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Decreased postural control in adolescents born with extremely low birth weight
Hannes Petersen1, Arnar-Thor Tulinius, Ingibjörg Georgsdóttir
1Faculty of Medicine, University of Iceland, 101, Reykjavík, Iceland, hpet@hi.is.
Insights
Adolescents born extremely low birth weight (ELBW) exhibit poorer postural control and stability compared to full-term peers. These long-term functional deficits highlight the need for early interventions in neonatal care.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Biomechanics
Background:
- Infant survival rates for extremely low birth weight (ELBW) have improved.
- ELBW infants face risks of long-term neurodevelopmental disorders.
- Postural control deficits may persist into adolescence.
Purpose of the Study:
- To assess postural control and stability adaptation in adolescents born ELBW.
- To compare ELBW adolescents with full-term controls.
Main Methods:
- Posturography was performed on 29 ELBW adolescents and 21 controls.
- Tests included eyes open/closed, unperturbed, and perturbed standing (calf vibration).
- Stability and adaptation were analyzed in anteroposterior and lateral directions.
Main Results:
- ELBW group showed significantly decreased anteroposterior stability in quiet stance and during perturbations.
- ELBW group had reduced lateral stability during perturbations.
- Adaptation to perturbations did not fully compensate for ELBW-related stability deficits.
Conclusions:
- Adolescent ELBW survivors commonly have long-term postural control deficits.
- These deficits manifest as increased energy use for stability and reduced stability.
- Interventions are recommended for neonatal care and later life to address these functional deficits.
Abstract:
The survival rates of infants born preterm with extremely low birth weight (ELBW ≤ 1000 g) have gradually improved over the last decades. However, these infants risk to sustain long-term disorders related to poor neurodevelopment. The objective was to determine whether adolescents born with ELBW have decreased postural control and stability adaptation. Twenty-nine ELBW subjects performed posturography with eyes open and closed under unperturbed and perturbed standing by repeated calf vibration. Their results were compared with twenty-one age- and gender-matched controls born after full-term pregnancy. The ELBW group had significantly decreased stability compared with controls in anteroposterior direction, both during the easier quiet stance posturography (p = 0.007) and during balance perturbations (p = 0.007). The ELBW group had similar stability decrease in lateral direction during balance perturbations (p = 0.013). Statistically, the stability decreases were similar with eyes closed and open, but proportionally larger with eyes open in both directions. Both groups manifested significant adaptation (p ≤ 0.023) to the balance perturbations in anteroposterior direction, though this adaptation process could not compensate for the general stability deficits caused by ELBW on postural control. Hence, adolescent survivors of ELBW commonly suffer long-term deficits in postural control, manifested as use of substantially more recorded energy on performing stability regulating high-frequency movements and declined stability with closed and open eyes both in anteroposterior and lateral direction. The determined relationship between premature birth and long-term functional deficits advocates that interventions should be developed to provide preventive care in neonatal care units and later on in life.
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