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Babik I, Cunha AB, Srinivasan S. Biological and environmental factors may affect children's executive function through motor and sensorimotor development: Preterm birth and cerebral palsy. Infant Behav Dev 2023; 73:101881. [PMID: 37643499 DOI: 10.1016/j.infbeh.2023.101881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 08/03/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023]
Abstract
Disruptive biological and environmental factors may undermine the development of children's motor and sensorimotor skills. Since the development of cognitive skills, including executive function, is grounded in early motor and sensorimotor experiences, early delays or impairments in motor and sensorimotor processing often trigger dynamic developmental cascades that lead to suboptimal executive function outcomes. The purpose of this perspective paper is to link early differences in motor/sensorimotor processing to the development of executive function in children born preterm or with cerebral palsy. Uncovering such links in clinical populations would improve our understanding of developmental pathways and key motor and sensorimotor skills that are antecedent and foundational for the development of executive function. This knowledge will allow the refinement of early interventions targeting motor and sensorimotor skills with the goal of proactively improving executive function outcomes in at-risk populations.
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Affiliation(s)
- Iryna Babik
- Department of Psychological Science, Boise State University, Boise, ID, USA.
| | - Andrea B Cunha
- Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sudha Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
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2
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Deng W, Sargent B, Havens K, Vanderbilt D, Rosales M, Pulido JC, Matarić MJ, Smith BA. Correlation between performance and quantity/variability of leg exploration in a contingency learning task during infancy. Infant Behav Dev 2023; 70:101788. [PMID: 36399847 DOI: 10.1016/j.infbeh.2022.101788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/26/2022] [Accepted: 11/08/2022] [Indexed: 11/17/2022]
Abstract
Quantity and quality of motor exploration are proposed to be fundamental for infant motor development. However, it is still not clear what types of motor exploration contribute to learning. To determine whether changes in quantity of leg movement and/or variability of leg acceleration are related to performance in a contingency learning task, twenty 6-8-month-old infants with typical development participated in a contingency learning task. During this task, a robot provided reinforcement when the infant's right leg peak acceleration was above an individualized threshold. The correlation coefficient between the infant's performance and the change in quantity of right leg movement, linear variability, and nonlinear variability of right leg movement acceleration from baseline were calculated. Simple linear regression and multiple linear regression were calculated to explain the contribution of each variable to the performance individually and collectively. We found significant correlation between the performance and the change in quantity of right leg movement (r = 0.86, p < 0.001), linear variability (r = 0.71, p < 0.001), and nonlinear variability (r = 0.62, p = 0.004) of right leg movement acceleration, respectively. However, multiple linear regression showed that only quantity and linear variability of leg movements were significant predicting factors for the performance ratio (p < 0.001, adjusted R2 = 0.94). These results indicated that the quantity of exploration and variable exploratory strategies could be critical for the motor learning process during infancy.
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Affiliation(s)
- Weiyang Deng
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, USA,.
| | - Barbara Sargent
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, USA,.
| | - Kathryn Havens
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, USA,.
| | - Douglas Vanderbilt
- Division of Behavioral Pediatrics, Department of Pediatrics, Keck School of Medicine, University of Southern California, USA,.
| | - Marcelo Rosales
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, USA,.
| | - Jose Carlo Pulido
- Department of Innovation and Product Design, University Carlos III of Madrid, Spain,.
| | - Maja J Matarić
- Department of Computer Science, Viterbi School of Engineering, University of Southern California, USA,.
| | - Beth A Smith
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, USA,; Division of Behavioral Pediatrics, Department of Pediatrics, Keck School of Medicine, University of Southern California, USA,; Developmental Neuroscience and Neurogenetics Program, The Saban Research Institute, Children's Hospital Los Angeles, USA.
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3
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Prosser LA, Aguirre MO, Zhao S, Bogen DK, Pierce SR, Nilan KA, Zhang H, Shofer FS, Johnson MJ. Infants at risk for physical disability may be identified by measures of postural control in supine. Pediatr Res 2022; 91:1215-1221. [PMID: 34175891 PMCID: PMC8710181 DOI: 10.1038/s41390-021-01617-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 04/29/2021] [Accepted: 05/20/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Early detection of delay or impairment in motor function is important to guide clinical management and inform prognosis during a critical window for the development of motor control in children. The purpose of this study was to investigate the ability of biomechanical measures of early postural control to distinguish infants with future impairment in motor control from their typically developing peers. METHODS We recorded postural control from infants lying in supine in several conditions. We compared various center of pressure metrics between infants grouped by birth status (preterm and full term) and by future motor outcome (impaired motor control and typical motor control). RESULTS One of the seven postural control metrics-path length-was consistently different between groups for both group classifications and for the majority of conditions. CONCLUSIONS Quantitative measures of early spontaneous infant movement may have promise to distinguish early in life between infants who are at risk for motor impairment or physical disability and those who will demonstrate typical motor control. Our observation that center of pressure path length may be a potential early marker of postural instability and motor control impairment needs further confirmation and further investigation to elucidate the responsible neuromotor mechanisms. IMPACT The key message of this article is that quantitative measures of infant postural control in supine may have promise to distinguish between infants who will demonstrate future motor impairment and those who will demonstrate typical motor control. One of seven postural control metrics-path length-was consistently different between groups. This metric may be an early marker of postural instability in infants at risk for physical disability.
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Affiliation(s)
- Laura A. Prosser
- grid.25879.310000 0004 1936 8972Department of Pediatrics, University of Pennsylvania, Philadelphia, PA USA ,grid.239552.a0000 0001 0680 8770Division of Rehabilitation Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Maria Ovando Aguirre
- grid.25879.310000 0004 1936 8972Department of Bioengineering, University of Pennsylvania, Philadelphia, PA USA
| | - Susan Zhao
- grid.25879.310000 0004 1936 8972Department of Bioengineering, University of Pennsylvania, Philadelphia, PA USA
| | - Daniel K. Bogen
- grid.25879.310000 0004 1936 8972Department of Bioengineering, University of Pennsylvania, Philadelphia, PA USA
| | - Samuel R. Pierce
- grid.239552.a0000 0001 0680 8770Department of Physical Therapy, The Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Kathleen A. Nilan
- grid.239552.a0000 0001 0680 8770Division of Neonatology, The Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Huayan Zhang
- grid.239552.a0000 0001 0680 8770Division of Neonatology, The Children’s Hospital of Philadelphia, Philadelphia, PA USA ,Department of Neonatology, Guangzhou Women’s and Children’s Medical Center, Guangzhou, Guangdong China
| | - Frances S. Shofer
- grid.25879.310000 0004 1936 8972Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Michelle J. Johnson
- grid.25879.310000 0004 1936 8972Department of Bioengineering, University of Pennsylvania, Philadelphia, PA USA ,grid.25879.310000 0004 1936 8972Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, PA USA
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Caballero C, Barbado D, Hérnandez-Davó H, Hernández-Davó JL, Moreno FJ. Balance dynamics are related to age and levels of expertise. Application in young and adult tennis players. PLoS One 2021; 16:e0249941. [PMID: 33857225 PMCID: PMC8049250 DOI: 10.1371/journal.pone.0249941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 03/27/2021] [Indexed: 11/18/2022] Open
Abstract
In tennis, coaches consider balance fundamental for the acquisition of skilled motor performance. However, the potential relationship between balance and tennis expertise and performance has not been explored yet. Therefore, this study assessed the relationship between balance and tennis performance using linear and non-linear parameters through 1) the comparison of tennis players of different ages and levels of expertise, and 2) analyzing the relationship between balance and tennis serving speed and accuracy. One hundred and six recreational and expert male tennis players took part in the study (age range 10-35 years old). Temporal dynamics of postural control during a balance task on an unstable surface were analyzed through the mean velocity and the detrended fluctuation analysis (DFAV) of center of pressure (COP). Tennis serve performance was quantified by measuring accuracy and speed. Traditional variables measuring balance performance only showed differences according to age but not to sport performance. COP showed a reduction of auto-correlated variability (reflected by DFAV) with age but mainly in expert players. COP dynamics was the only balance parameter discriminating sport expertise and it was related to age. Balance dynamics exhibited by expert tennis players DFAV results support the idea that, along the years, sport experience induces balance adaptations characterized by a higher ability to perform postural adjustments. These results also reinforce the use of non-linear analysis to reveal subtle balance adaptations produced by sport practice. Finally, the lack of correlations suggests that balance, measured with scattering variables, in a non-specific task is not a main determinant of sport performance in tennis serve.
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Affiliation(s)
- Carla Caballero
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Elche, Alicante, Spain
| | - David Barbado
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Elche, Alicante, Spain
| | - Héctor Hérnandez-Davó
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Elche, Alicante, Spain
| | - José Luis Hernández-Davó
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Elche, Alicante, Spain
| | - Francisco J. Moreno
- Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, Elche, Alicante, Spain
- * E-mail:
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Sato NTDS, Cunha AB, Antonio GLN, Tudella E. Does late preterm birth impact trunk control and early reaching behavior? Infant Behav Dev 2021; 63:101556. [PMID: 33819770 DOI: 10.1016/j.infbeh.2021.101556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 03/05/2021] [Accepted: 03/18/2021] [Indexed: 10/21/2022]
Abstract
The aims of the study were to 1) verify the level of trunk control longitudinally and reaching behavior while sitting in two positions in late preterm (LPT) and full-term (FT) infants, 2) determine whether the level of trunk control relates to reaching outcomes. Twenty LPT infants and 36 infants born FT were assessed via three in-lab visits: at 6, 7, and 8 months. At each visit, the Segmental Assessment of Trunk Control (SATCo) and reaching assessment were performed, where the infants were positioned sitting in the ring and at 90° of flexion of hips, knees, and ankles. Accurate manual support to the trunk was provided in each visit. LPT infants presented a lower level of trunk control over time. LPT infants presented a higher percentage of unimanual reaches and successful grasping at 7 months' visit, and a higher number of reaches at 8 months' visit compared to FT infants. The sitting positions did not influence reaching performance. The level of trunk control relates to functional reaching strategies only in FT infants. This study might provide insights for clinicians for understanding the level of trunk control, the importance of reaching behaviors for exploration, and considering these behaviors as strategies for intervention.
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Affiliation(s)
- Natalia Tiemi da Silva Sato
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, km 235, Sao Carlos, SP, 13565-905, Brazil.
| | - Andréa Baraldi Cunha
- Department of Physical Therapy, University of Delaware (UD), 540 S College Ave, Newark, DE, 19713, USA
| | - Giovanna Laura Neves Antonio
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, km 235, Sao Carlos, SP, 13565-905, Brazil
| | - Eloisa Tudella
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, km 235, Sao Carlos, SP, 13565-905, Brazil
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Wu Y, Rijssen IM, Buurman MT, Dijkstra L, Hamer EG, Hadders‐Algra M. Temporal and spatial localisation of general movement complexity and variation-Why Gestalt assessment requires experience. Acta Paediatr 2021; 110:290-300. [PMID: 32274828 PMCID: PMC7818473 DOI: 10.1111/apa.15300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 03/30/2020] [Accepted: 04/01/2020] [Indexed: 11/23/2022]
Abstract
Aim General movements’ assessment (GMA), based on Gestalt perception, identifies infants at risk of cerebral palsy. However, the requirement of ample experience to construct the assessor's inner criteria for abnormal movement hampers its widespread clinical use. This study aims to describe details of general movements (GMs) in various body parts and to investigate their association with GMA‐Gestalt. Methods Participants were 24 typically developing infants and 22 very‐high‐risk infants. GMs were assessed during the writhing (0‐8 weeks) and/or fidgety GM phase (2‐5 months) by GMA‐Gestalt and a semi‐quantification of the duration of simple movements and complex movements in various body parts. Results During both GM phases, the quality of movement often varied within a single assessment, but the degree of complexity and variation of movements in trunk, arms and legs were interrelated (ρ = 0.32‐0.84). Longer durations of complex movements in arms and legs (P < .042) were further associated with a better quality in GMA‐Gestalt. Head movement was associated with movements in other body parts only in the writhing phase and not associated with GMA‐Gestalt during both GM phases. Conclusion Infants did not show consistently over time and across body parts simple or complex movements. Detailed description of movement characteristics may facilitate the development of computer‐based GMA.
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Affiliation(s)
- Ying‐Chin Wu
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology Groningen The Netherlands
| | - Ilse M. Rijssen
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology Groningen The Netherlands
| | - Maria T. Buurman
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology Groningen The Netherlands
| | - Linze‐Jaap Dijkstra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology Groningen The Netherlands
| | - Elisa G. Hamer
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology Groningen The Netherlands
- Department of Neurology Radboud University Medical Center Nijmegen The Netherlands
| | - Mijna Hadders‐Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology Groningen The Netherlands
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Valentini NC, Pereira KRG, Chiquetti EMDS, Formiga CKMR, Linhares MBM. Motor trajectories of preterm and full-term infants in the first year of life. Pediatr Int 2019; 61:967-977. [PMID: 31293014 DOI: 10.1111/ped.13963] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 04/02/2019] [Accepted: 05/16/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Motor development occurs throughout periods of motor skill acquisition, adjustment and variability. The objectives of this study were to analyze and compare biological and health characteristics and motor skill acquisition trajectories in preterm and full-term infants during the first year of life. METHODS Two thousand, five hundred and seventy-nine infants (1,361 preterm) from 22 states were assessed using the Alberta Infant Motor Scale. Multivariate General Linear Model, t-tests, ANOVA, and Tukey tests were used. RESULTS An age × group significant interaction was found for motor scores. On follow-up tests full-term infants had higher scores in prone, supine, sitting and standing postures that require trunk control from 9 to 10 months of age; although this advantage was observed for sitting from the second month of life. CONCLUSION During the first trimester of life, preterm infants have higher scores in the supine and standing postures. Regarding motor trajectories, from newborn to 12 months, the period of higher motor acquisition was similar between full-term and preterm infants for prone (3-10 months), supine (1-6 months), and standing (6-12 months). For the sitting posture, however, full-term infants had a period of intensive motor learning of acquisition from the first to 7 months of life, whereas for preterm infants a shorter period was observed (3-7 months). CONCLUSION Although the periods of higher motor acquisition were similar, full-term infants had higher scores in more control-demanding postures. Intervention for preterm infants needs to extend beyond the first months of life, and include guidance to parents to promote motor development strategies to achieve control in the higher postures.
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Affiliation(s)
- Nadia Cristina Valentini
- Health and Human Performance, Auburn University, Auburn, Alabama, USA.,Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Keila Ruttnig Guidony Pereira
- PPGCMH-Human Movement Science Graduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Eloá Maria Dos Santos Chiquetti
- PPGCMH-Human Movement Science Graduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Cibelle Kayenne Martins Roberto Formiga
- Department of Medical Sciences, University of São Paulo, São Paulo, Brazil.,School of Physical Education and Physical Therapy, State University of Goiás, Goiânia, Brazil
| | - Maria Beatriz Martins Linhares
- Department of Psychology, University of São Paulo, São Paulo, Brazil.,Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Kuiper MJ, Brandsma R, Lunsing RJ, Eggink H, ter Horst HJ, Bos AF, Sival DA. The neurological phenotype of developmental motor patterns during early childhood. Brain Behav 2019; 9:e01153. [PMID: 30485703 PMCID: PMC6346655 DOI: 10.1002/brb3.1153] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 09/26/2018] [Accepted: 10/01/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION During early childhood, typical human motor behavior reveals a gradual transition from automatic motor patterns to acquired motor skills, by the continuous interplay between nature and nurture. During the wiring and shaping of the underlying motor networks, insight into the neurological phenotype of developmental motor patterns is incomplete. In healthy, typically developing children (0-3 years of age), we therefore aimed to investigate the neurological phenotype of developmental motor patterns. METHODS In 32 healthy, typically developing children (0-3 years), we video-recorded spontaneous motor behavior, general movements (GMs), and standardized motor tasks. We classified the motor patterns by: (a) the traditional neurodevelopmental approach, by Gestalt perception and (b) the classical neurological approach, by the clinical phenotypic determination of movement disorder features. We associated outcomes by Cramer's V. RESULTS Developmental motor patterns revealed (a) choreatic-like features (≤3 months; associated with fidgety GMs (r = 0.732) and startles (r = 0.687)), (b) myoclonic-like features (≤3 months; associated with fidgety GMs (r = 0.878) and startles (r = 0.808)), (c) dystonic-like features (0-3 years; associated with asymmetrical tonic neck reflex (r = 0.641) and voluntary movements (r = 0.517)), and (d) ataxic-like features (>3 months; associated with voluntary movements (r = 0.928)). CONCLUSIONS In healthy infants and toddlers (0-3 years), typical developmental motor patterns reveal choreatic-, myoclonic-, dystonic- and ataxic-like features. The transient character of these neurological phenotypes is placed in perspective of the physiological shaping of the underlying motor centers. Neurological phenotypic insight into developmental motor patterns can contribute to adequate discrimination between ontogenetic and initiating pathological movement features and to adequate interpretation of therapeutic interactions.
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Affiliation(s)
- Marieke J. Kuiper
- Department of NeurologyUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
| | - Rick Brandsma
- Department of NeurologyUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
| | - Roelineke J. Lunsing
- Department of NeurologyUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
| | - Hendriekje Eggink
- Department of NeurologyUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
| | - Hendrik J. ter Horst
- Department of Neonatology, Beatrix Children’s HospitalUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
| | - Arend F. Bos
- Department of Neonatology, Beatrix Children’s HospitalUniversity Medical Center Groningen, University of GroningenGroningenThe Netherlands
| | - Deborah A. Sival
- Department of Pediatrics, Beatrix Children’s HospitalUniversity Medical Center GroningenGroningenThe Netherlands
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Gliga T. Telling Apart Motor Noise and Exploratory Behavior, in Early Development. Front Psychol 2018; 9:1939. [PMID: 30369897 PMCID: PMC6194153 DOI: 10.3389/fpsyg.2018.01939] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 09/20/2018] [Indexed: 11/13/2022] Open
Abstract
Infants' minutes long babbling bouts or repetitive reaching for or mouthing of whatever they can get their hands on gives very much the impression of active exploration, a building block for early learning. But how can we tell apart active exploration from the activity of an immature motor system, attempting but failing to achieve goal directed behavior? I will focus here on evidence that infants increase motor activity and variability when faced with opportunities to gather new information (about their own bodies or the world) and propose this as a guiding principle for separating variability generated for exploration from noise. I will discuss mechanisms generating movement variability, and suggests that, in the various forms it takes, from deliberate hypothesis testing to increasing environmental variability, it could be exploited for learning. However, understanding how variability in motor acts contributes to early learning will require more in-depth investigations of both the nature of and the contextual modulation of this variability.
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Affiliation(s)
- Teodora Gliga
- School of Psychology, University of East Anglia, Norwich, United Kingdom.,Centre for Brain and Cognitive Development, Birkbeck, University of London, London, United Kingdom
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Abstract
OBJECTIVE To examine the influence of age, sex, attention-deficit hyperactivity disorder (ADHD) status, previous history of concussion, and days since injury on postconcussion postural control assessment in adolescents who have suffered a concussion. DESIGN Prospective cohort study. SETTING Hospital-based outpatient clinic. PARTICIPANTS Seventy-one participants (42 males; 29 females) with mean age 14.14 ± 2.44. INDEPENDENT VARIABLES Age, sex, previous concussion history, ADHD status, total and severity of postconcussion symptoms, and days since injury. MAIN OUTCOME MEASURES Total Balance Error Scoring System score, path length, center-of-pressure (COP) area, sample entropy, and Romberg quotient. RESULTS Pearson product-moment correlation coefficients were calculated to test for potential associations between the continuous participant characteristics and the postural control variables. Spearman correlation was used to test the association between symptom severity and the postural control variables. Standard multiple regression was used to model the extent to which participant characteristics accounted for the variance in the postural sway variables. Age was significantly associated with all of the postural sway variables except COP area for the eyes open condition and sample entropy in the anterior-posterior direction for the eyes closed condition. Sex, ADHD status, and previous concussion history did not significantly predict postural control scores. CONCLUSIONS Age significantly influences scores on common postconcussion postural control assessments. CLINICAL RELEVANCE This study demonstrates that age is a critical factor that needs to be accounted for to improve the clinical appropriateness and utility of current postconcussion postural control assessments.
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Al-Whaibi RM. Using senses to encourage head and upper limb voluntary movement in young infants: Implications for early intervention. Dev Neurorehabil 2016; 19:295-314. [PMID: 25826653 DOI: 10.3109/17518423.2014.1002636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE It has long been suggested that a neonate's movement and responses to external stimuli are the product of reflexive reactions rather than purposeful movements. However, several studies have demonstrated that this is not the case. Rationale of literature included: This study seeks to review reports showing that sensory stimuli resulted in newborns recognising and responding to different stimuli with active head or upper limb movements. We also discuss this in the context of current literature about early training on the advancement of movement and brain development. Results and outcomes: Taken together, it is clear that early active experience shapes learning in newborns. CONCLUSIONS The impact of this research is most exciting for applications that would induce infants to make purposeful movements, especially as a means for early intervention and rehabilitation for the treatment of infants with or at high risk for developmental delay.
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Affiliation(s)
- Reem M Al-Whaibi
- a Rehabilitation Department , College of Health and Rehabilitation Sciences, Princess Noura University , Riyadh , Saudi Arabia
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12
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Dusing SC, Thacker LR, Galloway JC. Infant born preterm have delayed development of adaptive postural control in the first 5 months of life. Infant Behav Dev 2016; 44:49-58. [PMID: 27285202 DOI: 10.1016/j.infbeh.2016.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 12/23/2015] [Accepted: 05/12/2016] [Indexed: 12/14/2022]
Abstract
UNLABELLED Infants born preterm are at increased risk of developmental disabilities, that may be attributed to their early experiences and ability to learn. The purpose of this paper was to evaluate the ability of infants born preterm to adapt their postural control to changing task demands. METHODS This study included 18 infants born at 32 weeks of gestation or less whose posture was compared in supine under 2 conditions, with and without a visual stimulus presented. The postural variability, measured with root mean squared displacement of the center of pressure, and postural complexity, measured with the approximate entropy of the center of pressure displacement were measured longitudinally from 2.5 to 5 months of age. RESULTS AND DISCUSSION The infants looked at the toys in midline for several months prior to adapting their postural variability in a manner similar to full term infants. Only after postural variability was reduced in both the caudal cephalic and medial lateral direction in the toy condition did the infants learn to reach for the toy. Postural complexity did not vary between conditions. These findings suggest that infants used a variety of strategies to control their posture. In contrast to research with infants born full term, the infants born preterm in this study did not identify the successful strategy of reducing movement of the center of pressure until months after showing interest in the toy. This delayed adaptation may impact the infants ability to learn over time.
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Affiliation(s)
- Stacey C Dusing
- Motor Development Lab, Department of Physical Therapy, Department of Pediatrics, Virginia Commonwealth University, United States.
| | - Leroy R Thacker
- School of Nursing, Virginia Commonwealth University, United States.
| | - James C Galloway
- Department of Physical Therapy, Biomechanics and Movement Sciences Program, University of Delaware, United States.
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13
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Nishiyori R, Bisconti S, Meehan SK, Ulrich BD. Developmental changes in motor cortex activity as infants develop functional motor skills. Dev Psychobiol 2016; 58:773-83. [DOI: 10.1002/dev.21418] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 03/16/2016] [Indexed: 01/03/2023]
Affiliation(s)
- Ryota Nishiyori
- School of Kinesiology; University of Michigan; Ann Arbor Michigan
- Center for Human Growth and Development; University of Michigan; Ann Arbor Michigan
| | - Silvia Bisconti
- Center for Human Growth and Development; University of Michigan; Ann Arbor Michigan
| | - Sean K. Meehan
- School of Kinesiology; University of Michigan; Ann Arbor Michigan
| | - Beverly D. Ulrich
- School of Kinesiology; University of Michigan; Ann Arbor Michigan
- Center for Human Growth and Development; University of Michigan; Ann Arbor Michigan
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14
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Dusing SC. Postural variability and sensorimotor development in infancy. Dev Med Child Neurol 2016; 58 Suppl 4:17-21. [PMID: 27027603 DOI: 10.1111/dmcn.13045] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2015] [Indexed: 11/27/2022]
Abstract
Infants develop skills through a coupling between their sensory and motor systems. Newborn infants must interpret sensory information and use it to modify movements and organize the postural control system based on the task demands. This paper starts with a brief review of evidence on the use of sensory information in the first months of life, and describes the importance of movement variability and postural control in infancy. This introduction is followed by a review of the evidence for the interactions between the sensory, motor, and postural control systems in typically development infants. The paper highlights the ability of young infants to use sensory information to modify motor behaviors and learn from their experiences. Last, the paper highlights evidence of atypical use of sensory, motor, and postural control in the first months of life in infants who were born preterm, with neonatal brain injury or later diagnosed with cerebral palsy (CP).
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Affiliation(s)
- Stacey C Dusing
- Motor Development Lab, Department of Physical Therapy, Department of Pediatrics, Children's Hospital of Richmond, Virginia Leadership Education in Neurodevelopmental Disabilities Program, Virginia Commonwealth University, Richmond, VA, USA
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15
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Campbell SK, Cole W, Boynewicz K, Zawacki LA, Clark A, Gaebler-Spira D, deRegnier RA, Kuroda MM, Kale D, Bulanda M, Madhavan S. Behavior During Tethered Kicking in Infants With Periventricular Brain Injury. Pediatr Phys Ther 2015; 27:403-12. [PMID: 26397087 PMCID: PMC4703037 DOI: 10.1097/pep.0000000000000173] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe behavior of children with periventricular brain injury (PBI) in a tethered-kicking intervention. METHODS Sixteen infants with PBI were randomly assigned to exercise or no-training in a longitudinal pilot study. Frequencies of leg movements and interlimb coordination were described from videos at 2 and 4 months' corrected age (CA). RESULTS Eight of the 13 children (62%) with longitudinal data increased the frequency of leg movements while tethered to a mobile between 2 and 4 months' CA. Movement frequency was correlated with scores on the Test of Infant Motor Performance, but no differences between experimental groups were found. Children with typical development at 12 months' CA increased the proportion of leg movements that were synchronous between 2 and 4 months, as did a child with cerebral palsy in the experimental group. CONCLUSIONS The tethered-kicking intervention facilitates movement in infants with PBI, but effects on development remain to be demonstrated.
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Affiliation(s)
- Suzann K Campbell
- Department of Physical Therapy (Drs Campbell, Bulanda, and Madhavan), University of Illinois at Chicago, Chicago, Illinois; Center for Clinical and Translational Science (Dr Campbell), University of Illinois at Chicago, Chicago, Illinois; Department of Psychology (Dr Cole), New York University, New York, New York; Department of Physical Therapy (Dr Boynewicz), East Tennessee State University, Johnson City, Tennessee; Pediatric Physical Therapist (Ms Zawacki), Oak Park, Illinois; Physical Therapy Department (Dr Clark), University of Illinois Hospital and Health Sciences System, Chicago, Illinois; Departments of Pediatrics (Drs Gaebler-Spira and deRegnier), Northwestern University, Chicago, Illinois; Department of Physical Medicine and Rehabilitation (Drs Gaebler-Spira and Kuroda), Rehabilitation Institute of Chicago, Northwestern University, Chicago, Illinois; Rehabilitation Services (Dr Kale), Consonus Healthcare, Milwaukie, Oregon
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16
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Postural complexity influences development in infants born preterm with brain injury: relating perception-action theory to 3 cases. Phys Ther 2014; 94:1508-16. [PMID: 24903116 PMCID: PMC4183893 DOI: 10.2522/ptj.20140023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND PURPOSE Perception-action theory suggests a cyclical relationship between movement and perceptual information. In this case series, changes in postural complexity were used to quantify an infant's action and perception during the development of early motor behaviors. CASE DESCRIPTION Three infants born preterm with periventricular white matter injury were included. OUTCOMES Longitudinal changes in postural complexity (approximate entropy of the center of pressure), head control, reaching, and global development, measured with the Test of Infant Motor Performance and the Bayley Scales of Infant and Toddler Development, were assessed every 0.5 to 3 months during the first year of life. All 3 infants demonstrated altered postural complexity and developmental delays. However, the timing of the altered postural complexity and the type of delays varied among the infants. For infant 1, reduced postural complexity or limited action while learning to control her head in the midline position may have contributed to her motor delay. However, her ability to adapt her postural complexity eventually may have supported her ability to learn from her environment, as reflected in her relative cognitive strength. For infant 2, limited early postural complexity may have negatively affected his learning through action, resulting in cognitive delay. For infant 3, an increase in postural complexity above typical levels was associated with declining neurological status. DISCUSSION Postural complexity is proposed as a measure of perception and action in the postural control system during the development of early behaviors. An optimal, intermediate level of postural complexity supports the use of a variety of postural control strategies and enhances the perception-action cycle. Either excessive or reduced postural complexity may contribute to developmental delays in infants born preterm with white matter injury.
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17
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Claxton LJ, Strasser JM, Leung EJ, Ryu JH, O'Brien KM. Sitting infants alter the magnitude and structure of postural sway when performing a manual goal-directed task. Dev Psychobiol 2014; 56:1416-22. [PMID: 24604626 DOI: 10.1002/dev.21211] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 01/31/2014] [Indexed: 11/12/2022]
Abstract
In typical daily life, adults routinely adapt posture so that balance can be maintained while other goal-directed activities are performed. Interestingly, newly standing infants also control posture based on the demands of a task. It is unknown if the ability to properly adapt postural movements as a goal-directed task is performed emerges soon after the acquisition of independent stance or if it is present at earlier key postural milestones, such as independent sitting. In this study, the postural sway patterns of independently sitting infants were compared while either holding or not holding a toy. Infants exhibited less postural sway when holding the toy. This reduction in sway allowed infants to look at and stabilize the toy in their hand. Thus, the ability to adjust postural movements while performing a concurrent goal-directed task emerges long before the acquisition of independent stance.
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Affiliation(s)
- Laura J Claxton
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN
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18
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Dusing SC, Izzo TA, Thacker LR, Galloway JC. Postural complexity differs between infant born full term and preterm during the development of early behaviors. Early Hum Dev 2014; 90:149-56. [PMID: 24485170 PMCID: PMC3950939 DOI: 10.1016/j.earlhumdev.2014.01.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 12/20/2013] [Accepted: 01/07/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Postural control differs between infants born preterm and full term at 1-3weeks of age. It is unclear if differences persist or alter the development of early behaviors. The aim of this longitudinal study was to compare changes in postural control variability during development of head control and reaching in infants born preterm and full term. METHODS Eighteen infants born preterm (mean gestational age 28.3±3.1weeks) were included in this study and compared to existing data from 22 infants born full term. Postural variability was assessed longitudinally using root mean squared displacement and approximate entropy of the center of pressure displacement from birth to 6months as measures of the magnitude of the variability and complexity of postural control. Behavioral coding was used to quantify development of head control and reaching. RESULTS Group differences were identified in postural complexity during the development of head control and reaching. Infants born preterm used more repetitive and less adaptive postural control strategies than infants born full term. Both groups changed their postural complexity utilized during the development of head control and reaching. DISCUSSION Early postural complexity was decreased in infants born preterm, compared to infants born full term. Commonly used clinical assessments did not identify these early differences in postural control. Altered postural control in infants born preterm influenced ongoing skill development in the first six months of life.
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Affiliation(s)
- Stacey C Dusing
- Motor Development Lab, Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, United States.
| | - Theresa A Izzo
- Physical Therapist, Virginia Commonwealth University Health System, Richmond, VA, United States.
| | - Leroy R Thacker
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, United States.
| | - James C Galloway
- Department of Physical Therapy, Biomechanics and Movement Sciences Program, University of Delaware, Newark, DE, United States.
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19
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Donati M, Cecchi F, Bonaccorso F, Branciforte M, Dario P, Vitiello N. A modular sensorized mat for monitoring infant posture. SENSORS 2013; 14:510-31. [PMID: 24385029 PMCID: PMC3926572 DOI: 10.3390/s140100510] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 12/11/2013] [Accepted: 12/17/2013] [Indexed: 11/16/2022]
Abstract
We present a novel sensorized mat for monitoring infant's posture through the measure of pressure maps. The pressure-sensitive mat is based on an optoelectronic technology developed in the last few years at Scuola Superiore Sant'Anna: a soft silicone skin cover, which constitutes the mat, participates in the transduction principle and provides the mat with compliance. The device has a modular structure (with a minimum of one and a maximum of six sub-modules, and a total surface area of about 1 m2) that enables dimensional adaptation of the pressure-sensitive area to different specific applications. The system consists of on-board electronics for data collection, pre-elaboration, and transmission to a remote computing unit for analysis and posture classification. In this work we present a complete description of the sensing apparatus along with its experimental characterization and validation with five healthy infants.
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Affiliation(s)
- Marco Donati
- The BioRobotics Institute, Scuola Superiore Sant'Anna, viale Rinaldo Piaggio 34, Pontedera (PI) 56025, Italy.
| | - Francesca Cecchi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, viale Rinaldo Piaggio 34, Pontedera (PI) 56025, Italy.
| | - Filippo Bonaccorso
- The BioRobotics Institute, Scuola Superiore Sant'Anna, viale Rinaldo Piaggio 34, Pontedera (PI) 56025, Italy.
| | - Marco Branciforte
- The BioRobotics Institute, Scuola Superiore Sant'Anna, viale Rinaldo Piaggio 34, Pontedera (PI) 56025, Italy.
| | - Paolo Dario
- The BioRobotics Institute, Scuola Superiore Sant'Anna, viale Rinaldo Piaggio 34, Pontedera (PI) 56025, Italy.
| | - Nicola Vitiello
- The BioRobotics Institute, Scuola Superiore Sant'Anna, viale Rinaldo Piaggio 34, Pontedera (PI) 56025, Italy.
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20
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Hadders-Algra M. Typical and atypical development of reaching and postural control in infancy. Dev Med Child Neurol 2013; 55 Suppl 4:5-8. [PMID: 24237271 DOI: 10.1111/dmcn.12298] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2013] [Indexed: 11/30/2022]
Abstract
Successful reaching requires postural control, either by active regulation or by postural support. The present paper reviews literature on typical and atypical development of reaching and postural control during infancy. Typically, reaching movements end in grasping around 4 months of age. Initially, reaches are characterized by large variation, including many trajectory corrections. During the first year, the movements get increasingly straight and smooth. Reaching in low-risk preterm infants is initially characterized by advanced development, but minor impairments may emerge in the second half of infancy. In high-risk preterm infants, development of reaching is characterized by delay and non-optimal reaching performance. Typical development of postural adjustments is characterized by variation and an increasing ability to adapt the variable repertoire to the specifics of the situation. The latter is facilitated by an increasing role of anticipatory mechanisms in the second half of infancy. Atypically developing infants may have a reduced repertoire and usually have difficulties in adapting postural adjustments. In infancy, most reaching movements are performed during sitting. The postural challenge of sitting may interfere in particular with the development of reaching in atypically developing infants. The practical implications of this suggestion are discussed.
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Affiliation(s)
- Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics - Developmental Neurology, Groningen, the Netherlands
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21
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Dusing SC, Lobo MA, Lee HM, Galloway JC. Intervention in the first weeks of life for infants born late preterm: a case series. Pediatr Phys Ther 2013; 25:194-203. [PMID: 23542201 PMCID: PMC3621113 DOI: 10.1097/pep.0b013e3182888b86] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Infants born late preterm (34-36 weeks of gestation) account for 350 000 US births per year, are at risk for developmental delays, and are rarely included in intervention studies. PURPOSE To describe a novel parent-delivered movement intervention program for very young infants and outcomes following intervention and to evaluate the feasibility of using a comprehensive set of outcome measures. SUMMARY OF KEY POINTS Two infants born late preterm received intervention from 0.5 to 2.0 months of adjusted age. Development, postural control, reaching, and object exploration assessments were completed at 3 time points. The intervention was well tolerated by the family. Improvements in developmental outcomes, postural control, and object exploration are presented. STATEMENT OF CONCLUSION Very early movement experience provided daily by parents may improve development. In combination, norm-referenced and behavioral measures appear sensitive to changes in infant behaviors.
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Affiliation(s)
- Stacey C Dusing
- Motor Development Laboratory, Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia 23298, USA.
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