Comparing neuromotor functions in 45- and 65-year-old adults with 18-year-old adolescents.

Aim: This cross-sectional analysis investigates how neuromotor functions of two independent cohorts of approximately 45- and 65-year-old individuals are different from 18-year-old adolescents using the Zurich Neuromotor Assessment-2 (ZNA-2). Methods: A total of 186 individuals of the Zurich Longitudinal Studies (ZLS) born in the 1950s (mean age 65.1 years, SD = 1.2 year, range of ages 59.0-67.5 years, n = 151, 82 males) and 1970s (mean age 43.6 years, SD = 1.3 year, range of ages 40.8-46.6 years, n = 35, 16 males) were tested with the ZNA-2 on 14 motor tasks combined in 5 motor components: fine motor, pure motor, balance, gross motor, and associated movements. Motor performance measures were converted into standard deviation scores (SDSs) using the normative data for 18-year-old individuals as reference. Results: The motor performance of the 45-year-old individuals was remarkably similar to that of the 18-year-olds (SDS from -0.22 to 0.25) apart from associated movements (-0.49 SDS). The 65-year-olds showed lower performance than the 18-year-olds in all components of the ZNA-2, with the smallest difference observed for associated movements (-0.67 SDS) and the largest for gross motor skills (-2.29 SDS). Higher body mass index (BMI) was associated with better performance on gross motor skills for 45-year-olds but with worse performance for 65-year-olds. More educational years had positive effects on gross motor skills for both ages. Interpretation: With the exception of associated movements, neuromotor functions as measured with the ZNA-2 are very similar in 45- and 18-year-olds. In contrast, at age 65 years, all neuromotor components show significantly lower function than the norm population at 18 years. Some evidence was found for the last-in-first-out hypothesis: the functions that developed later during adolescence, associated movements and gross motor skills, were the most vulnerable to age-related decline.

Secular trends in motor performance in Swiss children and adolescents from 1983 to 2018.

Introduction: Environmental changes, including globalization, urbanization, social and cultural changes in society, and exposure to modern digital technology undoubtedly have an impact on children's activity and lifestyle behavior. In fact, marked reductions in children's physical activity levels have been reported over the years and sedentary behavior has increased around the world. The question arises whether these environmental changes had an impact on general motor performance in children and adolescents. The study aimed to investigate secular trends of motor performance in Swiss children and adolescents, aged between 7 and 18 years, over a period of 35 years from 1983 to 2018. Methods: Longitudinal data on the five motor components of the Zurich Neuromotor Assessment (ZNA) - pure motor (PM), fine motor (FM), dynamic balance (DB), static balance (SB), and contralateral associated movements (CAM) - were pooled with cross-sectional data on PM and FM from eight ZNA studies between 1983 and 2018. Regression models were used to estimate the effect of the year of birth on motor performance and body mass index (BMI) measurements. Models were adjusted for age, sex, and socioeconomic status. Results: The secular trend estimates in standard deviation scores (SDS) per 10 years were - 0.06 [-0.33; 0.22, 95% Confidence Interval] for PM, -0.11 [-0.41; 0.20] for FM, -0.38 [-0.66; -0.09] for DB (-0.42 when controlled for BMI), -0.21 [-0.47; 0.06] for SB, and - 0.01 [-0.32; 0.31] for CAM. The mean change in BMI data was positive with 0.30 SDS [0.07; 0.53] over 10 years. Discussion: Despite substantial societal changes since the 1980s, motor performance has remained relatively stable across generations. No secular trend was found in FM, PM, SB, and CAM over a period of 35 years. A secular trend in DB was present independent of the secular trend in body mass index.

Motor and visuomotor function in 10-year-old children with congenital heart disease: association with behaviour.

BACKGROUND: Children with CHD are at increased risk for neurodevelopmental impairments. There is little information on long-term motor function and its association with behaviour. AIMS: To assess motor function and behaviour in a cohort of 10-year-old children with CHD after cardiopulmonary bypass surgery. METHODS: Motor performance and movement quality were examined in 129 children with CHD using the Zurich Neuromotor Assessment providing four timed and one qualitative component, and a total timed motor score was created based on the four timed components. The Beery Test of Visual-Motor Integration and the Strengths and Difficulties Questionnaire were administered. RESULTS: All Zurich Neuromotor Assessment motor tasks were below normative values (all p ≤ 0.001), and the prevalence of poor motor performance (≤10th percentile) ranged from 22.2% to 61.3% in the different components. Visuomotor integration and motor coordination were poorer compared to norms (all p ≤ 0.001). 14% of all analysed children had motor therapy at the age of 10 years. Children with a total motor score ≤10th percentile showed more internalising (p = 0.002) and externalising (p = 0.028) behavioural problems. CONCLUSIONS: School-aged children with CHD show impairments in a variety of motor domains which are related to behavioural problems. Our findings emphasise that motor problems can persist into school-age and require detailed assessment and support.

Assessing Motor Performance in Preschool Children: The Zurich Neuromotor Assessment-2 and the Movement Assessment Battery for Children-2.

Comparing motor assessment tools that are available for young children is important in order to select the most appropriate clinical and research tools. Hence, this study compared motor performance assessed with the Zurich Neuromotor Assessment-2 (ZNA-2) to the Movement Assessment Battery for Children-2 (MABC-2). The sample consisted of 169 children, aged 3-5 years (87 boys; 51%). We used Pearson correlations to examine relationships between the ZNA-2 and MABC-2 component and total scores. In addition, Pearson correlations were performed between individual fine motor and balance items of the ZNA-2 and MABC-2. Results were that the total scores of the ZNA-2 and MABC-2 correlated moderately (r = .40, p < .001). Non-significant to moderate correlations were found between components (r = -.00 to .47) and between individual items of fine motor skills (r = .04 to .38) and balance (r = -.12 to .38). Thus, the ZNA-2 and MABC-2 measure partly similar and partly different aspects of motor performance.

A quick and qualitative assessment of gross motor development in preschool children.

There is a need for a quick, qualitative, reliable, and easy tool to assess gross motor development for practitioners. The aim of this cross-sectional study is to present the Zurich Neuromotor Assessment-Q (ZNA-Q), which assesses static and dynamic balance in children between 3 and 6 years of age in less than 5 min. A total of 216 children (103 boys; 113 girls; median age 4 years, 4 months; interquartile range 1 year, 3 months) were enrolled from day-care centers, kindergartens, and schools, and were tested with 5 different gross motor tasks: standing on one leg, tandem stance, hopping on one leg, walking on a straight line, and jumping sideways. All ordinal measures (consisting of qualitative measures and scales) featured a marked developmental trend and substantial inter-individual variability. Test-retest reliability was assessed on 37 children. It varied from .17 for tandem stance to .43 for jumping sideways for the individual tasks, and it was .41 and .67 for the static and dynamic balance components, respectively. For the whole ZNA-Q, test-retest reliability was .7.Conclusion: Ordinal scales enable practitioners to gather data on children's gross motor development in a fast and uncomplicated way. It offers the practitioner with an instrument for the exploration of the current developmental motor status of the child. What is Known: • Measurement of gross motor skills in the transitional period between motor mile stones and quantitative assessments is difficult. • Assessment of gross motor skills is relatively easy. What is New: • Supplementary and quick gross motor test battery for children for practitioners. • Normative values of five gross motor skills measured with ordinal scales.

Assessment of Nervous System of High-risk Infants: 236 Cases Report / 中国康复理论与实践

Objective:To investigate evaluation methods to predict the outcome of nervous system development in high-risk infants. Methods:From March, 2015 to March, 2016, 336 high-risk infants were enrolled. They were assessed by General Movements (GMs) Quality Assessment, 0~1 Years Old 20 Items Neuromotor Assessment and Gesell Developmental Schedules. Results:A total of 236 infants finishied the study. GMs Quality Assessment showed that 203 cases were normal and 33 cases were abnormal in the writhing movements stage; 218 cases were normal and 18 cases were abnormal in the fidgety movemonts stage. 0~1 Years Old 20 Items Neuromotor Assessment showed that 202 cases were normal and 34 cases were abnormal. Gesell Developmental Schedules showed that 12 cases were abnormal. Conclusion:The combination of GMs Quality Assessment, 0~1 Years Old 20 Items Neuromotor Assessment and Gesell Developmental Schedules could better predict the nervous system development of high-risk infants.

The Validity of Two Neuromotor Assessments for Predicting Motor Performance at 12 Months in Preterm Infants.

OBJECTIVE: To evaluate the validity of the Test of Infant Motor Performance (TIMP) and general movements (GMs) assessment for predicting Alberta Infant Motor Scale (AIMS) score at 12 months in preterm infants. METHODS: A total of 44 preterm infants who underwent the GMs and TIMP at 1 month and 3 months of corrected age (CA) and whose motor performance was evaluated using AIMS at 12 months CA were included. GMs were judged as abnormal on basis of poor repertoire or cramped-synchronized movements at 1 month CA and abnormal or absent fidgety movement at 3 months CA. TIMP and AIMS scores were categorized as normal (average and low average and >5th percentile, respectively) or abnormal (below average and far below average or <5th percentile, respectively). Correlations between GMs and TIMP scores at 1 month and 3 months CA and the AIMS classification at 12 months CA were examined. RESULTS: The TIMP score at 3 months CA and GMs at 1 month and 3 months CA were significantly correlated with the motor performance at 12 months CA. However, the TIMP score at 1 month CA did not correlate with the AIMS classification at 12 months CA. For infants with normal GMs at 3 months CA, the TIMP score at 3 months CA correlated significantly with the AIMS classification at 12 months CA. CONCLUSION: Our findings suggest that neuromotor assessment using GMs and TIMP could be useful to identify preterm infants who are likely to benefit from intervention.

Impact of age, sex, socioeconomic status, and physical activity on associated movements and motor speed in preschool children.

INTRODUCTION: Young children generally show contralateral associated movements (CAMs) when they are making an effort to perform a unimanual task. CAM and motor speed are two relevant aspects of motor proficiency in young children. These CAMs decrease over age, while motor speed increases. As both CAM and motor speed are associated with age, we were interested in whether these two parameters are also linked with each other. METHOD: In this study, three manual dexterity tasks with the dominant and nondominant hands (pegboard, repetitive hand, and repetitive finger tasks) were used to investigate the effect of covariates (age, sex, socioeconomic status, total physical activity) on both motor speed and CAMs in preschool children. RESULTS: There was a significant age effect for both motor speed and CAMs in all tasks when the dominant hand was used. When the nondominant hand was used, the decrease in the intensity of CAMs over age was not consistently significant. The influence of physical activity and socioeconomic status on motor proficiency was small. Furthermore, the correlation between motor speed and CAMs, although significant, was low. CONCLUSIONS: Motor speed improved with age over three fine motor tasks in preschool children. Decrease in CAMs was observed but it was not always significant when the nondominant hand was working. Motor speed and CAMs were only weakly associated. We conclude that the excitatory pathways responsible for motor speed and inhibitory pathways responsible for reducing CAMs occupy two different domains in the brain and therefore mostly behave independently of each other.

The Validity of Two Neuromotor Assessments for Predicting Motor Performance at 12 Months in Preterm Infants

OBJECTIVE: To evaluate the validity of the Test of Infant Motor Performance (TIMP) and general movements (GMs) assessment for predicting Alberta Infant Motor Scale (AIMS) score at 12 months in preterm infants. METHODS: A total of 44 preterm infants who underwent the GMs and TIMP at 1 month and 3 months of corrected age (CA) and whose motor performance was evaluated using AIMS at 12 months CA were included. GMs were judged as abnormal on basis of poor repertoire or cramped-synchronized movements at 1 month CA and abnormal or absent fidgety movement at 3 months CA. TIMP and AIMS scores were categorized as normal (average and low average and >5th percentile, respectively) or abnormal (below average and far below average or < 5th percentile, respectively). Correlations between GMs and TIMP scores at 1 month and 3 months CA and the AIMS classification at 12 months CA were examined. RESULTS: The TIMP score at 3 months CA and GMs at 1 month and 3 months CA were significantly correlated with the motor performance at 12 months CA. However, the TIMP score at 1 month CA did not correlate with the AIMS classification at 12 months CA. For infants with normal GMs at 3 months CA, the TIMP score at 3 months CA correlated significantly with the AIMS classification at 12 months CA. CONCLUSION: Our findings suggest that neuromotor assessment using GMs and TIMP could be useful to identify preterm infants who are likely to benefit from intervention.

Association between Body Composition and Motor Performance in Preschool Children.

OBJECTIVE: Being overweight makes physical movement more difficult. Our aim was to investigate the association between body composition and motor performance in preschool children. METHODS: A total of 476 predominantly normal-weight preschool children (age 3.9 ± 0.7 years; m/f: 251/225; BMI 16.0 ± 1.4 kg/m2) participated in the Swiss Preschoolers' Health Study (SPLASHY). Body composition assessments included skinfold thickness, waist circumference (WC), and BMI. The Zurich Neuromotor Assessment (ZNA) was used to assess gross and fine motor tasks. RESULTS: After adjustment for age, sex, socioeconomic status, sociocultural characteristics, and physical activity (assessed with accelerometers), skinfold thickness and WC were both inversely correlated with jumping sideward (gross motor task ß-coefficient -1.92, p = 0.027; and -3.34, p = 0.014, respectively), while BMI was positively correlated with running performance (gross motor task ß-coefficient 9.12, p = 0.001). No significant associations were found between body composition measures and fine motor tasks. CONCLUSION: The inverse associations between skinfold thickness or WC and jumping sideward indicates that children with high fat mass may be less proficient in certain gross motor tasks. The positive association between BMI and running suggests that BMI might be an indicator of fat-free (i.e., muscle) mass in predominately normal-weight preschool children.

Comparison between the Movement ABC-2 and the Zurich Neuromotor Assessment in Preschool Children.

An established test instrument for the assessment of motor performance in children between 3 and 16 years is the Movement Assessment Battery for Children - Second Edition (M-ABC-2). The Zurich Neuromotor Assessment (ZNA) is also widely used for the evaluation of children's motor performance but has not been compared with the M-ABC-2 for children below five years for the purpose of convergent validity. Forty-seven children (26 boys, 21 girls) between three and five years of age were assessed using the M-ABC-2 and the ZNA3-5. Rank correlations between scores of different test components were calculated. Only low-to-moderate correlations were observed when separate components of these tests were compared (.31 to .68, p < .05), especially when involving the associated movements from the ZNA3-5 (-.05 to -.13, p > .05). However, the correlation between summary scores of the two tests was .77 (p < .001), and it increased to .84 when associated movements were excluded, which was comparable in magnitude to the test-retest reliability of the M-ABC-2, supporting convergent validity between the two tests. Although the ZNA3-5 and M-ABC-2 measure different aspects of motor behavior, the two instruments may thus measure essentially the same construct.

Identification of neuromotor deficits common to autism spectrum disorder and attention deficit/hyperactivity disorder, and imitation deficits specific to autism spectrum disorder.

Deficits in motor and imitation abilities are a core finding in autism spectrum disorders (ASD), but impaired motor functions are also found in attention deficit/hyperactivity disorder (ADHD). Given recent theorising about potential aetiological overlap between the two disorders, the present study aimed to assess difficulties in motor performance and imitation of facial movements and meaningless gestures in a sample of 24 ADHD patients, 22 patients with ASD, and 20 typically developing children, matched for age (6-13 years) and similar in IQ (>80). Furthermore, we explored the impact of comorbid ADHD symptoms on motor and imitation performance in the ASD sample and the interrelationships between the two groups of variables in the clinical groups separately. The results show motor dysfunction was common to both disorders, but imitation deficits were specific to ASD. Together with the pattern of interrelated motor and imitation abilities, which we found exclusively in the ASD group, our findings suggest complex phenotypic, and possibly aetiological, relationships between the two neurodevelopmental conditions.

Similarities and dissimilarities between the movement ABC-2 and the Zurich neuromotor assessment in children with suspected developmental coordination disorder.

An established tool for the assessment of motor performance in children with developmental coordination disorder (DCD) is the Movement-ABC-2 (M-ABC-2). The Zurich Neuromotor Assessment (ZNA) is also widely used for the evaluation of children's motor performance, but has not been compared with the M-ABC-2. Fifty-one children (39 males) between 5 and 7 years of age with suspected DCD were assessed using the M-ABC-2 and the ZNA. Rank correlations between scores of different test components were calculated. The structure of the tests was explored using canonical-correlation analysis. The correlation between total scores of the two motor tests was reasonable (0.66; p<0.001). However, ZNA scores were generally lower than those of M-ABC-2, due to poor performance in the fine motor adaptive component and increased contralateral associated movements (CAM). The canonical-correlation analysis revealed that ZNA measures components like pure motor skills and CAM that are not represented in the M-ABC-2. Furthermore, there was also no equivalent for the aiming and catching items of the M-ABC-2 in ZNA. The two tests measure different motor characteristics in children with suspected DCD and, thus, can be used complementary for the diagnosis of the disorder.

Long-term neurodevelopmental outcome with hypoxic-ischemic encephalopathy.

OBJECTIVES: To determine the long-term neurodevelopmental outcome for children after hypoxic-ischemic encephalopathy (HIE) without major disability, and to examine neonatal injury patterns detected on cerebral magnetic resonance imaging (MRI) in relation to later deficits. STUDY DESIGN: Prospectively enrolled children with HIE and neonatal cerebral MRI data (n = 68) were examined at a mean age of 11.2 years (range, 8.2-15.7 years). Eleven children had a major disability (ie, cerebral palsy or mental retardation). Brain injury was scored according to the region and extent of injury. RESULTS: Children without major disability (n = 57) had lower full-scale and performance IQ scores compared with norms (P = .02 and .01, respectively), and the proportion of children with an IQ <85 was higher than expected (P = .04). Motor performance on the Zurich Neuromotor Assessment was affected in the pure motor, adaptive fine motor, and gross motor domains, as well as in the movement quality domain (all P < .001). Watershed injury pattern on neonatal MRI correlated with full-scale and verbal IQ scores (P = .006 and <.001, respectively), but neonatal MRI pattern did not correlate with motor performance in children without major disability. CONCLUSION: Children who sustained neonatal HIE without major disability are at increased risk for long-term intellectual, verbal, and motor deficits. The severity of watershed injury is correlated with later intellectual performance. Long-term follow-up examinations are necessary for early detection of neurodevelopmental impairment and early initiation of adequate therapies.

Neuromotor Assessments and Developmental Movement Disorders

Development in motor skills and abnormal movement patterns in developing child are clearly observed and easily identified by the parents. Motor delay and movement disorder are common presentations for children with developmental disorders. Therefore, assessment for motor development and movement disorder become the major developmental focus of early in life. Physical examination has been considered as a key element for identifying developmental motor disorder. Traditionally, development of tone, primitive reflexes, postural reaction and motor milestone are commonly used as the evaluation tools for early identification of children at high risk for developmental disorder. Recently the assessment of the quality of general movements was introduced as a new form of neuromotor assessment of young infant. Therefore, clinical usefulness of the assessments for detecting neurological dysfunction was briefly reviewed in this paper. As well, there are a lot of movement disorders shown in child. The movement disorders can be separated into transient, paroxysmal and chronic ones according to their evolution. Since the knowledge of the movement disorders in each category enables us to understand the evolution of movement disorders, avoid unnecessary tests and treatments, and also give the proper information to the parents, the movement disorders were briefly reviewed in this paper.

Escalas de avaliação neuromotora em pré-escolares: revisão bibliográfica / Neuromotor scales for preschool childrren assessment: a review

O sistema nervoso da criança esta em constante transformação e a combinação entre fatores genéticos e ambientais e o que determina o seu desenvolvimento neuropsicomotor. O use de avaliações padronizadas permite identificar se a criança esta apresentando ou não problemas no seudesenvolvimento. O presente estudo tem por finalidade realizar uma revisão bibliográfica sobre as escalas de avaliação do desenvolvimento neuromotor aplicáveis a pré-escolares. Observa-se que as escalas variam quanto ao item analisado, quanto a idade, quanto a forma de interpretação dos resultados entre outros; portanto, o avaliador deve ter em mente o que deseja avaliar para fazer a escolha da escala adequada.(AU)

The child's nervous system is in constant transformation that determines its neurodevelopment and it appears to result from a combination of genetic and environmental factors. The use of standardized scales allows the identification of the neurodevelopmental disorders. This paper aims at establishing a bibliographic review on the neuromotor scales for the neurodevelopment assessment of preschool students. We observed that the scales vary according to the analysed item, the age, the way of interpreting the results, among other factors; therefore, the evaluator must keep in mind what he/she wishes to evaluate to choose the adequate scale.(AU)

Escalas de avaliação neuromotora em pré-escolares: revisão bibliográfica / Neuromotor scales for preschool childrren assessment: a review

O sistema nervoso da criança esta em constante transformação e a combinação entre fatores genéticos e ambientais e o que determina o seu desenvolvimento neuropsicomotor. O use de avaliações padronizadas permite identificar se a criança esta apresentando ou não problemas no seudesenvolvimento. O presente estudo tem por finalidade realizar uma revisão bibliográfica sobre as escalas de avaliação do desenvolvimento neuromotor aplicáveis a pré-escolares. Observa-se que as escalas variam quanto ao item analisado, quanto a idade, quanto a forma de interpretação dos resultados entre outros; portanto, o avaliador deve ter em mente o que deseja avaliar para fazer a escolha da escala adequada.

The child's nervous system is in constant transformation that determines its neurodevelopment and it appears to result from a combination of genetic and environmental factors. The use of standardized scales allows the identification of the neurodevelopmental disorders. This paper aims at establishing a bibliographic review on the neuromotor scales for the neurodevelopment assessment of preschool students. We observed that the scales vary according to the analysed item, the age, the way of interpreting the results, among other factors; therefore, the evaluator must keep in mind what he/she wishes to evaluate to choose the adequate scale.