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Development of postural adjustments during reaching in preterm infants
I B van der Fits1, E R Flikweert, E F Stremmelaar
1Department of Medical Physiology-Developmental Neurology, University of Groningen, The Netherlands.
Insights
Preterm infants exhibit disorganized postural adjustments during reaching, potentially due to impaired learning. These motor control issues persist despite normal early neurological assessments.
Area of Science:
- Developmental neuroscience
- Motor control
- Pediatric neurology
Background:
- Preterm infants often display postural abnormalities impacting development.
- Pathophysiology of postural development in preterm infants is poorly understood.
Purpose of the Study:
- To longitudinally investigate postural adjustment development during reaching in preterm infants.
- To explore the relationship between postural control, neurological outcomes, and early brain imaging.
Main Methods:
- Longitudinal study of 12 preterm infants (4-18 months corrected age).
- Simultaneous recording of video and electromyograms (EMG) of multiple muscle groups during reaching tasks.
- Comparison with data from 10 full-term infants.
Main Results:
- Preterm infants demonstrated excessive and temporally disorganized postural activity during reaching.
- Postural adjustments were not modulated by movement velocity or initial position.
- No correlation found between postural dysfunction and early hyperextension, 18-month neurological outcome, or neonatal brain ultrasound findings.
Conclusions:
- Preterm infants struggle with modulating postural adjustments during reaching, suggesting impaired motor learning.
- Postural control deficits in preterm infants are complex and not fully explained by early neurological markers.
Abstract:
Preterm infants often show postural abnormalities, such as hyperextension of neck and trunk, which can interfere with motor and cognitive development. Little is, however, known on the pathophysiology of postural development in preterm infants. Therefore, we longitudinally studied the development of postural adjustments during reaching movements in 12 preterm infants between the (corrected) ages of 4 and 18 mo. Five infants showed minor neurological dysfunctions at 18 mo, such as a mild diffuse hypotonia, a mild hypertonia of the legs, or a mild asymmetry in posture and motility, and seven infants were neurologically normal. Each assessment consisted of a simultaneous recording of video-data and surface electromyograms of arm, neck, trunk, and leg muscles during reaching in various lying and sitting positions. Comparable data on postural development in ten full-term infants were available. The preterm infants showed an excessive amount of postural activity during reaching movements at all ages studied. Moreover, the postural adjustments were temporally disorganized and could not be modulated with respect to the velocity of the arm movement and the initial sitting position. We hypothesized that the preterms' disability to modulate their postural adjustments might be due to a reduced capacity to learn from prior experience. In our small group the postural dysfunctions were not related to the presence of hyperextension at early ages, to the neurological outcome at 18 mo, or to the lesions found on the neonatal brain ultrasound scans.