ABSTRACT
Purpose: No previous study examined trunk control development in preterm infants. The present study examined the longitudinal development of segmental trunk control from 4 to 12 months of (corrected) age in preterm infants in comparison with full-term infants.Methods: Thirty-one preterm infants and 30 full-term infants were recruited. All infants were tested monthly using the Segmental Assessment of Trunk Control and the Alberta Infant Motor Scale at 4, 8 and 12 months of age.Results: Segmental trunk control development was significantly delayed in the preterm infants. Statistically significant positive correlations were found between trunk control status and gross motor skills.Conclusion: This was first study showing that segmental trunk control development was significantly different in preterm infants. Segmental trunk control and gross motor performance were coupled in young infants. A dual focus on training upright trunk control and specific motor skills may maximise therapy outcomes for infants with motor delay.
Subject(s)
Infant, Premature/growth & development , Motor Skills Disorders/epidemiology , Motor Skills , Postural Balance , Female , Humans , Infant , Infant, Newborn , Male , Posture , Torso/growth & development , Torso/physiologyABSTRACT
Purpose: To explore the relationship between segmental trunk control and specific gross motor skills at 4, 8 and 12 months of (corrected) age in young infants.Methods: Thirty-one preterm infants and 30 full-term infants were recruited by convenience. All infants were tested using the Segmental Assessment of Trunk Control and the Alberta Infant Motor Scale at 4, 8 and 12 months of age.Results: The gross motor function in supine at 4 months and in the standing position at 12 months was significantly delayed in the preterm infants. Positive correlations were found between segmental trunk control levels and specific motor skills in prone, supine, sitting and standing positions at 8 and 12 months of age.Conclusion: This report was the first to demonstrate the association between segmental trunk control and specific gross motor skills in young infants. This new information provides clinicians with greater understanding about infant development.
Subject(s)
Infant, Premature/growth & development , Motor Skills , Postural Balance , Child Development , Female , Humans , Infant , Infant, Newborn , Male , Posture , Torso/growth & development , Torso/physiologyABSTRACT
BACKGROUND: Trunk control is generally considered to be related to gross motor development. However, this assumption has not been validated with clinical data. This pilot study was the first of its kind to examine the longitudinal development of segmental trunk control and gross motor development from 4 to 12 months of age in typically developing full-term infants. METHODS: A convenience cohort of 20 healthy full-term infants (mean gestation = 39.0 weeks, SD 1.2; mean birthweight = 2975.0 g, SD 297.0; males = 10) was recruited. All study infants were tested and scored monthly by independent assessors using the Segmental Assessment of Trunk Control and the Alberta Infant Motor Scale from 4 to 12 months of age. RESULTS: A developmental trend of segmental trunk control was found in the infants. Static vertical upright trunk control developed prior to active and reactive control. Statistically significant correlations were found between trunk control status and gross motor development mainly in prone and sitting positions from 8 months of age onwards (all p < 0.004, Spearman's r ranged from 0.644 to 0.798). CONCLUSIONS: This pilot study provides preliminary clinical evidence to support the inter-dependency between vertical upright trunk control and gross motor development in young infants, particularly as upright functional skills are gained. This suggests that a dual focus on training upright trunk control alongside gross motor skills could be of benefit in the treatment of infants with movement disorders.
Subject(s)
Child Development/physiology , Motor Skills/physiology , Postural Balance/physiology , Torso/physiology , Female , Humans , Infant , Male , Motor Disorders/rehabilitation , Pilot Projects , Statistics, NonparametricABSTRACT
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.
Subject(s)
Child Development/physiology , Physical Examination/methods , Postural Balance/physiology , Torso/growth & development , Female , Follow-Up Studies , Humans , Infant , Infant, Premature , Male , Psychometrics , Reproducibility of Results , Videotape RecordingABSTRACT
PURPOSE: This study investigated whether targeted training was feasible with young children younger than 2 years with poor trunk control due to cerebral palsy or developmental delay without using specialized equipment and the overall change in trunk control and functional ability, with the addition of targeted training to standard care physical therapy. SUMMARY OF KEY POINTS: Four children younger than 24 months with motor disorders were recruited. No difficulty was identified in using targeted training with this group. Within 3 months of commencing intervention, the 4 children had increased trunk control and functional abilities including independent sitting and bilateral hand use in play. CONCLUSIONS AND RECOMMENDATIONS FOR CLINICAL PRACTICE: This form of targeted training was feasible for young children with motor disorders and augmented standard care therapy in enhancing both trunk control and motor skills. Targeted training should be further investigated as a potentially effective treatment.
