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Early spontaneous movements and spatiotemporal gait characteristics in preterm children
Yusuf Topal1, Bilge Nur Yardımcı-Lokmanoğlu2, Semra Topuz3
1Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye. fztyusuftopal@hotmail.com.
Insights
Preterm children may achieve typical gait patterns by age 3-4, with early movement assessments potentially indicating later neurodevelopmental outcomes. This research highlights the importance of early motor assessments for predicting gait development in preterm infants.
Area of Science:
- Pediatric neurology
- Developmental pediatrics
- Movement science
Background:
- Preterm birth can impact motor development, with gait abnormalities observed in early childhood.
- Previous research indicates gait differences between preterm and term children, which may resolve with age.
Purpose of the Study:
- To analyze spatiotemporal gait characteristics in preterm children aged 3-4 years across different gestational age groups.
- To investigate the relationship between early general movements assessment (Motor Optimality Score-Revised) and gait parameters in preterm children.
Main Methods:
- Prospective study including extremely preterm and very preterm (EP-VP, <32 weeks GA), moderate to late preterm (MLP, 32-<37 weeks GA), and term children.
- Spatiotemporal gait characteristics were assessed using the GAITRite® electronic walkway.
- Early spontaneous movements were evaluated using the General Movements Assessment (Motor Optimality Score-Revised, MOS-R) at 9-20 weeks post-term.
Main Results:
- EP-VP children exhibited shorter step lengths, while MLP children showed greater step length variability compared to term peers.
- MOS-R scores correlated with step length, step length variability, and base of support in EP-VP children.
- Specific MOS-R subcategories, including age-adequate movement repertoire and postural patterns, were associated with gait characteristics.
Conclusions:
- Preterm children may largely normalize most spatiotemporal gait parameters by 3-4 years of age compared to term peers.
- Early movement assessments (MOS-R, movement repertoire, postural patterns) may serve as predictive markers for later neurodevelopmental outcomes in preterm children without cerebral palsy.
Abstract:
This study aimed to analyze spatiotemporal gait characteristics of preterm children from 3 to 4 years of age according to different gestational age groups and to examine the relationship between the detailed general movements assessment and spatiotemporal gait characteristics. A total of 74 preterm children, 32 extremely preterm and very preterm (EP-VP, < 32 weeks gestational age) and 42 moderate to late preterm (MLP, 32 to < 37 weeks gestational age), were included in this prospective study, along with 38 term children. Early spontaneous movements of preterm children were assessed from videos at 9-20 weeks post-term according to the general movements assessment, which determines the Motor Optimality Score-Revised (MOS-R). The spatiotemporal gait characteristics of all children were evaluated using the GAITRite®electronic walkway at self-selected walking speeds. EP-VP children walked with shorter step lengths (p = 0.039), and MLP children walked with greater step length variability (p = 0.003) than their term peers. The MOS-R results were related to step length (r = 0.36, p = 0.042), step length variability (r = -0.56, p = 0.001), and base of support (r = -0.37, p = 0.038) in EP-VP children. The MOS-R subcategories, age-adequate movement repertoire, and postural patterns were related to some of the spatiotemporal gait characteristics, including step length, step length variability, and base of support (p < 0.05). Conclusion: EP-VP and MLP children might catch up to their term peers at 3 to 4 years of age in terms of most gait parameters. In addition to the MOS-R, age-adequate movement repertoire and postural patterns of preterm children without cerebral palsy in early life may be a marker of later neurodevelopmental dysfunction. What is Known: • Preterm children walk with a wider step width, a greater step length asymmetry and step time, and a shorter stride length at 18 to 22 months of age compared with term children at a self-selected speed, while these differences disappear in children 4.5-5 years old and older. What is New: • Early spontaneous movements were related to some spatiotemporal gait characteristics. • Preterm children might catch up to term children at 3-4 years of age in spatiotemporal gait characteristics while walking at a self-selected speed.
