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Postural adjustments in preterm infants at 4 and 6 months post-term during voluntary reaching in supine position
Bjorg Fallang1, Ola Didrik Saugstad, Mijna Hadders-Algra
1Oslo University College, Health Sciences, Physiotherapy Programme, Pilestredet 52, 0167 Oslo, Norway. bjorg.fallang@hf.hio.no
Insights
Preterm infants exhibit distinct "still" postural behavior during reaching compared to full-term infants. This strategy may indicate potential later motor dysfunction, despite appearing adequate in the short term.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Motor Control
Background:
- Motor development, particularly balance control, often differs in preterm infants compared to full-term infants.
- The underlying causes and mechanisms of these motor differences in preterm infants remain poorly understood.
- Understanding these differences is crucial for early identification and intervention.
Purpose of the Study:
- To investigate postural behavior during reaching in preterm infants using kinetic and kinematic measurements.
- To compare the postural strategies of preterm infants with those of age-matched full-term infants.
- To explore the relationship between postural behavior and general cognitive and motor development assessments.
Main Methods:
- Longitudinal study of 32 preterm infants (without cerebral palsy) and 13 full-term controls at corrected ages of 4 and 6 months.
- Kinetic measurements of the Center of Pressure (COP) during reaching tasks on a forceplate.
- Kinematic analysis of reaching movements, including movement units and peak velocity (Vmax).
- Assessment of cognitive and motor development using General Movements (GMs) and Bayley Scales.
Main Results:
- Preterm infants displayed significantly "still" postural behavior (COP) compared to the more mobile behavior of full-term infants.
- A more "still" postural strategy at 6 months correlated with better reaching movement quality and normal General Movements at 4 months.
- This suggests "still" postural behavior is an adequate strategy for preterm infants but may signal future issues.
Conclusions:
- "Still" postural behavior is an adequate short-term motor strategy for preterm infants.
- However, this specific postural behavior may serve as an early indicator of potential later motor dysfunction.
- Further research is needed to elucidate the long-term implications of this finding for preterm infant development.
Abstract:
Gradually it is getting clear that motor development - in particular balance control - in so-called "low-risk" preterm infants often differs from that in full-term infants. However, little is known on the etiology and pathophysiology of these problems. The aim of this study was to evaluate postural behavior during reaching by means of kinetic and kinematic measurements. Preterm infants (n = 32) without cerebral palsy were investigated longitudinally at the corrected ages of 4 and 6 mo. Thirteen age-matched full-term infants served as controls. Cognitive and motor development were assessed by means of the quality of General Movements (GMs) at 4 mo and Bayley scales at 6 and 12 mo. The infants were lying supine on a forceplate reaching for a toy and the kinetics of the total body's Center of Pressure (COP) was measured in cranial-caudal and medial-lateral direction. The analysis focused on COP displacement, Vmax and oscillatory changes of the COP displacement during reaching. The kinematic analysis of reaching focused on movement units, Vmax and a compound kinematic variable reflecting the quality of reaching. The results showed that preterm infants showed a remarkable "still" postural behavior, which differed significantly from the mobile COP behavior of the full-term infants. More "still" postural behavior at 6 mo was associated with a better quality of reaching movements and with normal GMs at 4 mo. We concluded that "still" postural behavior is an adequate postural strategy of preterm infants. But it might be that this postural behavior is an indicator of later dysfunction.