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Segmental Assessment of Trunk Control in infants from 4 to 9 months of age- a psychometric study
Tamis W Pin1, Penelope B Butler2, Hon-Ming Cheung3
1Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. tamis.pin@polyu.edu.hk.
Insights
The Segmental Assessment of Trunk Control (SATCo) is reliable and responsive for assessing infant trunk control from 4 to 9 months. This tool shows potential for differentiating trunk control between full-term and preterm infants.
Area of Science:
- Pediatric motor development
- Infant neurodevelopmental assessment
- Clinical biomechanics
Background:
- Trunk control is vital for infant motor development, enabling movement against gravity.
- Traditional assessments view the trunk as a single unit, unlike the Segmental Assessment of Trunk Control (SATCo).
- SATCo's reliability and validity are established in children with neuro-disability but require validation in infants.
Purpose of the Study:
- To evaluate the reliability, validity, and responsiveness of the Segmental Assessment of Trunk Control (SATCo).
- To assess SATCo's suitability for infants aged 4 to 9 months.
- To determine if SATCo can differentiate between full-term and preterm infants' trunk control.
Main Methods:
- Recruited full-term and preterm infants (gestational age < 30 weeks).
- Assessed infants monthly from 4 to 9 months corrected age using SATCo.
- Employed intra-class correlation coefficients (ICC) for reliability and Mann Whitney U/Friedman tests for validity and responsiveness.
Main Results:
- SATCo demonstrated good intra- and inter-rater reliability (ICC > 0.75) in full-term infants, with an exception at 6 months.
- Preterm infants showed significantly lower reactive trunk control at 8 months (p=0.016), the only significant difference noted.
- Full-term infants exhibited significant developmental trends in static, active, and reactive trunk control (p < 0.001).
Conclusions:
- SATCo is a reliable and responsive tool for assessing infant trunk control (4-9 months).
- Caution is advised for infants aged 5-6 months and those already sitting independently.
- SATCo differentiated reactive trunk control between full-term and preterm infants at 8 months; further investigation in infants with motor disorders is needed.
Background:
Efficient trunk control is crucial in infant motor development when infants first learn how to move against gravity. Traditional assessments of trunk control commonly treat the trunk as one unit but the Segmental Assessment of Trunk Control (SATCo) assesses trunk control segment by segment. Good reliability and validity of the SATCo have been proved in children with neuro-disability but not yet validated in young infants. The present study was to examine if the SATCo was reliable, valid and responsive for infants aged 4 to 9 months.
Methods:
Infants born at full-term and at less than 30 weeks of gestation were recruited and assessed using the SATCo monthly from 4 to 9 months of age (corrected for prematurity). Intra-class correlation coefficients (ICC) were used to examine intra- and inter-rater reliability between 2 raters. The ability of the SATCo to demonstrate differences between the full-term and preterm infants was examined using the Mann Whitney U test. The responsiveness of the SATCo on the full-term infants was tested using the Friedman test.
Results:
Twenty full-term (mean gestation = 38.7 weeks; birthweight = 3019.9 g) and 20 preterm infants (mean gestation = 27.2 weeks; birthweight = 989.6 g) were recruited. The intra and inter-rater reliability of the SATCo levels on full-term infants was good (all ICC > 0.75), except inter-rater reliability at 6 months. The preterm infants scored significantly lower in reactive trunk control at 8 months (Mann Whitney U = 102.0, p = 0.016) but this was the only difference noted. A significant developmental trend was shown in the static, active and reactive trunk control of the full-term infants (Chi-square = 81.4, 75.6 and 79.5 respectively, all p < 0.001.
Conclusions:
The SATCo was reliable and responsive in assessing trunk control in young infants aged from 4 to 9 months. Care should be exercised when testing infants aged 5 to 6 months, who are more likely to use subtle hand support, and for those who have already achieved independent sitting. The SATCo could differentiate the reactive trunk control between the full-term and preterm infants at 8 months but not earlier. Psychometric properties of the SATCo in infants with motor disorders requires further investigation.
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