Effect of Neonatal Posture on Later Lower Limb Rotation and Gait in Premature Infants

Katz, Kenneth A.; Krikler, R.; Wielunsky, E.; Merlob, Paul

doi:10.1097/01241398-199107000-00019

Cited by 14 publications

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“…Concerning lower limbs ("frog leg" posture), external rotation disappeared more significantly in the "Coconou" group than in "Home-Cocoon group," which is in favor of the lateral rolled pads linked to a small pad supporting the pelvis and preventing the external rotation of the knees. This physiologic support is also important for motor outcome of lower limbs 5,16,27 preventing hip deformities or muscular retractions. 3,4,6,7 Our findings point out very significant incidental postural abnormalities in head, arm, and knee position linked to the length of time spent (between 10 and 20 days) in the NICU, while the preterms were cared for predominantly in prone position.…”

Section: Discussionmentioning

confidence: 99%

“…Prolonged lying position, prone or supine, results in the body being flattened against the mattress, leading to postural deformities that can reinforce neurologic abnormalities, 2 such as hip abduction and external rotation, [3][4][5][6][7] lateral flexion and elevation of upper limbs with scapular retraction, [8][9][10][11] flattened head (plagiocephaly), 2,12-14 abnormal movement patterns, and delays in reaching developmental milestones and acquiring motor skills. 2,3,9,15,16 Correct body positioning can prevent some of these abnormalities, according to some studies, by using small rolled-up sheets or bean bags, 4,5 special pillows, 12 or postural support nappies. 7 However, few studies 2 have examined and tested the effect of a support to reduce postural abnormalities, and they assess only the optimal development of different parts of the body, such as upper or lower limbs.…”

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confidence: 99%

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Comparative Effects of 2 Positional Supports on Neurobehavioral and Postural Development in Preterm Neonates

Vaivre‐Douret

Golse

2007

Journal of Perinatal &Amp; Neonatal Nursing

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Preventing abnormal neurobehavioral and postural development requires careful nursing in preterm neonates. The purpose of this prospective study is to assess the effects of 2 different lying-position body supports for physiologic and functional positioning. Thirty preterm neonates were eligible, born between 28 and 35 weeks' gestation. A first sample experimented with a "Home-Cocoon" support made by nurses with rolled sheets, and a second sample provided a "Coconou" support, made with a specifically designed rolled pad. Assessments of body posture and of neurobehavior were administered pretest (on admission without support) and posttest (at discharge). In addition, nurses were asked to answer a questionnaire concerning motor behavior. All preterm neonates showed gains in postural development, but the "Coconou" group performed significantly better than the "Home-Cocoon" group, with fewer cranial deformities, with head positioning, arm relaxation, and better orthopedic leg position. The overall quality of behavior increased for the 2 groups, but visual pursuit was very significantly better for the "Coconou" group. Nurses' assessment was also better for the "Coconou" support. These results point to the benefits of positioning with a specifically designed support like "Coconou," promoting optimal prophylactic neurobehavioral and postural developmental care for preterm neonates.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Comparative Effects of 2 Positional Supports on Neurobehavioral and Postural Development in Preterm Neonates

Vaivre‐Douret

Golse

2007

Journal of Perinatal &Amp; Neonatal Nursing

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“…However, ultrasound examination of the hip is recommended if these motions do not change during the following weeks. Increased range of lateral rotation and decreased range of medial rotation should not be regarded as rotational deformities in preterm infants: rotation spontaneously returns to normal values as the infants grow (Katz et al 1991).…”

Section: Discussionmentioning

confidence: 99%

Normal Ranges of Hip Motion of Preterm Infants

Katz¹,

Davidson²,

Dulitzky³

1992

Journal of Pediatric Orthopaedics

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Hip motion undergoes continuous changes during infancy (Coon et al. 1975, Phelps et al. 1985. Several authors have discussed the importance of knowing normal ranges of hip motion in various agegroups for the evaluation and treatment of motor problems (Phelps et al. 1985). Limited abduction or marked abduction and decreased flexion contractures sometimes are associated with unstable hips in term infants (Wynne-Davies 1970, Renshaw 1986).Much information is available about the hip motion of term infants, but such data are not available for preterm infants. The present study was designed to establish normal values of hip motion for preterm infants of various gestational ages. PatientsThe hip motion of 158 preterm infants (89 female, 69 male) with gestational ages (GA) between 25 and 36 weeks was measured during their first week of life. Their birthweights ranged from 610 to b500g: 45 (28 per cent) weighed < 1500g. 47 infants were the results of multiple pregnancy; 76 were delivered by caesarean section and 21 presented by the breech.Those with birthweights < 1S00g received mechanical ventilation. All others were managed without any form of ventilation. Oxygen, if needed, was supplied by hood.None of the infants had structural deformities or hip instability, as assessed by Ortolani and Barlow tests and by ultrasonography on discharge from the NICU.The infants who received mechanical ventilation were nursed supine: all the other infants were nursed prone during their stay in the NICU.The infants were divided into 12 groups, according to GA, each comprising between four and 26 infants (see Table 11). MethodThe methods of measurement used have been described previously (Forero et al. 1989). Measurements were obtained from the left leg only, based on the finding of Haas et al. (1973) that there is no significant difference in range of motion between the right and left hips of newborn infants. A clear plastic goniometer with a 180" dial in 5' increments was used, and all angles were measured to the nearest 5'. Diapers were removed and the beginning and end positions of hip flexion, abduction, adduction, medial and lateral rotation of the hip were measured.The beginning and end positions of hip flexion were measured with the infant supine. The greater trochanter and lateral condyle of the femur were marked, with the hip in extension, for proper placement of the goniometer arms. The goniometer P m m m m m m m e 5 993

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“…This posture may cause children to walk with a marked out-toeing gait for 4 to 6 years or longer (Davis et al, 1993;Katz et al, 1991;Konishi et al, 1994). The posture may also be cosmetically displeasing for parents, who would prefer their infants to look like their full-term counterparts (Budreau, 1987).…”

Section: Postural Complications Of Prone Positioningmentioning

confidence: 99%

Neuromotor Development and the Physiologic Effects of Positioning in Very Low Birth Weight Infants

Monterosso¹,

Kristjanson²,

Cole³

2002

J Obstet Gynecol Neonatal Nurs

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Objective: To provide a comprehensive literature review of neuromotor development and related physiologic effects of positioning in very low birth weight infants.Data Sources: MEDLINE, CINHAL, Health Star, Current Contents, and the Australian Medical Index (1966−2000) databases were searched. Unpublished studies (e.g., dissertations, conference proceedings) and all relevant references listed in articles also were examined.Study Selection: One hundred and eighty theoretical writings, research studies, and clinical papers related to neuromotor development, the physiologic effects of positioning, and interventions to minimize or prevent short-and long-term effects of positioning in very low birth weight infants were reviewed.Data Extraction: Studies were assessed for scientific rigor, evidence of theoretical foundation, and clinical relevance. Comparisons were made across data sources to determine the most reliable, valid, and consistent findings.Data Synthesis: Three compelling results emerged: (a) The development of posture and mobility in newborn infants requires an optimal balance between active and passive muscle tone, (b) the prone position is physiologically more beneficial for the preterm infant than supine and lateral positions, and (c) the prone position can lead to short-and long-term postural and associated developmental problems.Conclusion: Use of empirically tested postural interventions appropriate for an infant's gestational age, health status, and overall organizational capacity is recommended. JOGNN, 31, 138-146; 2002.

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Effect of Neonatal Posture on Later Lower Limb Rotation and Gait in Premature Infants

Cited by 14 publications

References 0 publications

Comparative Effects of 2 Positional Supports on Neurobehavioral and Postural Development in Preterm Neonates

Comparative Effects of 2 Positional Supports on Neurobehavioral and Postural Development in Preterm Neonates

Normal Ranges of Hip Motion of Preterm Infants

Neuromotor Development and the Physiologic Effects of Positioning in Very Low Birth Weight Infants

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