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Postural Control Measurements to Predict Future Motor Impairment in Preterm Infants: A Systematic Review
Jennifer Bosserman1, Sonia Kelkar2, Kristen D LeBlond3
1Physical Medicine and Rehabilitation, Johns Hopkins Hospital, Baltimore, MD 21205, USA.
Insights
Postural measurement tools effectively assess preterm infants' center of pressure and asymmetry. These tools can predict future motor delays, offering objective insights into development.
Area of Science:
- Developmental Pediatrics
- Neuroscience
- Biomedical Engineering
Background:
- Preterm infants exhibit higher rates of developmental delays compared to full-term infants.
- Postural control assessment is crucial for early identification of potential motor impairments.
Purpose of the Study:
- To systematically review evidence on pressure mats and force plates for measuring center of pressure (COP) and asymmetry in preterm infants.
- To compare measures between preterm and full-term infants.
- To evaluate the predictive capability of these tools for future motor impairment.
Main Methods:
- Systematic literature review of PubMed, Embase, Scopus, and CINAHL.
- Quality assessment and risk of bias evaluation using the ROB2 tool.
- Analysis of nine selected manuscripts utilizing various postural measurement tools.
Main Results:
- All reviewed postural measurement tools (pressure mats, force plates) effectively assessed COP in preterm infants.
- Reduced postural complexity preceding midline head control was associated with future motor delay.
- These tools offer objective and quick measures of postural control and asymmetry.
Conclusions:
- Postural measurement tools are valuable for assessing preterm infants' motor control and asymmetry.
- These objective measures can predict future motor impairment and serve as an alternative to traditional assessments.
- Early detection of subtle postural deficits may guide timely interventions for preterm infants.
Abstract:
Preterm infants are more likely to demonstrate developmental delays than fullterm infants. Postural measurement tools may be effective in measuring the center of pressure (COP) and asymmetry, as well as predicting future motor impairment. The objective of this systematic review was to evaluate existing evidence regarding use of pressure mats or force plates for measuring COP and asymmetry in preterm infants, to determine how measures differ between preterm and fullterm infants and if these tools appropriately predict future motor impairment. The consulted databases included PubMed, Embase, Scopus, and CINAHL. The quality of the literature and the risk of bias were assessed utilizing the ROB2: revised Cochrane risk-of bias tool. Nine manuscripts met the criteria for review. The postural control tools included were FSA UltraThin seat mat, Conformat Pressure-Sensitive mat, Play and Neuro-Developmental Assessment, and standard force plates. Studies demonstrated that all tools were capable of COP assessment in preterm infants and support the association between the observation of reduced postural complexity prior to the observation of midline head control as an indicator of future motor delay. Postural measurement tools provide quick and objective measures of postural control and asymmetry. Based on the degree of impairment, these tools may provide an alternative to standardized assessments that may be taxing to the preterm infant, inaccessible to therapists, or not sensitive enough to capture motor delays.
