Fallang Bjørg, Saugstad Ola Didrik, Grøgaard Jens, Hadders-Algra Mijna
Oslo University College, Health Sciences, Physiotherapy Programme, Norway.
Pediatr Res. 2003 May;53(5):836-42. doi: 10.1203/01.PDR.0000058925.94994.BC. Epub 2003 Feb 20.
Many preterm infants may experience so-called minor developmental disorders; however, in general, the problems in motor behavior are not detected until school age. To introduce therapies aimed at the prevention of these problems, we need to increase our knowledge of motor function and dysfunction at early age. The present study focused on the organization of reaching movements in full-term and preterm infants without cerebral palsy. The reaching behavior of premature infants (n = 63) was assessed longitudinally at the corrected ages of 4 and 6 mo. Clinical assessments were made at 6 and 12 mo of age. On the basis of the infant's morbidity during the early stay in the neonatal intensive care unit, the preterm infants were allocated into a high-risk and a low-risk group. Results from a previous study in full-term infants (n = 13) were included. Kinematics of reaching movements in supine position were measured, and the analysis focused on movement velocity and movement units. A compound parameter of kinematic variables was created, reflecting the quality of reaching movements. The present study showed that at the age of 4 mo, low-risk preterm infants showed more often optimal reaching behavior than full-term and preterm high-risk infants. This better reaching performance was related to a better general motor and behavioral development during the first year of life. At the age of 6 mo, the advantage of the low-risk group in reaching behavior had disappeared and a disadvantage in the form of nonoptimal reaching behavior of the high-risk group emerged.
许多早产儿可能会经历所谓的轻度发育障碍；然而，一般来说，运动行为方面的问题直到学龄期才会被发现。为了引入旨在预防这些问题的治疗方法，我们需要增加对早期运动功能和功能障碍的了解。本研究聚焦于无脑瘫的足月儿和早产儿的伸手动作组织。对63名早产儿在矫正年龄4个月和6个月时的伸手行为进行了纵向评估。在6个月和12个月大时进行了临床评估。根据早产儿在新生儿重症监护病房早期住院期间的发病率，将其分为高危组和低危组。纳入了之前一项对13名足月儿的研究结果。测量了仰卧位伸手动作的运动学指标，分析重点是运动速度和运动单元。创建了一个反映伸手动作质量的运动学变量复合参数。本研究表明，在4个月大时，低危早产儿比足月儿和高危早产儿更常表现出最佳伸手行为。这种更好的伸手表现与出生后第一年更好的总体运动和行为发育有关。在6个月大时，低危组在伸手行为方面的优势消失，高危组出现了非最佳伸手行为形式的劣势。
