Neuromotor development of preterm and full-term infants

Gorga, Delia; Stern, Francine Martin; Ross, Gail; Nagler, Willibald

doi:10.1016/0378-3782(88)90050-3

Cited by 57 publications

(32 citation statements)

References 7 publications

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“…Clinical studies indicated that the quality of reaching and grasping behavior in LR preterm infants is less satisfactory than that in FT infants (9,11,12). To the best of our knowledge no data have been reported on the development of kinematic characteristics of reaching movements in preterm infants.…”

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confidence: 88%

Kinematic Quality of Reaching Movements in Preterm Infants

et al. 2003

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Many preterm infants may experience so-called minor developmental disorders; however, in general, the problems in motor behavior are not detected until school age. To introduce therapies aimed at the prevention of these problems, we need to increase our knowledge of motor function and dysfunction at early age. The present study focused on the organization of reaching movements in full-term and preterm infants without cerebral palsy. The reaching behavior of premature infants (n ϭ 63) was assessed longitudinally at the corrected ages of 4 and 6 mo. Clinical assessments were made at 6 and 12 mo of age. On the basis of the infant's morbidity during the early stay in the neonatal intensive care unit, the preterm infants were allocated into a high-risk and a low-risk group. Results from a previous study in full-term infants (n ϭ 13) were included. Kinematics of reaching movements in supine position were measured, and the analysis focused on movement velocity and movement units. A compound parameter of kinematic variables was created, reflecting the quality of reaching movements. The present study showed that at the age of 4 mo, low-risk preterm infants showed more often optimal reaching behavior than full-term and preterm high-risk infants. This better reaching performance was related to a better general motor and behavioral development during the first year of life. At the age of 6 mo, the advantage of the low-risk group in reaching behavior had disappeared and a disadvantage in the form of nonoptimal reaching behavior of the high-risk group emerged. There is an increasing awareness that many preterm infants may experience subtle long-term morbidities. Usually these so-called minor developmental disorders, such as clumsiness and specific learning disorders, are identified first at school age (1-3). It has been questioned whether these minor developmental disorders can be detected at early age, so that intervention aiming at the prevention of problems that interfere with academic achievement could be introduced timely.Recently, evidence has been provided that early motor development in preterm infants without major developmental disorders differs from that of full-term (FT) infants. The majority of studies focused on postural development. They indicated that so-called "low-risk" preterm infants show significantly more often an exaggerated trunk extension (4, 5) or "transient dystonia" (6, 7) than FT infants. Van der Fits et al. (8), who studied the development of postural adjustments during reaching, reported that low-risk (LR) preterm infants showed an excessive amount of postural activity. Moreover, the postural adjustments of the preterm infants were temporally disorganized and could not be modulated to task-specific conditions, such as the velocity of the reaching arm and sitting position. The mild dysfunctions in postural control of preterm infants are related to a poorer quality of reaching and grasping at the age of 1 y (9, 10) and possibly also to motor dysfunctions (7) or learning problems (6) at school age...

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confidence: 88%

Kinematic Quality of Reaching Movements in Preterm Infants

et al. 2003

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“…Hadders-Algra and co-workers (5,6) reported that abnormal GM at 2-4 mo are also related to complex MND and fine manipulative dysfunction. Both nonoptimal reaching and abnormal GM may point to a deficit in the planning or coordination of movements-in reaching, an inadequate number of MU (24) and inadequate velocity profile; in GM, a deficiency in movement complexity and variation (25), an inability to fine-tune motor output, and nonfluent movements (26). It is plausible that a deficiency in planning or coordinating movements puts the child at risk for complex MND and fine manipulative disability.…”

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confidence: 99%

Quality of Reaching and Postural Control in Young Preterm Infants Is Related to Neuromotor Outcome at 6 Years

et al. 2005

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A substantial proportion of the "apparently normal" preterm infants exhibit minor and moderate dysfunctions in neuromotor outcome as they grow older. Birth characteristics, minor abnormalities on the neonatal ultrasound scan of the brain, and motor milestones have only limited value in the early detection of these children. The aim of the present study was to investigate whether nonoptimal reaching and relatively immobile postural behavior at an early age are associated with dysfunctional neuromotor and behavioural development at school age. The preterm children and full-term children of the present follow-up study participated in a previous study on the characteristics of reaching kinematics and the kinetics of posture at 4 and 6 mo corrected age. At the age of 6 y, the children were re-assessed by means of the Touwen neurologic assessment, the Movement ABC, and the Child Behavior Check List. The results demonstrated that in preterm children without cerebral palsy, a lack of successful reaching at 4 mo and a nonoptimal quality of reaching at 6 mo are related to the development of a complex form of minor neurologic dysfunction (MND) and fine manipulative disability at 6 y. Thus, these early signs indicate the presence of clinically significant brain dysfunction. A relatively immobile postural behavior at 4 mo was associated with simple MND, coordination problems, and at 6 mo with a worse score on the Movement ABC and internalizing behavior. This suggests that a relatively immobile postural behavior points to a mild form of brain dysfunction. A substantial proportion of "apparently neurologically normal" preterm infants do exhibit minor and moderate dysfunctions in neuromotor outcome as they grow older (1). Yet, these dysfunctions, which may seriously interfere with daily living activities, are not generally detected before school age. We therefore need to increase our knowledge of risk factors and patterns of early neuromotor development that relate to impaired motor outcome at school age. So far, the prospective value of birth characteristics and minor abnormalities on the neonatal ultrasound scan of the brain have been inconsistent for later motor impairments in this preterm group (1,2).Prediction of motor impairments at school age on the basis of the assessment of motor milestones at an early age is hampered by the presence of many false negatives (3,4). Prediction based on the quality of early motor behavior may be better. Recent work by 6) indicated that an abnormal quality of GM, which had been present until about 4 mo corrected age, was related to MND at early and later school age. A nonoptimal quality of specific motor functions, such as reaching and grasping at 9 mo, has also been associated with reduced quality of hand motor performance at 2.6 y (7).Preterm infants often show an abnormal quality of postural behavior (8), which has been addressed in terms of transient

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“…For fluent movement these two components of muscle power should balance each other (for details see de Groot 1992ade Groot , 1993. These discrepancies have been well described and are clinically recognizable and intimately linked to, for example, hyperextension of trunk and shoulders leading to poor postural control (Georgieff et al 1986, Gorga et al 1988, de Groot et al 1992b. In turn, dysfunctional postural control is considered to be one of the key symptoms in children with major motor deficits (Aicardi et al 1998).…”

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Transient dystonias revisited: a comparative study of preterm and term children at 2¹/₂ years of age

Vries

Groot

2002

Develop Med Child Neuro

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Minor neurological dysfunctions (MND) have frequently been reported as an outcome of preterm birth. Behavioural and learning difficulties are a known feature, but coordination problems are especially described in preterm infants at later ages. All preterm infants in our study were born with a gestational age of <32 weeks and a birthweight of <1500 g. The aim of the study was to determine if in a normal clinical situation, children at risk for developing coordination problems could be detected by focusing particularly on their spontaneous, although elicited, motor performance. Forty-two children of 2 years 6 months of age were studied of whom 25 were 'low-risk' preterm and 17 were born at term. All children had been followed up since birth. In a structured, free-field situation the quality of body rotation, spontaneous reaching-out, and manipulation during parts of the Bayley Developmental Test were observed and videotaped. Body rotations were scored on a 2-point scale, and arm and hand functions on a 3-point scale. Most preterm infants showed nonoptimal body rotations and borderline or non-optimal arm and hand functions in contrast to most term children. A clear connection was found between less optimal body rotations and poor arm and hand functions. Retrospectively, poor arm and hand functions at 2 years 6 months seemed to be related to those at 39 weeks. At the age of 39 weeks a clear relation had been found between poor postural control (many preterm infants could not sit independently) and earlier hyperextension of the trunk at 18 weeks and quality of arm-hand functions. In the present study at 2 years 6 months a correlation with the former hyperextension could no longer be found, but there was a significant relation between poor trunk rotation and arm and hand function and the earlier arm and hand functions at 39 weeks.

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Neuromotor development of preterm and full-term infants

Cited by 57 publications

References 7 publications

Kinematic Quality of Reaching Movements in Preterm Infants

Kinematic Quality of Reaching Movements in Preterm Infants

Quality of Reaching and Postural Control in Young Preterm Infants Is Related to Neuromotor Outcome at 6 Years

Transient dystonias revisited: a comparative study of preterm and term children at 2¹/₂ years of age

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Neuromotor development of preterm and full-term infants

Cited by 57 publications

References 7 publications

Kinematic Quality of Reaching Movements in Preterm Infants

Kinematic Quality of Reaching Movements in Preterm Infants

Quality of Reaching and Postural Control in Young Preterm Infants Is Related to Neuromotor Outcome at 6 Years

Transient dystonias revisited: a comparative study of preterm and term children at 21/2 years of age

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Transient dystonias revisited: a comparative study of preterm and term children at 2¹/₂ years of age