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An instrument to measure independent walking: are there differences between preterm and fullterm infants?
L de Groot1, C J de Groot, B Hopkins
1Faculty of Human Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands.
Insights
Assessing early walking quality is crucial for detecting developmental impairments. Preterm infants, especially those small for gestational age, often exhibit poorer walking patterns, indicating potential developmental concerns.
Area of Science:
- Developmental Pediatrics
- Motor Development
- Clinical Assessment
Background:
- Independent walking is a key developmental milestone.
- The quality of early walking patterns receives limited attention.
- Deviant walking features can occur even in typically timed walkers, potentially indicating developmental issues.
Purpose of the Study:
- To develop a standardized instrument for qualitative assessment of early walking.
- To compare the walking quality of preterm and full-term infants.
- To identify early indicators of developmental impairments through gait analysis.
Main Methods:
- A study group of 52 infants (33 preterm, 19 full-term) was assessed.
- Walking performance was evaluated 14 days after achieving independent 5-meter walking.
- Gait quality was categorized as optimal, near-optimal, near-poor, or poor.
Main Results:
- Preterm infants, adjusted for age, showed a delayed onset of walking.
- Preterm infants exhibited a qualitatively distinct pattern of locomotion compared to full-term infants.
- Younger and small-for-gestational-age preterm infants were disproportionately represented in the near-poor and poor walking categories.
Conclusions:
- Early walking quality assessment is vital for identifying developmental deviations.
- Preterm birth, particularly when associated with small-for-gestational age, is linked to poorer early walking patterns.
- A standardized qualitative assessment tool can aid in the early detection of potential developmental impairments in infants.
Abstract:
In clinical practice walking independently has always been considered a major milestone in development. Nevertheless, little attention has been paid to the quality of movement expressed in the first attempts at walking free. Even when children achieve walking within a normal time range, some of them show features that are deviant. Early walking is difficult to judge, but at the same time may provide a sensitive means for detecting possible developmental impairments. The main aim of this paper is to provide a standardized clinical instrument for the qualitative assessment of early walking in a structured free field situation and to compare preterm and fullterm infants. All subjects were assessed 14 days after being able to walk 5 meters independently. The study group consisted of 52 children, of whom 33 were born prematurely (further distinguished in terms of being small- or appropriate-for-gestational age), and 19 were born fullterm. Judgments of walking performance were made in terms of optimal, near-optimal, near-poor, or poor. After correction for age, the preterm group was still later in the onset of walking, but more importantly, showed a qualitatively different pattern of locomotion. Those who were the youngest and small-for-gestational age were overrepresented in the near-poor and poor categories of walking.