The rate of motor impairment in EP and/or ELBW children assessed at 8 years of age increased between eras, an increase caused by non-CP motor impairment.

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Aim To explore the efficacy of movement‐based interventions to improve motor skills in preschool‐age children with, or at risk of, motor impairment, including those with a diagnosis of cerebral palsy, autism spectrum disorder, and developmental coordination disorder. Method Relevant electronic databases were searched for randomized or quasi‐randomized controlled trials. Outcomes were classified using domains of the International Classification of Functioning, Disability and Health: Children & Youth version. Quality was assessed using the Physiotherapy Evidence Database scale. Risk of bias was assessed using the Cochrane Risk of Bias tool. Effect sizes were calculated using Cohen’s d. Results Seventeen articles exploring a heterogeneity of intervention types, population groups, and outcome measures met the inclusion criteria. Movement‐based interventions did not significantly improve outcomes in either the body structure and function or activity domains in most studies. No studies used a participation outcome measure. Interpretation There is a paucity of evidence exploring movement‐based interventions in the preschool‐age group. Although movement‐based interventions showed potential for improving body structure and function and activity outcomes for children with motor impairment, results were mostly not significant. Small sample sizes, variable study quality, and risk of bias limit confidence in the results. What this paper adds The evidence is inconclusive to support movement‐based interventions in this group. No studies used outcome measures assessing participation. Variability in intervention type and study quality limit confidence in results.

Objective Children born < 30 weeks’ gestation have more motor impairment than do children born at term (37–42 weeks’ gestation), but reported outcomes have largely focused on cerebral palsy (CP) and Developmental Coordination Disorder (DCD). The aim of this study was to compare muscle strength, motor skills and physical activity of preschool-aged children born < 30 weeks with those born at term. Methods In this cohort study, 123 children born < 30 weeks and 128 born at term were assessed. Children were ≥ 4 years, 0 months and < 6 years, 0 months’ corrected age at the time of the assessment. Outcomes included: grip strength (kg), Movement Assessment Battery for Children 2nd edition (MABC-2), Little Developmental Coordination Disorder Questionnaire (L-DCDQ), accelerometer-measured physical activity (PA), and a parent-completed PA diary. Linear regression and mixed effects models were used to examine differences between children born < 30 weeks and those born at term. Results Children born < 30 weeks had poorer grip strength (preferred hand; mean difference [95% confidence interval] -0.60 kg [−1.04, −0.15], p = 0.008) and poorer motor competence (MABC-2 standard score mean difference − 2.17 [−3.07, −1.27], p < 0.001; L-DCDQ total score mean difference − 5.5 [−9.2, −2.8], p < 0.001) than term-born children. Children born < 30 weeks also completed fewer minutes of accelerometer-measured PA (mean difference − 41 minutes, [−62, −20], p < 0.001), more minutes of accelerometer-measured stationary behavior (mean difference 33 minutes, [12, 54], p = 0.002), and more minutes of parent-reported screen time (mean difference 21 minutes, [10, 32], p < 0.001) per day. Conclusions Preschool-aged children born < 30 weeks had poorer muscle strength, motor skills and physical activity levels than term-born children. These findings suggest that preschool-aged children born < 30 weeks may benefit from enhanced surveillance and PA promotion to improve life-long health outcomes. Impact In our study, children born < 30 weeks had reduced muscle strength, poorer motor skills, participated in less physical activity (PA), and had more stationary and screen behaviour than term-born children. These findings emphasize that awareness of multidomain motor deficits in children born < 30 weeks’ gestation is needed in clinical practice. Given the associations between higher PA and health benefits, and recognition that PA levels can track from early childhood into adulthood, our study highlights the need for assessment and promotion of PA in preschool-aged children born < 30 weeks’ gestation. Lay Summary Children born < 30 weeks had reduced muscle strength, poorer motor skills, participated in less physical activity (PA), and had more stationary and screen behavior than term-born children. Awareness of multidomain motor deficits in children born at < 30 weeks’ gestation is needed in clinical practice. Given the associations between higher PA and health benefits, and in recognition that PA levels can track from early childhood into adulthood, this study highlights the need for assessment and promotion of PA in preschool-aged children born at < 30 weeks’ gestation.

In Australia, approximately 18% of newborn babies are admitted to a neonatal intensive or special care nursery. While most babies admitted to a neonatal intensive or special care nursery are discharged home within a few weeks, around 6% of babies spend more than 2 weeks in hospital. For the parents of these babies, much of their leave entitlements (Australian Government Paid Parental Leave Scheme is up to18 weeks for the primary care giver and up to 2 weeks for partners) are used before their baby comes home from hospital. The time babies and parents spend together in the early developmental period, during the hospitalisation and when the baby is discharged home, is crucial for optimal child development and bonding. Yet care givers who have a baby admitted to neonatal intensive or special care for extended periods are not currently entitled to any extra parental leave payments in Australia. We recommend the Australian Paid Parental Leave Act is changed to allow primary carers access to 1 week of extra parental leave pay for every week in hospital (for babies admitted to hospital for more than 2 weeks), up to a maximum of 14 weeks. For fathers and partners of these babies, we recommend an additional 2 weeks of extra Dad and Partner Pay. The net cost, taking into account likely productivity benefits, would be less than 1.5% of the current cost of the scheme and would improve health and socio‐economic outcomes for the baby, family and society.

Aim: The study aim was to (1) investigate the barriers and enablers experienced by consumers to accessing and engaging with health tools in hospital waiting areas and (2) evaluate consumers’ ideas for designing a health literacy responsive waiting area. Background: Health information, resources, and supports (“health tools”) in waiting areas should be responsive to the health literacy needs of consumers. However, consumers’ experiences of using health tools and their ideas for improving them are not known. Methods: Multicenter study was set in hospital waiting areas of outpatient rehabilitation services. Semistructured in-person interviews were conducted with 33 adult consumers attending appointments for various health conditions. Seven stages of the Framework Method were used to analyze data. Results: Six themes were identified which explained barriers and enablers from the perspective of consumers. The barriers were accessibility issues; personal factors—physical condition, emotional state, and preferences; and poorly presented and outdated resources. The enablers were design suits consumer needs and preferences; usable in available time or portable; and compatible environment for engaging and sharing. Consumers shared design ideas which fit within four typologies. Conclusions: A range of barriers and enablers exist which have an impact on consumers’ ability to engage with available health information, resources, and supports in hospital outpatient waiting areas. Practical insights from the perspective of consumers can be applied to future health service design. Consumer’s design ideas suggest that partnerships with consumers should be formed to design health literacy responsive waiting areas.

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