestone acquisition; and (ii) explore the relationship between developmental milestone acquisition and later development. For this purpose 105 children/adolescents with DS were involved in this study, divided in two groups, Preschoolers (n = 39) and School-age participants (n = 66). Information on the age of acquisition of Sitting, Walking, Babbling, and Sphincter Control was collected, together with cognitive, motor, and adaptive functioning. Sitting predicted later motor development, but, with age, it became less important in predicting motor development in everyday life. Babbling predicted later language development in older children. Finally, Sphincter Control emerged as the strongest predictor of motor, cognitive, language, and adaptive skills, with its role being more evident with increasing age. Our data suggest that the age of reaching the milestones considered in the study has an influence on successive development, a role that can be due to common neural substrates, the environment, and the developmental cascade effect.
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Affiliation(s)
- Chiara Locatelli
- IRCCS, St. Orsola-Malpighi Polyclinic, via Massarenti 11, 40138 Bologna, Italy; (C.L.); (A.F.); (S.F.); (S.R.); (A.M.); (G.P.); (G.S.)
| | - Sara Onnivello
- Department of Developmental Psychology and Socialization, University of Padova, via Venezia 8, 35131 Padova, Italy; (S.O.); (F.P.); (C.M.); (R.V.); (S.L.)
| | - Francesca Antonaros
- Unit of Histology, Embryology and Applied Biology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, via Belmeloro 8, 40126 Bologna, Italy; (F.A.); (G.R.); (M.C.); (M.C.P.); (L.V.); (P.S.)
| | - Agnese Feliciello
- IRCCS, St. Orsola-Malpighi Polyclinic, via Massarenti 11, 40138 Bologna, Italy; (C.L.); (A.F.); (S.F.); (S.R.); (A.M.); (G.P.); (G.S.)
| | - Sonia Filoni
- IRCCS, St. Orsola-Malpighi Polyclinic, via Massarenti 11, 40138 Bologna, Italy; (C.L.); (A.F.); (S.F.); (S.R.); (A.M.); (G.P.); (G.S.)
- Specialisation School in Anesthesia, Intensive Care and Pain Care, University of Modena and Reggio Emilia, Largo del Pozzo, 71, 41125 Modena, Italy
| | - Sara Rossi
- IRCCS, St. Orsola-Malpighi Polyclinic, via Massarenti 11, 40138 Bologna, Italy; (C.L.); (A.F.); (S.F.); (S.R.); (A.M.); (G.P.); (G.S.)
| | - Francesca Pulina
- Department of Developmental Psychology and Socialization, University of Padova, via Venezia 8, 35131 Padova, Italy; (S.O.); (F.P.); (C.M.); (R.V.); (S.L.)
| | - Chiara Marcolin
- Department of Developmental Psychology and Socialization, University of Padova, via Venezia 8, 35131 Padova, Italy; (S.O.); (F.P.); (C.M.); (R.V.); (S.L.)
| | - Renzo Vianello
- Department of Developmental Psychology and Socialization, University of Padova, via Venezia 8, 35131 Padova, Italy; (S.O.); (F.P.); (C.M.); (R.V.); (S.L.)
| | - Enrico Toffalini
- Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy;
| | - Giuseppe Ramacieri
- Unit of Histology, Embryology and Applied Biology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, via Belmeloro 8, 40126 Bologna, Italy; (F.A.); (G.R.); (M.C.); (M.C.P.); (L.V.); (P.S.)
| | - Anna Martelli
- IRCCS, St. Orsola-Malpighi Polyclinic, via Massarenti 11, 40138 Bologna, Italy; (C.L.); (A.F.); (S.F.); (S.R.); (A.M.); (G.P.); (G.S.)
| | - Giulia Procaccini
- IRCCS, St. Orsola-Malpighi Polyclinic, via Massarenti 11, 40138 Bologna, Italy; (C.L.); (A.F.); (S.F.); (S.R.); (A.M.); (G.P.); (G.S.)
| | - Giacomo Sperti
- IRCCS, St. Orsola-Malpighi Polyclinic, via Massarenti 11, 40138 Bologna, Italy; (C.L.); (A.F.); (S.F.); (S.R.); (A.M.); (G.P.); (G.S.)
| | - Maria Caracausi
- Unit of Histology, Embryology and Applied Biology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, via Belmeloro 8, 40126 Bologna, Italy; (F.A.); (G.R.); (M.C.); (M.C.P.); (L.V.); (P.S.)
| | - Maria Chiara Pelleri
- Unit of Histology, Embryology and Applied Biology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, via Belmeloro 8, 40126 Bologna, Italy; (F.A.); (G.R.); (M.C.); (M.C.P.); (L.V.); (P.S.)
| | - Lorenza Vitale
- Unit of Histology, Embryology and Applied Biology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, via Belmeloro 8, 40126 Bologna, Italy; (F.A.); (G.R.); (M.C.); (M.C.P.); (L.V.); (P.S.)
| | - Gian Luca Pirazzoli
- Medical Department, Maggiore Hospital, Largo Nigrisoli 2, 40133 Bologna, Italy;
| | - Pierluigi Strippoli
- Unit of Histology, Embryology and Applied Biology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, via Belmeloro 8, 40126 Bologna, Italy; (F.A.); (G.R.); (M.C.); (M.C.P.); (L.V.); (P.S.)
| | - Guido Cocchi
- Neonatology Unit, St. Orsola-Malpighi Polyclinic, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, via Massarenti 9, 40138 Bologna, Italy;
| | - Allison Piovesan
- Unit of Histology, Embryology and Applied Biology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, via Belmeloro 8, 40126 Bologna, Italy; (F.A.); (G.R.); (M.C.); (M.C.P.); (L.V.); (P.S.)
| | - Silvia Lanfranchi
- Department of Developmental Psychology and Socialization, University of Padova, via Venezia 8, 35131 Padova, Italy; (S.O.); (F.P.); (C.M.); (R.V.); (S.L.)
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A comparison of the early motor repertoire of very preterm infants and term infants. Eur J Paediatr Neurol 2021; 32:73-79. [PMID: 33848955 DOI: 10.1016/j.ejpn.2021.03.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To obtain reference data on the early motor repertoire of very preterm infants compared with healthy term infants at three months' post-term age. STUDY DESIGN In this observational study, using Prechtl's method on the assessment of the early motor repertoire, we compared the quality of fidgety movements and the concurrent motor optimality score - revised of infants with a gestational age <30 weeks and/or a birth weight <1000 g with healthy infants with a gestational age of 37-42 weeks. RESULTS One hundred eighty very preterm and 180 healthy term infants participated. The median motor optimality scores - revised of very preterm infants were significantly lower in comparison to those of term infants, with scores of 24 (25th-75th percentiles: 23-26) and 26 (25th-75th percentiles: 26-28), respectively. Fidgety movements were aberrant (abnormal or absent) more often in very preterm infants than in term infants. The odds ratio was 4.59 (95% CI, 1.51-13.92). Compared with term infants, very preterm infants had poorer scores on the subscales age-adequate movement repertoire, observed postural patterns, and movement character with odds ratios ≥2.97. We found no differences regarding observed movement patterns. CONCLUSION This study provides reference data on the early motor repertoire of very preterm and healthy term infants. It demonstrates that the early motor repertoire of very preterm infants is poorer than that of term infants, a finding consistent with existing knowledge that prematurity increases the risk of poor neurodevelopment.
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The ontogeny of limbs movements towards midline in healthy infants born at term. Early Hum Dev 2021; 155:105324. [PMID: 33581484 DOI: 10.1016/j.earlhumdev.2021.105324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/04/2021] [Accepted: 01/24/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Movements towards midline are part of the age-adequate motor repertoire of infants. They develop contemporaneously to general movements, changing from occasional simple contact to proper midline motor patterns. AIM The aim of this study is to describe the ontogeny of movements towards midline in full term healthy infants. STUDY DESIGN Parents were asked to record their infant every second week, from term age to 22 weeks post-term. SUBJECTS 25 healthy full-term infants. RESULTS Three main epochs of development were detected: in the first one, between birth and 4 weeks post-term, movements towards midline were occasional, apparently due to the dominant flexed posture of elbow and knees and the adducted posture of shoulders and hips. In the second epoch, from 4 to 8 weeks, the limbs movements towards midline markedly decreased. In the third one, after 8 weeks, movements towards midline increased again in frequency, first appearing in lower limbs then in upper limbs, first solely as contact and thereafter as manipulation. A temporal overlapping with the occurrence of intermittent or continual fidgety movements was detected. CONCLUSIONS Movements towards midline progressively change, through a defined timeline, in full term healthy infants. The increased knowledge about the normal age-adequate motor repertoire can help physicians in clinical assessment of high risk infants.
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Movements and posture in infants born extremely preterm in comparison to term-born controls. Early Hum Dev 2021; 154:105304. [PMID: 33556691 DOI: 10.1016/j.earlhumdev.2020.105304] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/11/2020] [Accepted: 12/15/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Identifying altered motor development at an early stage is crucial for infants born extremely preterm (EPT), as they face a high risk of long-term neurodevelopmental impairment. The Prechtl General Movement Assessment (GMA), including the Motor Optimality Score Revised (MOS-R), can provide important insights into these infants' later neurodevelopmental function. AIMS To compare age-specific movements and postures in infants born EPT compared to term-born controls at three months corrected age. STUDY DESIGN A retrospective observational study design. SUBJECTS 53 infants born EPT (mean gestational age 25 weeks; 23-26) were included and matched for gender and recording age with 53 term-born controls (mean gestational age 40 weeks, 37-41). OUTCOME MEASURES GMA including the MOS-R at three months corrected age (re-analysis of video-recordings). RESULTS Of the infants born EPT, 19% showed aberrant fidgety movements (FMs); all term-born infants had normal FMs. There was a significant difference in MOS-R (p≤0.001) between controls (median = 26, IQR 26-28) and EPT infants (median = 18, IQR 17-21), as well as in all subcategories of the MOS-R. The EPT group had a significantly higher number of infants showing atypical movement and postural patterns as well as a reduced repertoire for the age compared to the controls. All infants born EPT moved monotonously and jerky. P-values were all <0.001. CONCLUSION Infants born EPT have an altered early motor development. The MOS-R may contribute to further understanding of motor performance in this group of children since it can detect neurological- and motor alterations at a very early age.
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De Roubaix A, Van de Velde D, Roeyers H, Van Waelvelde H. Standardized motor assessments before the age of five predicting school-aged motor outcome including DCD: A systematic review. Eur J Paediatr Neurol 2021; 30:29-57. [PMID: 33385976 DOI: 10.1016/j.ejpn.2020.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/10/2020] [Accepted: 12/05/2020] [Indexed: 10/22/2022]
Abstract
AIM Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder usually diagnosed at primary-school-age. This systematic review aimed to summarize available standardized motor assessments before five years of age predicting DCD, complex Minor Neurological Disorder (cMND) and motor delay assessed by a standardized motor test. METHODS A systematic search was performed in MEDLINE, CINAHL, WoS, Scopus, CENTRAL and ERIC. A hand search was executed. Only data of non-Cerebral Palsy children was included. RESULTS At or before two years, the BSID, motor subtests of GMDS, NOMAS, and NSMDA might be valuable in detecting school-aged motor delay, while starting at three years, the PDMS, motor subtests of GMDS, NSDMA, M-ABC-2, and CAMPB show promising results. General movements Assessment is associated with cMND, but does not seem sensitive enough to detect DCD. Predictive values are superior in high-risk groups and improve as children age. However, no assessment instrument reached 80% sensitivity and specificity. CONCLUSION Standardized motor assessments before five years seem valuable in detecting early motor problems. More longitudinal research commencing in infancy, including multiple assessments over time and the implementation of clear diagnostic criteria is imperative.
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Affiliation(s)
- Amy De Roubaix
- Faculty of Medicine and Health Care Sciences, Department of Rehabilitation Sciences, Ghent University, Entrance 46, UZ Ghent, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - Dominique Van de Velde
- Faculty of Medicine and Health Care Sciences, Department of Rehabilitation Sciences, Ghent University, Entrance 46, UZ Ghent, C. Heymanslaan 10, 9000, Ghent, Belgium.
| | - Herbert Roeyers
- Faculty of Psychology and Educational Sciences, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium.
| | - Hilde Van Waelvelde
- Faculty of Medicine and Health Care Sciences, Department of Rehabilitation Sciences, Ghent University, Entrance 46, UZ Ghent, C. Heymanslaan 10, 9000, Ghent, Belgium.
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Wu Y, Bouwstra H, Heineman KR, Hadders‐Algra M. Atypical general movements in the general population: Prevalence over the last 15 years and associated factors. Acta Paediatr 2020; 109:2762-2769. [PMID: 32335944 PMCID: PMC7754433 DOI: 10.1111/apa.15329] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/16/2020] [Accepted: 04/22/2020] [Indexed: 11/30/2022]
Abstract
AIM To determine the prevalence of atypical general movements (GMs) in the general population, to examine its time trend and associated factors. METHODS Participants consisted of 300 infants born in 2016-2018 (current cohort; gestational age 39.4 weeks (27-42); 162 boys), representative of the Dutch population. GMs were assessed at 2-4 months corrected age in terms of GM-complexity (definitely abnormal (DA) or not) and fidgety movements (present or absent). GM-complexity data from a cohort of 455 Dutch infants born in 2001-2002 were used to investigate the time trend. RESULTS In the current cohort, 10 infants (3%) showed DA GM-complexity and 8 (3%) absent fidgety movements. Only one infant had both GM-impairments (0.3%). The prevalence of DA GM-complexity did not differ from that in the 2001-2002 cohort (adjusted odds ratio (OR) = 1.47 [0.53, 4.06]). DA GM-complexity was associated with maternal smoking (adjusted OR = 3.59 [1.56, 8.28]) and marginally with prematurity (adjusted OR = 2.78 [1.00, 7.74]); absence of fidgety movements was curvilinearly associated with assessment age only (OR = 1.06 [1.01, 1.12]). CONCLUSION In the general population, the prevalence of DA GM-complexity and absent fidgety movements is 3%. The finding that they rarely co-occur and are associated with different factors indicates that GM-assessment needs to address both aspects.
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Affiliation(s)
- Ying‐Chin Wu
- University of Groningen, University Medical Center GroningenDepartment of PaediatricsDivision of Developmental NeurologyGroningenThe Netherlands
| | - Hylco Bouwstra
- University of Groningen, University Medical Center GroningenDepartment of PaediatricsDivision of Developmental NeurologyGroningenThe Netherlands
- Department of General Practice and Elderly Care MedicineAmsterdam UMCAmsterdamThe Netherlands
| | - Kirsten R. Heineman
- University of Groningen, University Medical Center GroningenDepartment of PaediatricsDivision of Developmental NeurologyGroningenThe Netherlands
- SEIN Stichting Epilepsie Instellingen NederlandZwolleThe Netherlands
| | - Mijna Hadders‐Algra
- University of Groningen, University Medical Center GroningenDepartment of PaediatricsDivision of Developmental NeurologyGroningenThe Netherlands
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Wu YC, Straathof EJM, Heineman KR, Hadders-Algra M. Typical general movements at 2 to 4 months: Movement complexity, fidgety movements, and their associations with risk factors and SINDA scores. Early Hum Dev 2020; 149:105135. [PMID: 32795785 DOI: 10.1016/j.earlhumdev.2020.105135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/02/2020] [Accepted: 07/07/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Movement complexity and the presence of fidgety movements (FMs) during general movements (GMs) both reflect aspects of neurological integrity in early infancy. AIM To assess interrelations between the degree of movement complexity and characteristics of FMs during typical GMs and to investigate associations between mildly impaired GMs and risk factors and neurodevelopmental condition. STUDY DESIGN Observational cohort study. SUBJECTS 283 infants (25 born preterm) at 2-4 months corrected age, representative of the general Dutch population. OUTCOME MEASURES GMs were classified in terms of GM-complexity (normal or mildly abnormal (MA)) and FMs (clearly present, sporadic, or exaggerated). Concurrent neurological, developmental and socio-emotional status were measured with the Standardized Infant NeuroDevelopmental Assessment (SINDA). RESULTS Infants with MA GM-complexity had a higher risk of having sporadic FMs and exaggerated FMs. Perinatal complications were not associated with mildly impaired GMs. MA GM-complexity was associated with advanced maternal age (adjusted OR = 2.29 [1.11, 4.76]) and having a non-native Dutch mother (adjusted OR = 2.93 [1.29, 6.64]). It was also associated with atypical neurological (OR = 7.62 [3.51, 16.54]) and developmental scores (OR = 2.38 [1.16, 4.88]). Sporadic and exaggerated FMs were associated with low-to-middle maternal education (adjusted OR = 2.88, [1.45, 5.72]) and having a non-native Dutch father (adjusted OR = 7.16 [1.41, 36.32]), respectively. However, neither sporadic nor exaggerated FMs were associated with the SINDA outcomes. CONCLUSIONS GM-complexity and FMs are two interrelated but different aspects of GMs. Mild impairments in GM-complexity and FMs share a non-optimal socio-economic background as risk factor, but only MA GM-complexity is associated with a concurrent non-optimal neurodevelopmental condition.
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Affiliation(s)
- Ying-Chin Wu
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands; Department of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan
| | - Elisabeth J M Straathof
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands
| | - Kirsten R Heineman
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands; SEIN, Stichting Epilepsie Instellingen Nederland, Zwolle, the Netherlands
| | - Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands.
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In-Home Mobility Training With a Portable Body Weight Support System of an Infant With Down Syndrome. Pediatr Phys Ther 2020; 32:E76-E82. [PMID: 32991571 DOI: 10.1097/pep.0000000000000752] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To report on the feasibility of an open-area, portable body weight support system (PBWSS) for in-home use and overground mobility training in an infant with Down syndrome. SUMMARY OF KEY POINTS The family used the PBWSS on average 4 days/week and for a mean duration of 27.9 minutes/day. Within sessions, the infant's mobility in the open area was greater with PBWSS assistance. The infant's mobility increased whereas variable trends were noted in the infant's motor, language, and cognitive development. CONCLUSIONS The long-term and frequent use of the PBWSS by this family provided opportunities to practice on emerging motor skills and exploratory actions that may have had a positive effect on her mobility and overall development. RECOMMENDATION FOR CLINICAL PRACTICE High-dose, body weight-supported training on emerging motor skills is feasible in the infants' natural environments. Future studies using a large sample will quantify the effects.
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Baumann N, Tresilian J, Wolke D. Effects of infant motor problems and treatment with physiotherapy on child outcomes at school-age. Early Hum Dev 2020; 149:105140. [PMID: 32738517 DOI: 10.1016/j.earlhumdev.2020.105140] [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: 05/22/2020] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Early motor coordination problems have previously been associated with various developmental outcomes at school-age. AIMS Investigate whether and how treatment with physiotherapy may alter associations between early motor problems and subsequent developmental outcomes. STUDY DESIGN A prospective whole-population study. SUBJECTS 1374 children were followed from birth to 8 years. OUTCOME MEASURES Early motor functioning was determined with standard neurological examinations at birth and at 5 months. Information on receipt of physiotherapy was collected through parent interviews at 5, 20 and 56 months. Developmental outcomes at 6 and 8 years included motor skills, mental health, cognitive function, and attention regulation and were determined through standard tests, parent reports and observed behavior ratings. RESULTS Early motor problems were associated with lower motor skills, cognitive function, and attention regulation at school-age, but not with mental health. In addition to early motor problems, receipt of physiotherapy was independently and negatively related to outcomes at school-age. Accounting for imbalances in covariates, including initial motor scores, via propensity score matching attenuated the adverse effects of receipt of physiotherapy on school-aged outcomes. CONCLUSIONS Infant motor problems are associated with motor and cognitive outcomes at school-age. Early motor problems may represent a starting point of a trajectory of difficulties that may lead to a higher risk of problems in multiple developmental domains. No evidence for a beneficial effect of treatment with physiotherapy was found.
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Affiliation(s)
- Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, United Kingdom.
| | - James Tresilian
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, United Kingdom; Warwick Medical School, University of Warwick, Coventry, United Kingdom
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Vinding RK, Rago D, Kelly RS, Gürdeniz G, Rasmussen MA, Stokholm J, Bønnelykke K, Litonjua AA, Weiss ST, Lasky-Su J, Bisgaard H, Chawes BL. Delayed Motor Milestones Achievement in Infancy Associates with Perturbations of Amino Acids and Lipid Metabolic Pathways. Metabolites 2020; 10:metabo10090337. [PMID: 32824932 PMCID: PMC7570268 DOI: 10.3390/metabo10090337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 07/29/2020] [Accepted: 08/15/2020] [Indexed: 11/20/2022] Open
Abstract
The relationship between developmental milestone achievement in infancy and later cognitive function and mental health is well established, but underlying biochemical mechanisms are poorly described. Our study aims to discover pathways connected to motor milestone achievement during infancy by using untargeted plasma metabolomic profiles from 571 six-month-old children in connection with age of motor milestones achievement (Denver Developmental Index) in the Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC2010) mother–child cohort. We used univariate regression models and multivariate modelling (Partial Least Squares Discriminant Analysis: PLS-DA) to examine the associations and the VDAART (Vitamin D Antenatal Asthma Reduction Trial) cohort for validation. The univariate analyses showed 62 metabolites associated with gross-motor milestone achievement (p < 0.05) as well as the PLS-DA significantly differentiated between slow and fast milestone achievers (AUC = 0.87, p = 0.01). Higher levels of tyramine-O-sulfate in the tyrosine pathway were found in the late achievers in COPSAC (p = 0.0002) and in VDAART (p = 0.02). Furthermore, we observed that slow achievers were characterized by higher levels of fatty acids and products of fatty acids metabolism including acyl carnitines. Finally, we also observed changes in the lysine, histidine, glutamate, creatine and tryptophan pathways. Observing these metabolic changes in relation to gross-motor milestones in the first year of life, may be of importance for later cognitive function and mental health.
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Affiliation(s)
- Rebecca Kofod Vinding
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, 1017 Copenhagen, Denmark; (R.K.V.); (D.R.); (G.G.); (M.A.R.); (J.S.); (K.B.); (B.L.C.)
| | - Daniela Rago
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, 1017 Copenhagen, Denmark; (R.K.V.); (D.R.); (G.G.); (M.A.R.); (J.S.); (K.B.); (B.L.C.)
| | - Rachel S. Kelly
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA; (R.S.K.); (S.T.W.); (J.L.-S.)
| | - Gözde Gürdeniz
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, 1017 Copenhagen, Denmark; (R.K.V.); (D.R.); (G.G.); (M.A.R.); (J.S.); (K.B.); (B.L.C.)
| | - Morten Arendt Rasmussen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, 1017 Copenhagen, Denmark; (R.K.V.); (D.R.); (G.G.); (M.A.R.); (J.S.); (K.B.); (B.L.C.)
- Department of Food Science, University of Copenhagen, 1958 Frederiksberg, Denmark
| | - Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, 1017 Copenhagen, Denmark; (R.K.V.); (D.R.); (G.G.); (M.A.R.); (J.S.); (K.B.); (B.L.C.)
| | - Klaus Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, 1017 Copenhagen, Denmark; (R.K.V.); (D.R.); (G.G.); (M.A.R.); (J.S.); (K.B.); (B.L.C.)
| | - Augusto A. Litonjua
- Division of Pediatric Pulmonary Medicine, Golisano Children’s Hospital, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Scott T. Weiss
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA; (R.S.K.); (S.T.W.); (J.L.-S.)
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA; (R.S.K.); (S.T.W.); (J.L.-S.)
| | - Hans Bisgaard
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, 1017 Copenhagen, Denmark; (R.K.V.); (D.R.); (G.G.); (M.A.R.); (J.S.); (K.B.); (B.L.C.)
- Correspondence: ; Tel.: +45-38677360
| | - Bo Lund Chawes
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, 1017 Copenhagen, Denmark; (R.K.V.); (D.R.); (G.G.); (M.A.R.); (J.S.); (K.B.); (B.L.C.)
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Exploring the Unmet Need for Technology to Promote Motor Ability in Children Younger Than 5 Years of Age: A Systematic Review. Arch Rehabil Res Clin Transl 2020; 2:100051. [PMID: 33543078 PMCID: PMC7853335 DOI: 10.1016/j.arrct.2020.100051] [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] [Indexed: 11/29/2022] Open
Abstract
Objective To (1) identify types of technology that promote motor ability in children younger than 5 years of age, (2) report on the type of support these devices provide, and (3) evaluate their potential for use in the community (outside of the laboratory or clinic). Data Sources A literature search of PubMed was conducted in February 2019 using specific terms, including child, rehabilitation, movement, and instrumentation. Study Selection The search yielded 451 peer-reviewed articles, which were screened by multiple reviewers. Articles that described the use of devices for the purpose of motor rehabilitation and/or assistance (regardless of device type or body part targeted) in the age range of 0-5 years were eligible for inclusion. Data Extraction In conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, final stage data extraction consisted of full text readings where each article was reviewed twice by 3 independent reviewers. Data Synthesis About half of the devices available (46%) for children younger than 5 years of age are orthotics and corrective casting devices. There are more facilitative (ie, power mobility devices) than inhibitive (ie, casting) technologies being used. Approximately 60% of the devices are designed for use by a single body part. Walking is the most common motor skill addressed. Although most of the devices were used to some degree outside of the laboratory or clinic, most of the devices available are considered investigative and are not available for commercial purchase. Conclusions Many types of pediatric devices to assist movement exist, but the current scope of employed devices is limited. There is a need for developing technology that allows for, if not supports, high-dosage, early, and variable motor practice that can take place in community settings.
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Early Motor Trajectories Predict Motor but not Cognitive Function in Preterm- and Term-Born Adults without Pre-existing Neurological Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093258. [PMID: 32392779 PMCID: PMC7246453 DOI: 10.3390/ijerph17093258] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/24/2020] [Accepted: 04/30/2020] [Indexed: 12/16/2022]
Abstract
Very preterm (VP; <32 weeks gestation) and/or very low birth weight (VLBW; <1500 g) birth has been associated with an increased risk of adverse motor and cognitive outcomes that may persist into adulthood. The aim of this study was to determine whether motor development in the first five years of life is associated with motor and cognitive outcomes in adulthood. A prospective observational study in Germany followed 260 VP/VLBW and 229 term-born individuals from birth into adulthood. Early motor trajectories (i.e., high and low degree of motor difficulties) were determined from neurological examinations from birth to 56 months. Adult motor and cognitive outcomes were determined from information from multiple instruments and IQ tests, respectively. Associations of VP/VLBW birth and early motor difficulties on adult outcomes were assessed using regression analyses. VP/VLBW individuals had an increased risk for early motor difficulties (Relative Risk: 11.77, 95% confidence interval (CI): 4.28, 32.35). Early motor difficulties were associated with poorer motor competence in adulthood (β = 0.22, p < 0.001), independent of VP/VLBW birth. Adult IQ was predicted by VP/VLBW (β = −0.12, p < 0.05) and child IQ (β = 0.51, p < 0.001), while early motor difficulties ceased to be associated with adult IQ once participants with a neurological impairment were excluded (β = 0.02, p > 0.05). Motor problems in childhood were homotypically associated with poorer motor competence in adulthood. Similarly, early cognitive problems were homotypically associated with adult cognitive outcomes. Thus, both motor and cognitive function should be assessed in routine follow-up during childhood.
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Mebius MJ, Bilardo CM, Kneyber MCJ, Modestini M, Ebels T, Berger RMF, Bos AF, Kooi EMW. Onset of brain injury in infants with prenatally diagnosed congenital heart disease. PLoS One 2020; 15:e0230414. [PMID: 32210445 PMCID: PMC7094875 DOI: 10.1371/journal.pone.0230414] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 02/28/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The exact onset of brain injury in infants with congenital heart disease (CHD) is unknown. Our aim was, therefore, to assess the association between prenatal Doppler flow patterns, postnatal cerebral oxygenation and short-term neurological outcome. METHODS Prenatally, we measured pulsatility indices of the middle cerebral (MCA-PI) and umbilical artery (UA-PI) and calculated cerebroplacental ratio (CPR). After birth, cerebral oxygen saturation (rcSO2) and fractional tissue oxygen extraction (FTOE) were assessed during the first 3 days after birth, and during and for 24 hours after every surgical procedure within the first 3 months after birth. Neurological outcome was determined preoperatively and at 3 months of age by assessing general movements and calculating the Motor Optimality Score (MOS). RESULTS Thirty-six infants were included. MOS at 3 months was associated with MCA-PI (rho 0.41, P = 0.04), UA-PI (rho -0.39, P = 0.047, and CPR (rho 0.50, P = 0.01). Infants with abnormal MOS had lower MCA-PI (P = 0.02) and CPR (P = 0.01) and higher UA-PI at the last measurement (P = 0.03) before birth. In infants with abnormal MOS, rcSO2 tended to be lower during the first 3 days after birth, and FTOE was significantly higher on the second day after birth (P = 0.04). Intraoperative and postoperative rcSO2 and FTOE were not associated with short-term neurological outcome. CONCLUSION In infants with prenatally diagnosed CHD, the prenatal period may play an important role in developmental outcome. Additional research is needed to clarify the relationship between preoperative, intra-operative and postoperative cerebral oxygenation and developmental outcome in infants with prenatally diagnosed CHD.
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Affiliation(s)
- Mirthe J. Mebius
- Division of Neonatology, Beatrix Children’s Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
| | - Catherina M. Bilardo
- Department of Obstetrics & Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Martin C. J. Kneyber
- Division of Pediatric Critical Care Medicine, Beatrix Children’s Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Critical Care, Anesthesiology, Peri-operative & Emergency medicine (CAPE), University of Groningen, Groningen, The Netherlands
| | - Marco Modestini
- Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Tjark Ebels
- Center for Congenital Heart Diseases, Department of Cardiothoracic Surgery, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Rolf M. F. Berger
- Center for Congenital Heart Diseases, Pediatric Cardiology, Beatrix Children’s Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arend F. Bos
- Division of Neonatology, Beatrix Children’s Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Elisabeth M. W. Kooi
- Division of Neonatology, Beatrix Children’s Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Kokkoni E, Mavroudi E, Zehfroosh A, Galloway JC, Vidal R, Heinz J, Tanner HG. GEARing smart environments for pediatric motor rehabilitation. J Neuroeng Rehabil 2020; 17:16. [PMID: 32041623 PMCID: PMC7011606 DOI: 10.1186/s12984-020-0647-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 01/20/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND There is a lack of early (infant) mobility rehabilitation approaches that incorporate natural and complex environments and have the potential to concurrently advance motor, cognitive, and social development. The Grounded Early Adaptive Rehabilitation (GEAR) system is a pediatric learning environment designed to provide motor interventions that are grounded in social theory and can be applied in early life. Within a perceptively complex and behaviorally natural setting, GEAR utilizes novel body-weight support technology and socially-assistive robots to both ease and encourage mobility in young children through play-based, child-robot interaction. This methodology article reports on the development and integration of the different system components and presents preliminary evidence on the feasibility of the system. METHODS GEAR consists of the physical and cyber components. The physical component includes the playground equipment to enrich the environment, an open-area body weight support (BWS) device to assist children by partially counter-acting gravity, two mobile robots to engage children into motor activity through social interaction, and a synchronized camera network to monitor the sessions. The cyber component consists of the interface to collect human movement and video data, the algorithms to identify the children's actions from the video stream, and the behavioral models for the child-robot interaction that suggest the most appropriate robot action in support of given motor training goals for the child. The feasibility of both components was assessed via preliminary testing. Three very young children (with and without Down syndrome) used the system in eight sessions within a 4-week period. RESULTS All subjects completed the 8-session protocol, participated in all tasks involving the selected objects of the enriched environment, used the BWS device and interacted with the robots in all eight sessions. Action classification algorithms to identify early child behaviors in a complex naturalistic setting were tested and validated using the video data. Decision making algorithms specific to the type of interactions seen in the GEAR system were developed to be used for robot automation. CONCLUSIONS Preliminary results from this study support the feasibility of both the physical and cyber components of the GEAR system and demonstrate its potential for use in future studies to assess the effects on the co-development of the motor, cognitive, and social systems of very young children with mobility challenges.
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Affiliation(s)
- Elena Kokkoni
- Department of Bioengineering, University of California, Riverside, CA 92521 USA
- Department of Mechanical Engineering, University of Delaware, Newark, DE 19716 USA
| | - Effrosyni Mavroudi
- Department of Biomedical Engineering and Mathematical Institute for Data Science, Johns Hopkins University, Baltimore, MD 21218 USA
| | - Ashkan Zehfroosh
- Department of Mechanical Engineering, University of Delaware, Newark, DE 19716 USA
| | - James C. Galloway
- Department of Physical Therapy and Biomechanics and Movement Science Program, University of Delaware, Newark, DE 19713 USA
| | - Renè Vidal
- Department of Biomedical Engineering and Mathematical Institute for Data Science, Johns Hopkins University, Baltimore, MD 21218 USA
| | - Jeffrey Heinz
- Department of Linguistics and Institute of Advanced Computational Science, Stony Brook University, Stony Brook, NY 11794 USA
| | - Herbert G. Tanner
- Department of Mechanical Engineering, University of Delaware, Newark, DE 19716 USA
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29
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Einspieler C, Bos AF, Krieber-Tomantschger M, Alvarado E, Barbosa VM, Bertoncelli N, Burger M, Chorna O, Del Secco S, DeRegnier RA, Hüning B, Ko J, Lucaccioni L, Maeda T, Marchi V, Martín E, Morgan C, Mutlu A, Nogolová A, Pansy J, Peyton C, Pokorny FB, Prinsloo LR, Ricci E, Saini L, Scheuchenegger A, Silva CRD, Soloveichick M, Spittle AJ, Toldo M, Utsch F, van Zyl J, Viñals C, Wang J, Yang H, Yardımcı-Lokmanoğlu BN, Cioni G, Ferrari F, Guzzetta A, Marschik PB. Cerebral Palsy: Early Markers of Clinical Phenotype and Functional Outcome. J Clin Med 2019; 8:E1616. [PMID: 31590221 PMCID: PMC6833082 DOI: 10.3390/jcm8101616] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/21/2019] [Accepted: 09/25/2019] [Indexed: 11/17/2022] Open
Abstract
The Prechtl General Movement Assessment (GMA) has become a cornerstone assessment in early identification of cerebral palsy (CP), particularly during the fidgety movement period at 3-5 months of age. Additionally, assessment of motor repertoire, such as antigravity movements and postural patterns, which form the Motor Optimality Score (MOS), may provide insight into an infant's later motor function. This study aimed to identify early specific markers for ambulation, gross motor function (using the Gross Motor Function Classification System, GMFCS), topography (unilateral, bilateral), and type (spastic, dyskinetic, ataxic, and hypotonic) of CP in a large worldwide cohort of 468 infants. We found that 95% of children with CP did not have fidgety movements, with 100% having non-optimal MOS. GMFCS level was strongly correlated to MOS. An MOS > 14 was most likely associated with GMFCS outcomes I or II, whereas GMFCS outcomes IV or V were hardly ever associated with an MOS > 8. A number of different movement patterns were associated with more severe functional impairment (GMFCS III-V), including atypical arching and persistent cramped-synchronized movements. Asymmetrical segmental movements were strongly associated with unilateral CP. Circular arm movements were associated with dyskinetic CP. This study demonstrated that use of the MOS contributes to understanding later CP prognosis, including early markers for type and severity.
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Affiliation(s)
- Christa Einspieler
- Research Unit iDN, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria.
| | - Arend F Bos
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, 9713 GZ Groningen, The Netherlands.
| | | | - Elsa Alvarado
- National Rehabilitation Institute, Cerebral Palsy Department, 14389 Mexico City, Mexico.
| | - Vanessa M Barbosa
- University of Illinois at Chicago, UI Health, Department of Occupational and Physical Therapy, Chicago, IL 60612, USA.
| | - Natascia Bertoncelli
- University of Modena and Reggio Emilia, Department of Clinical and Surgical Sciences for Mothers, Children and Adults, Neonatal Intensive Care Unit, 41124 Modena, Italy.
| | - Marlette Burger
- Stellenbosch University, Faculty of Medicine and Health Sciences, Department of Health and Rehabilitation Sciences, Cape Town 8000, South Africa.
| | - Olena Chorna
- IRCCS Fondazione Stella Maris, Department of Developmental Neuroscience, 56128 Pisa, Italy.
| | - Sabrina Del Secco
- IRCCS Fondazione Stella Maris, Department of Developmental Neuroscience, 56128 Pisa, Italy.
| | - Raye-Ann DeRegnier
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA.
| | - Britta Hüning
- University Hospital Essen, Department of Pediatrics I, 45122 Essen, Germany.
| | - Jooyeon Ko
- Daegu Health College, Department of Physical Therapy, 41453 Daegu, Korea.
| | - Laura Lucaccioni
- University of Modena and Reggio Emilia, Department of Clinical and Surgical Sciences for Mothers, Children and Adults, Neonatal Intensive Care Unit, 41124 Modena, Italy.
| | - Tomoki Maeda
- Oita University Faculty of Medicine, Department of Pediatrics, 879-5593 Oita, Japan.
| | - Viviana Marchi
- IRCCS Fondazione Stella Maris, Department of Developmental Neuroscience, 56128 Pisa, Italy.
- Institute of Life Sciences, Scuola Superiore Sant'Anna, 56127 Pisa, Italy.
| | - Erika Martín
- Children's Rehabilitation Institute Teleton, 72825 Puebla, Mexico.
| | - Catherine Morgan
- The University of Sydney Medical School, Children's Hospital at Westmead Clinical School, The Discipline of Child and Adolescent Health, Sydney 2050, NSW, Australia.
- The University of Sydney, Cerebral Palsy Alliance Research Institute, Sydney 2050, NSW, Australia.
| | - Akmer Mutlu
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, 06100 Ankara, Turkey.
| | - Alice Nogolová
- Municipal Hospital of Ostrava, Children 's Department, 72880 Ostrava, Czech Republic.
- Masaryk University, Faculty of Medicine, 62500 Brno, Czech Republic.
| | - Jasmin Pansy
- Medical University of Graz, Department of Pediatrics and Adolescent Medicine, Division of Neonatology, 8036 Graz, Austria.
| | - Colleen Peyton
- Northwestern University, Department of Physical Therapy and Human Movement Science, Chicago, IL 60611, USA.
| | - Florian B Pokorny
- Research Unit iDN, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria.
| | - Lucia R Prinsloo
- Cerebral Palsy Association Eastern Cape, Port Elizabeth 6001, South Africa.
| | - Eileen Ricci
- University of New England/Maine LEND Program, Portland, ME 04103, USA.
| | - Lokesh Saini
- Post Graduate Institute of Medical Education and Research, Department of Pediatrics, Pediatric Neurology Division, Chandigarh 160012, India.
| | - Anna Scheuchenegger
- Medical University of Graz, Department of Pediatrics and Adolescent Medicine, Division of Neonatology, 8036 Graz, Austria.
| | - Cinthia R D Silva
- Rede SARAH de Hospitais de Reabilitação, Reabilitação Infantil, 30510-000 Belo Horizonte, Brazil.
| | - Marina Soloveichick
- Lady Davis Carmel Medical Center, NICU Developmental Follow-up Clinic, 34362 Haifa, Israel.
| | - Alicia J Spittle
- University of Melbourne, School of Health Sciences, Department of Physiotherapy, Parkville 3052, Australia.
- Murdoch Children's Research Institute, Parkville 3052, Victoria, Australia.
| | - Moreno Toldo
- Kiran Society for Rehabilitation and Education of Children with Disabilities, Varanasi 221011, India.
| | - Fabiana Utsch
- Rede SARAH de Hospitais de Reabilitação, Reabilitação Infantil, 30510-000 Belo Horizonte, Brazil.
| | - Jeanetta van Zyl
- Stellenbosch University, Faculty of Medicine and Health Sciences, Department of Paediatrics and Child Health, Cape Town 8000, South Africa.
| | - Carlos Viñals
- National Rehabilitation Institute, Cerebral Palsy Department, 14389 Mexico City, Mexico.
| | - Jun Wang
- Children's Hospital of Fudan University, Department of Rehabilitation, Shanghai 201102, China.
| | - Hong Yang
- Children's Hospital of Fudan University, Department of Rehabilitation, Shanghai 201102, China.
| | - Bilge N Yardımcı-Lokmanoğlu
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, 06100 Ankara, Turkey.
| | - Giovanni Cioni
- IRCCS Fondazione Stella Maris, Department of Developmental Neuroscience, 56128 Pisa, Italy.
| | - Fabrizio Ferrari
- University of Modena and Reggio Emilia, Department of Clinical and Surgical Sciences for Mothers, Children and Adults, Neonatal Intensive Care Unit, 41124 Modena, Italy.
| | - Andrea Guzzetta
- IRCCS Fondazione Stella Maris, Department of Developmental Neuroscience, 56128 Pisa, Italy.
| | - Peter B Marschik
- Research Unit iDN, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria.
- University Medical Center Göttingen, Child and Adolescent Psychiatry and Psychotherapy, 37075 Göttingen, Germany.
- Karolinska Institutet, Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), 11330 Stockholm, Sweden.
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Schmeer KK, Guardino C, Irwin JL, Ramey S, Shalowitz M, Dunkel Schetter C. Maternal postpartum stress and toddler developmental delays: Results from a multisite study of racially diverse families. Dev Psychobiol 2019; 62:62-76. [PMID: 31172517 DOI: 10.1002/dev.21871] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 04/02/2019] [Accepted: 05/03/2019] [Indexed: 11/10/2022]
Abstract
Maternal psychosocial stress during pregnancy can adversely influence child development, but few studies have investigated psychosocial stress during the postpartum period and its association with risk of toddler developmental delays. Moreover, given the expanding diversity of the U.S. population, and well-documented health and stress disparities for racial and ethnic minorities, research examining the effect of postpartum stress on risk of developmental delays in diverse populations is of critical importance. In this study, data from the Community Child Health Network provided the opportunity to test maternal postpartum stress as a predictor of toddler risk of developmental delay in a sample of African American, Latina and non-Hispanic White women and their toddlers (N = 1537) recruited in urban, suburban, and rural communities. Postpartum maternal stress over 1 year was operationalized as perceived stress, life events, and negative impact of life events. Regression results revealed higher risk of developmental delays in toddlers whose mothers experienced more negative life events, greater negative impact of events, and higher perceived stress over the year. Prenatal stress, pregnancy/birth complications, and postpartum depression did not explain these associations. Maternal postpartum stress may contribute to increased risk for developmental delays and is an important target for psychosocial intervention.
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Affiliation(s)
- Kammi K Schmeer
- Department of Sociology, The Ohio State University, Columbus, Ohio
| | | | - Jessica L Irwin
- Department of Psychology, University of California, Los Angeles, California
| | - Sharon Ramey
- Department of Psychology, Virginia Tech Carilion Research Institute, Blacksburg, Virginia
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Maeda T, Iwata H, Sekiguchi K, Takahashi M, Ihara K. The association between brain morphological development and the quality of general movements. Brain Dev 2019; 41:490-500. [PMID: 30770148 DOI: 10.1016/j.braindev.2019.01.007] [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: 11/03/2018] [Revised: 12/31/2018] [Accepted: 01/23/2019] [Indexed: 11/16/2022]
Abstract
AIM To clarify the morphologic characteristics of the brain, which are the foundation of the emergence of general movements (GMs) in very-low-birth-weight infants. STUDY DESIGN Prospective cohort study. GMs were scored according to a semiquantitative scoring system: the GMs optimality score (GMOS) at preterm and term ages. Brain magnetic resonance imaging (MRI) at term-equivalent age was scored using a validated scoring system (MRI score). We examined the relationship between the two scores by multiple regression analysis with relevant clinical background. SUBJECTS We included 50 very-low-birth-weight infants cared for at Oita University Hospital from August 2012 to August 2018 who underwent MRI and GMs assessment. Their median gestational age and birth weight were 29w2d and 1145 g, respectively. RESULTS The MRI score and systemic steroid administration were related to preterm GMOS, and the MRI score was related to term GMOS. The component cerebellum score and cortical grey matter score of the MRI score were associated with preterm GMOS, and the cerebellum and the cerebral white matter scores were associated with term GMOS. CONCLUSION The quality of GMs was associated with brain morphological development. The co-evaluation of GMs and brain morphology leads to accurate developmental prediction.
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Affiliation(s)
- Tomoki Maeda
- Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan.
| | - Hajime Iwata
- Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan
| | - Kazuhito Sekiguchi
- Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan
| | - Mizuho Takahashi
- Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan
| | - Kenji Ihara
- Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan
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32
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Cejas I, Mitchell CM, Hoffman M, Quittner AL. Comparisons of IQ in Children With and Without Cochlear Implants: Longitudinal Findings and Associations With Language. Ear Hear 2019; 39:1187-1198. [PMID: 29624538 PMCID: PMC6173668 DOI: 10.1097/aud.0000000000000578] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To make longitudinal comparisons of intelligence quotient (IQ) in children with cochlear implants (CIs) and typical hearing peers from early in development to the school-age period. Children with additional comorbidities and CIs were also evaluated. To estimate the impact of socioeconomic status and oral language on school-age cognitive performance. DESIGN This longitudinal study evaluated nonverbal IQ in a multicenter, national sample of 147 children with CIs and 75 typically hearing peers. IQ was evaluated at baseline, prior to cochlear implantation, using the Bayley Scales of Infant and Toddler Development and the Leiter International Performance Scale. School-age IQ was assessed using the Wechsler Intelligence Scales for Children. For the current study, only the Perceptual Reasoning and Processing Speed indices were administered. Oral language was evaluated using the Comprehensive Assessment of Spoken Language. RESULTS Children in the CI group scored within the normal range of intelligence at both time points. However, children with additional comorbidities scored significantly worse on the Processing Speed, but not the Perceptual Reasoning Index. Maternal education and language were significantly related to school-age IQ in both groups. Importantly, language was the strongest predictor of intellectual functioning in both children with CIs and normal hearing. CONCLUSION These results suggest that children using cochlear implants perform similarly to hearing peers on measures of intelligence, but those with severe comorbidities are at-risk for cognitive deficits. Despite the strong link between socioeconomic status and intelligence, this association was no longer significant once spoken language performance was accounted for. These results reveal the important contributions that early intervention programs, which emphasize language and parent training, contribute to cognitive functioning in school-age children with CIs. For families from economically disadvantaged backgrounds, who are at-risk for suboptimal outcomes, these early intervention programs are critical to improve overall functioning.
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Affiliation(s)
- Ivette Cejas
- University of Miami, Department of Otolaryngology
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33
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Kepenek-Varol B, Tanrıverdi M, İşcan A, Alemdaroğlu-Gürbüz İ. The acute effects of physiotherapy on general movement patterns in preterm infants: A single-blind study. Early Hum Dev 2019; 131:15-20. [PMID: 30798037 DOI: 10.1016/j.earlhumdev.2019.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/27/2018] [Accepted: 02/13/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND The General Movement Assessment (GMA) is a video analysis method developed by Heinz Prechtl that examines the infant's spontaneous movements. In recent years, although many studies have been performed in preterm infants by applying GMA, few studies have shown the effects of early intervention on GMA. AIMS Current study was planned to determine the acute effects of a single-session early physiotherapy approach on preterm infants' general spontaneous movements, and to reveal the change in Motor Optimality Scale (MOS) score including FMs. STUDY DESIGN Prospective, single-blind study. SUBJECTS Current study was carried out with 32 preterm infants at postterm 12-16 weeks. OUTCOME MEASURES The infants included in the study were videotaped by a physiotherapist during 10-15 min before the physiotherapy session at postterm 12-16 weeks for GMA. After a single physiotherapy session, the same physiotherapist performed the same video footage second time. A blind evaluator assessed the videos taken before and after session and scored Motor Optimality Scale (MOS). RESULTS AND CONCLUSIONS There was no statistically significant difference between MOS sub-category and total score of the infants before and after the session (p > 0.05). According to the results of present study, a single-session early physiotherapy intervention did not have an acute effect on the spontaneous movements of preterm infants at postterm 12-16 weeks. Future studies are needed to demonstrate the short and long-term effects of early physiotherapy approaches to risky infants.
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Affiliation(s)
- Büşra Kepenek-Varol
- Nuh Naci Yazgan University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Kayseri, Turkey
| | - Müberra Tanrıverdi
- Bezmialem Vakıf University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, İstanbul, Turkey.
| | - Akın İşcan
- Bezmialem Vakıf University, Faculty of Medicine, Pediatric Neurology Department, İstanbul, Turkey
| | - İpek Alemdaroğlu-Gürbüz
- Hacettepe University, Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Ankara, Turkey.
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Havmoeller SR, Thomsen PH, Lemcke S. The early motor development in children diagnosed with ADHD: a systematic review. ATTENTION DEFICIT AND HYPERACTIVITY DISORDERS 2018; 11:233-240. [PMID: 30515726 DOI: 10.1007/s12402-018-0280-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 11/26/2018] [Indexed: 11/25/2022]
Abstract
Although there is limited knowledge about early signs of ADHD, deviations in motor development are suggested as a possible indicator of such early signs. The purpose of the present systematic review was to gather knowledge about motor development before three years of age in children later diagnosed with ADHD. A systematic search was completed in four research databases, and the quality of the identified studies was systematically assessed. Of 440 initial search results, only five studies met the inclusion criteria and were fully abstracted. Major methodological heterogeneity was found between the studies, and the results are pointing in various directions. One study found an association between delay in gross motor development and ADHD, while another did not. However, associations between both good early motor development as well as delayed were also found in one study. A study of premature infants showed no association between early motor development and attention problems at school age, and a study of high-risk children from a neonatal care unit found no association between abnormal general movements and later ADHD without comorbidity. The results of the studies are pointing in various directions. No firm conclusion can be drawn on early motor development in children with ADHD due to the very different results of the studies and the methodological heterogeneity.
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Affiliation(s)
- Sine Ravn Havmoeller
- Centre for Child and Adolescent Psychiatry, Research Department, Aarhus University Hospital, Aarhus, Denmark. .,Centre for Child and Adolescent Psychiatry, Research Department, Aarhus University Hospital, Skovagervej 2, 8240, Risskov, Denmark.
| | - Per H Thomsen
- Centre for Child and Adolescent Psychiatry, Research Department, Aarhus University Hospital, Aarhus, Denmark
| | - Sanne Lemcke
- Centre for Child and Adolescent Psychiatry, Research Department, Aarhus University Hospital, Aarhus, Denmark
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35
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Affiliation(s)
- Lucy Alderson
- Physiotherapy Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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36
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Thébault G, Martin S, Brouillet D, Brunel L, Dinomais M, Presles É, Fluss J, Chabrier S, Dégano C, Delion M, Deron J, Dray G, Drutel L, Groeschel S, Hertz‐Pannier L, Husson B, Kossorotoff M, Lazaro L, Lefranc J, The Tich SN, Peyric É, Ravel M, Renaud C, Vuillerot C. Manual dexterity, but not cerebral palsy, predicts cognitive functioning after neonatal stroke. Dev Med Child Neurol 2018; 60:1045-1051. [PMID: 29624666 DOI: 10.1111/dmcn.13752] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/06/2018] [Indexed: 12/20/2022]
Abstract
AIM To disentangle the respective impacts of manual dexterity and cerebral palsy (CP) in cognitive functioning after neonatal arterial ischaemic stroke. METHOD The population included 60 children (21 females, 39 males) with neonatal arterial ischaemic stroke but not epilepsy. The presence of CP was assessed clinically at the age of 7 years and 2 months (range 6y 11mo-7y 8mo) using the definition of the Surveillance of CP in Europe network. Standardized tests (Nine-Hole Peg Test and Box and Blocks Test) were used to quantify manual (finger and hand respectively) dexterity. General cognitive functioning was evaluated with the Wechsler Intelligence Scale for Children, Fourth Edition. Simple and multiple linear regression models were performed while controlling for socio-economic status, lesion side, and sex. RESULTS Fifteen children were diagnosed with CP. In simple regression models, both manual dexterity and CP were associated with cognitive functioning (β=0.41 [p=0.002] and β=0.31 [p=0.019] respectively). However, in multiple regression models, manual dexterity was the only associated variable of cognitive functioning, whether or not a child had CP (β=0.35; p=0.007). This result was reproduced in models with other covariables (β=0.31; p=0.017). INTERPRETATION As observed in typically developing children, manual dexterity is related to cognitive functioning in children having suffered a focal brain insult during the neonatal period. WHAT THIS PAPER ADDS Manual dexterity predicts cognitive functioning after neonatal arterial ischaemic stroke. Correlations between manual dexterity and cognitive functioning occur irrespective of sex, lesion side, presence of cerebral palsy, and socio-economic status. Residual motor ability may support cognitive functioning.
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Affiliation(s)
- Guillaume Thébault
- INSERM, UMR1059 Sainbiose, University of Saint-Étienne, University of Lyon, Saint-Étienne.,University Paul Valéry Montpellier 3, University Montpellier, Montpellier
| | - Sophie Martin
- University Paul Valéry Montpellier 3, University Montpellier, Montpellier
| | - Denis Brouillet
- University Paul Valéry Montpellier 3, University Montpellier, Montpellier
| | - Lionel Brunel
- University Paul Valéry Montpellier 3, University Montpellier, Montpellier
| | - Mickaël Dinomais
- Laboratoire d'Ingénierie des Systèmes Automatisés (LISA), University of Angers, Angers.,Physical and Rehabilitation Medicine Department, LUNAM, CHU Angers, Angers, France
| | - Émilie Presles
- INSERM, UMR1059 Sainbiose, University of Saint-Étienne, University of Lyon, Saint-Étienne
| | - Joel Fluss
- Paediatric Neurology Unit, Geneva University Hospitals, Geneva, Switzerland
| | - Stéphane Chabrier
- INSERM, UMR1059 Sainbiose, University of Saint-Étienne, University of Lyon, Saint-Étienne.,Paediatric Physical and Rehabilitation Medicine Department, French Centre for Paediatric Stroke, INSERM CIC1408, CHU Saint-Étienne, Saint-Étienne, France
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Senju A, Shimono M, Tsuji M, Suga R, Shibata E, Fujino Y, Kawamoto T, Kusuhara K. Inability of infants to push up in the prone position and subsequent development. Pediatr Int 2018; 60:811-819. [PMID: 29904976 DOI: 10.1111/ped.13632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 04/12/2018] [Accepted: 06/12/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND During routine health screening, some infants cannot maintain the prone position with extended arm support at 6 months. Little is known, however, about the development of full-term infants with this developmental deviation. We investigated the developmental course of infants with this characteristic. METHODS We enrolled 2,020 full-term infants who had been recruited at a regional center for the Japan Environment and Children's Study. Their development was measured using the Ages and Stages Questionnaire, third edition, at 0.5, 1, 1.5, 2, 2.5, and 3 years. The children were grouped according to their ability to stay prone on extended arms at 6 months, and their development was compared. RESULTS A total of 1,625 infants could stay prone on extended arms and 179 could not. We excluded 212 infants who could stay prone on extended arms only sometimes, and four who did not have a questionnaire response. In the gross motor domain, significant difference in questionnaire scores was observed between the "could" and "could-not" groups at 6 months (Hedges' g, 1.83) and persisted until 3 years (Hedges' g, 0.33). Significant differences were also observed in the communication, fine motor, problem solving, and personal-social domains at 6 months (Hedges' g, 0.20-0.58) and persisted until 1, 2, 2, and 1.5 years, respectively (Hedges' g, 0.21-0.25). CONCLUSIONS Infants who cannot maintain the prone position on extended arms lag behind those who can, although the effect sizes become relatively small after 1.5 years of age. Early intervention may be considered if delay is problematic or persistent.
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Affiliation(s)
- Ayako Senju
- Regional Center for Japan Environment and Children's Study (JECS), University of Occupational and Environmental Health, Kitakyushu, Japan.,Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masayuki Shimono
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Mayumi Tsuji
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Reiko Suga
- Regional Center for Japan Environment and Children's Study (JECS), University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Eiji Shibata
- Department of Obstetrics and Gynecology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Toshihiro Kawamoto
- Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Koichi Kusuhara
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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Fjørtoft T, Ustad T, Follestad T, Kaaresen PI, Øberg GK. Does a parent-administrated early motor intervention influence general movements and movement character at 3months of age in infants born preterm? Early Hum Dev 2017; 112:20-24. [PMID: 28672273 DOI: 10.1016/j.earlhumdev.2017.06.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/13/2017] [Accepted: 06/23/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Studies of preterm and term-born infants have shown absent fidgety movements and an abnormal movement character to be related to brain lesions and unfavourable neurological outcomes. AIMS The present study examines what effect a parent-administered early intervention program applied to preterm infants in a randomised control trial (RCT) between 34 and 36weeks gestational age has on their fidgety movements and overall movement character at three months of age. STUDY DESIGN The study was part of the RCT in an early intervention programme including preterm infants born between 2010 and 2014 at three Norwegian university hospitals. SUBJECTS 130 preterm infants participated in the study, with 59 of them in the control group and 71 in the intervention group. OUTCOME MEASURES Fidgety movements and overall movement character at three months corrected age. RESULTS No difference was found between the intervention group and the control group in terms of fidgety movements or movement character. Approximately half of the infants in both groups showed an abnormal movement character. CONCLUSION No evidence was found in this RCT to suggest that an intervention at 34 to 37weeks gestational age has a significant effect on the fidgety movements or overall movement character of preterm infants. This is in line with the assumption that absent fidgety movements and an abnormal movement character are due to permanent brain injury and are therefore good predictors for later neurological impairments.
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Affiliation(s)
- Toril Fjørtoft
- Clinics of Clinical services, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Tordis Ustad
- Clinics of Clinical services, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Turid Follestad
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Per Ivar Kaaresen
- Faculty of Clinical Medicine, University of Tromsø, The Arctic University of Norway, Norway; Pediatric and Adolescent Department, University Hospital North Norway, Tromsø, Norway
| | - Gunn Kristin Øberg
- Department of Health and Care Sciences, University of Tromsø, The Arctic University of Norway, Norway
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Salavati S, Einspieler C, Vagelli G, Zhang D, Pansy J, Burgerhof JGM, Marschik PB, Bos AF. The association between the early motor repertoire and language development in term children born after normal pregnancy. Early Hum Dev 2017; 111:30-35. [PMID: 28549271 PMCID: PMC5951278 DOI: 10.1016/j.earlhumdev.2017.05.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 05/03/2017] [Accepted: 05/15/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND The assessment of the early motor repertoire is a widely used method for assessing the infant's neurological status. AIM To determine the association between the early motor repertoire and language development. STUDY DESIGN Prospective cohort study. SUBJECTS 22 term children born after normal pregnancy; video recorded for the assessment of the early motor repertoire including their motor optimality score (MOS), according to Prechtl, at 3 and 5months post term. OUTCOME MEASURES At 4years 7months and 10years 5months, we tested the children's language performance by administering three tests for expressive language and two for receptive language. RESULTS Smooth and fluent movements at 3months of age was associated with better expressive language outcome at both 4years 7months and 10years 5months (betas 0.363 and 0.628). A higher MOS at 5months was associated with better expressive language at both ages (betas 0.486 and 0.628). The item postural patterns at 5months was the only aspect associated with poorer expressive language outcome (beta -0.677). CONCLUSION Predominantly, qualitative aspects of the early motor repertoire at the age of 3 and 5months are associated with language development.
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Affiliation(s)
- Sahar Salavati
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; iDN - Interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Austria.
| | - Christa Einspieler
- iDN - Interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Austria
| | - Giulia Vagelli
- SMILE Lab, Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Dajie Zhang
- iDN - Interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Austria
| | - Jasmin Pansy
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Johannes G M Burgerhof
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter B Marschik
- iDN - Interdisciplinary Developmental Neuroscience, Department of Phoniatrics, Medical University of Graz, Austria; Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Arend F Bos
- Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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40
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Ghassabian A, Sundaram R, Bell E, Bello SC, Kus C, Yeung E. Gross Motor Milestones and Subsequent Development. Pediatrics 2016; 138:peds.2015-4372. [PMID: 27354457 PMCID: PMC4925077 DOI: 10.1542/peds.2015-4372] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE We examined the longitudinal associations of age at achieving gross motor milestones and children's development in a US cohort of singletons and twins. METHODS In the Upstate KIDS study, a population-based study of children born between 2008 and 2010, information on age at achievement of motor milestones and developmental skills was available in 599 children (314 singletons, 259 twins, and 26 triplets). Mothers reported their children's major motor milestones at ∼4, 8, 12, 18, and 24 months. At age 4 years, children's development was clinically assessed by using the Battelle Developmental Inventory, Second Edition (BDI-2). Primary analyses by using multivariate linear regressions were conducted in singletons. We also examined the associations in twins. RESULTS Later achievement of standing with assistance predicted lower BDI-2 scores in singletons in adjusted models (B per SD of age at achievement, -21.9 [95% confidence interval (CI), -41.5 to -2.2]). Post hoc analysis on age of standing with assistance showed that associations were driven by differences in adaptive skills (B = -5.3 [95% CI, -9.0 to -1.6]) and cognitive skills (B = -5.9 [95% CI, -11.5 to -0.4]). Analyses restricted to twins suggested no association between the age at achievement of milestones and total BDI-2 score after adjustment for gestational age and birth weight. CONCLUSIONS This study provides evidence that the age of achieving motor milestones may be an important basis for various aspects of later child development. In twins, key predictors of later development (eg, perinatal factors) overshadow the predictive role of milestones in infancy.
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Affiliation(s)
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Erin Bell
- Departments of Environmental Health Sciences and,Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, New York
| | | | - Christopher Kus
- Division of Family Health, New York State Department of Health, Albany, New York
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Yeh KK, Liu WY, Wong AMK, Chung CY, Lien R, Chuang YF. Intra-observer reliability of Prechtl's method for the qualitative assessment of general movements in Taiwanese infants. J Phys Ther Sci 2016; 28:1588-94. [PMID: 27313378 PMCID: PMC4905917 DOI: 10.1589/jpts.28.1588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 02/03/2016] [Indexed: 11/25/2022] Open
Abstract
[Purpose] The aim of this study was to examine the intra-observer reliability for Prechtl's General Movements Assessment in Taiwanese infants. This includes the global General Movements Assessment, the Optimality List for Preterm General Movements and Writhing Movements, and the Assessment of Motor Repertoire-3 to 5 Months. [Subjects and Methods] Fifty-nine videos of 37 infants were observed and rated by one physical therapist twice. [Results] The intra-observer reliability ranged from good to very good for the global General Movements Assessment. The overall intra-observer reliabilities for the total score of the Optimality List from preterm up to postmenstrual age 46 weeks and the total score of the Assessment of Motor Repertoire for postmenstrual age 49 to 60 weeks were both good. [Conclusion] The results suggest that the intra-observer reliability of a certified physical therapist was satisfactory for Prechtl's method in Taiwanese infants.
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Affiliation(s)
- Kuo-Kuang Yeh
- Department of Physical Medicine and Rehabilitation, Chang
Gung Medical Foundation, Linkou Medical Center, Taiwan
- Department of Physical Therapy and Graduation, Institute of
Rehabilitation Science, College of Medicine, Chang Gung University, Taiwan
| | - Wen-Yu Liu
- Department of Physical Medicine and Rehabilitation, Chang
Gung Medical Foundation, Linkou Medical Center, Taiwan
- Department of Physical Therapy and Graduation, Institute of
Rehabilitation Science, College of Medicine, Chang Gung University, Taiwan
| | - Alice May-Kuen Wong
- Department of Physical Medicine and Rehabilitation, Chang
Gung Medical Foundation, Linkou Medical Center, Taiwan
- Department of Physical Therapy and Graduation, Institute of
Rehabilitation Science, College of Medicine, Chang Gung University, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang
Gung Medical Foundation, Taoyuan Branch, Taiwan
| | - Chia-Ying Chung
- Department of Physical Medicine and Rehabilitation, Chang
Gung Medical Foundation, Linkou Medical Center, Taiwan
| | - Reyin Lien
- Department of Neonatology, Chang Gung Medical Foundation,
Linkou Medical Center, Taiwan
| | - Yu-Fen Chuang
- Department of Physical Therapy and Graduation, Institute of
Rehabilitation Science, College of Medicine, Chang Gung University, Taiwan
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Hamer EG, Bos AF, Hadders-Algra M. Specific characteristics of abnormal general movements are associated with functional outcome at school age. Early Hum Dev 2016; 95:9-13. [PMID: 26896696 DOI: 10.1016/j.earlhumdev.2016.01.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 01/13/2016] [Accepted: 01/19/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Assessing the quality of general movements (GMs) is a non-invasive tool to identify at early age infants at risk for developmental disorders. AIM To investigate whether specific characteristics of definitely abnormal GMs are associated with developmental outcome at school age. STUDY DESIGN Observational cohort study (long-term follow-up). SUBJECTS Parents of 40 children (median age 8.3 years, 20 girls) participated in this follow-up study. In infancy (median corrected age 10 weeks), the children (median gestational age 30.3 weeks; birth weight 1243 g) had shown definitely abnormal GMs according to Hadders-Algra (2004). Information on specific GM characteristics such as the presence of fidgety movements, degree of complexity and variation, and stiff movements, was available (see Hamer et al. 2011). OUTCOME MEASURES A standardised parental interview (presence of CP, attendance of school for special education, Vineland Adaptive Behavior Scale to determine functional performance) and questionnaires (Developmental Coordination Disorder Questionnaire [DCD-Q] to evaluate mobility and Child Behavior Checklist to assess behaviour) were used as outcome measures. RESULTS Six children had cerebral palsy (CP), ten children attended a school for special education, and eight children had behavioural problems. Both the absence of fidgety movements and the presence of stiff movements were associated with CP (p=0.001; p=0.003, respectively). Stiff movements were also related to the need of special education (p=0.009). A lack of movement complexity and variation was associated with behavioural problems (p=0.007). None of the GM characteristics were related to DCD-Q scores. CONCLUSIONS The evaluation of fidgety movements and movement stiffness may increase the predictive power of definitely abnormal GMs for motor outcome--in particular CP. This study endorses the notion that the quality of GMs reflects the integrity of the infant's brain, assisting prediction of long-term outcome.
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Affiliation(s)
- Elisa G Hamer
- Department of Pediatrics, Division of Developmental Neurology, University of Groningen, University Medical Center, Groningen, The Netherlands; Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Arend F Bos
- Department of Pediatrics, Division of Neonatology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - Mijna Hadders-Algra
- Department of Pediatrics, Division of Developmental Neurology, University of Groningen, University Medical Center, Groningen, The Netherlands.
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High prevalence of abnormal motor repertoire at 3 months corrected age in extremely preterm infants. Eur J Paediatr Neurol 2016; 20:236-242. [PMID: 26786751 DOI: 10.1016/j.ejpn.2015.12.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 11/10/2015] [Accepted: 12/06/2015] [Indexed: 11/21/2022]
Abstract
AIMS To compare early motor repertoire between extremely preterm and term-born infants. An association between the motor repertoire and gestational age and birth weight was explored in extremely preterm infants without severe ultrasound abnormalities. METHODS In a multicentre study, the early motor repertoire of 82 infants born extremely preterm (ELGAN:<28 weeks) and/or with extremely low birth weight (ELBW:<1000 g) and 87 term-born infants were assessed by the "Assessment of Motor Repertoire - 2 to 5 Months" (AMR) which is part of Prechtl's "General Movement Assessment", at 12 weeks post-term age. Fidgety movements were classified as normal if present and abnormal if absent, sporadic or exaggerated. Concurrent motor repertoire was classified as normal if smooth and fluent and abnormal if monotonous, stiff, jerky and/or predominantly fast or slow. RESULTS Eight-teen ELBW/ELGAN infants had abnormal fidgety movements (8 absent, 7 sporadic and 3 exaggerated fidgety movements) compared with 2 control infants (OR:12.0; 95%CI:2.7-53.4) and 46 ELBW/ELGAN infants had abnormal concurrent motor repertoire compared with 17 control infants (OR:5.3; 95%CI:2.6-10.5). Almost all detailed aspects of the AMR differed between the groups. Results were the same when three infants with severe ultrasound abnormalities were excluded. In the remaining ELBW/ELGAN infants, there was no association between motor repertoire and gestational age or birth weight. CONCLUSION ELBW/ELGAN infants had poorer quality of early motor repertoire than term-born infants.The findings were not explained by severe abnormalities on neonatal ultrasound scans and were not correlated to the degree of prematurity. The consequences of these abnormal movement patterns remain to be seen in future follow-up studies.
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Lev-Enacab O, Sher-Censor E, Einspieler C, Daube-Fishman G, Beni-Shrem S. The Quality of Spontaneous Movements of Preterm Infants: Associations with the Quality of Mother-Infant Interaction. INFANCY 2015. [DOI: 10.1111/infa.12096] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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