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

Abstract

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.

Relationship Between Postural Control and Fine Motor Skills in Preterm Infants at 6 and 12 Months Adjusted Age

“…The results of this study expand the findings of previous studies that focused on only a single component or position (de Vries & de Groot, 2002;Fallang et al, 2003;Plantinga et al, 1997). These findings provide further evidence to support the relationship between general postural control and fine motor skills, including all of its components in different positions.…”

“…Past studies of postural control in premature infants (de Vries & de Groot, 2002;Fallang et al, 2003;Plantinga et al, 1997) examined only specific positions in the realm of possible postural control positions. For example, when studying the relationship between postural control and fine motor skills, Plantinga et al (1997) examined only the sitting position, de Vries and de Groot (2002) examined only trunk rotation, and Fallang et al (2003) focused only on reaching in the supine position.…”

The Effects of an Early Physical Therapy Intervention for Very Preterm, Very Low Birth Weight Infants: A Randomized Controlled Clinical Trial

“…6 -8 One motor phenomenon that has been identified as occurring among approximately one third of the preterm population in early infancy is transient dystonia, 9,10 more recently referred to as a faulty muscle power regulation. 11 Although the etiology of this condition is unknown, there are suggestions that this disorder is nonneurological, with a predominance of hyperextension of the trunk and extensor tone of the lower limbs evident. 3,[12][13][14][15][16] Transient dystonia has been linked to motor difficulties in early infancy, namely, in relation to rotational skills, gross motor skill acquisition, and quality of fine motor skill performance.…”

Exploring Objects With Feet Advances Movement in Infants Born Preterm: A Randomized Controlled Trial

“…17,18,26 More importantly, these differences often are predictive of future delays in functional skills such as walking or object exploration. 37,49,51 Thus, why is it that preterm infants appear to be relatively good at feet reaching, while struggling with other motor skills during young infancy? Galloway and Thelen 2 proposed that feet reaching was easier than hand reaching due, in part, to the interaction of 2 soft constraints: anatomical differences between the arms and legs and differences in early movement experiences of the arms and legs.…”

“…Various populations of preterm infants show marked differences from fullterm infants in terms of postural control, 48,49 reaching with the hands, 6 spontaneous kicking, 12,38,50 and kicking in the mobile paradigm. 17,18,26 More importantly, these differences often are predictive of future delays in functional skills such as walking or object exploration.…”