Hadzagić-Catibusić Feriha, Gavrankapetanović Ismet, Zubcević Smail, Meholjić Aisa, Rekić Amir, Sunjić Maja
Pedijatrijska Klinika, KCU Sarajevo.
Med Arh. 2004;58(3):189-90.
Infant walkers are mobile wheeled seats that allow infants to move around with their feet on the floor. They enable precocious locomotion in very young, otherwise prelocomotor infants. Prelocomotor walker experience prevents visual access to the moving limbs. Infant walker use can be associated with delay in achievement of normal locomotor milestones. Besides delayed motor development, contractures of the calf muscles and motor development mimicking spastic diparesis may appear. In the case of infant walker's use for the infants at risk for development of cerebral palsy, multiple side effects can be produced: the persistence of positive support reflex, heel cord contractures, subluxation and dislocation of the hips or pronation contractures of the upper extremities. The use of infant walkers increases the risk of injuries. The study has enrolled 150 children and their mothers, from three big cities in Bosnia and Herzegovina (Sarajevo, Bihać, Zenica). All relevant data have been collected through the questionnaires. 130 children (86.6%) have used infant walkers. The mean age when the use of infant walker has started was 7 months. The mean time of daily use of infant walker was 1 hour 49 minutes. Twenty three children had various motor disturbances, 13 out of them (56.5%) have used infant walker. The mild injuries caused by using the infant walkers have been registered in 17 cases (11.3%). 83 mothers (55.3%) were aware of infant walker's nocuous effects.
The use of infant walkers has been spread widely under our circumstances. There is significant discrepancy between mothers' knowledge about nocuous effects of infant walkers and their practice. The use of infant walkers for infants with motor disturbances is especially harmful. The main reason for using infant walker, despite of its harmfulness, was mother's preoccupation with everyday household activities. It is necessary to engage health professionals to support antiwalker campaign (warning labels on the infant walkers, public education programs, etc). We recommend safer alternatives for child daycare, like stationary activity centers (so called "fenced play gardens".
婴儿学步车是带轮子的可移动座椅,能让婴儿双脚踩地四处移动。它使非常年幼、原本处于运动前期的婴儿能够早熟地行走。运动前期使用学步车的经历会妨碍婴儿看到自己移动的肢体。使用婴儿学步车可能与正常运动里程碑的达成延迟有关。除了运动发育迟缓外,还可能出现小腿肌肉挛缩以及类似痉挛性双侧轻瘫的运动发育情况。对于有脑瘫发育风险的婴儿使用婴儿学步车,会产生多种副作用:阳性支持反射持续存在、跟腱挛缩、髋关节半脱位和脱位或上肢旋前挛缩。使用婴儿学步车会增加受伤风险。该研究招募了波斯尼亚和黑塞哥维那三个大城市(萨拉热窝、比哈奇、泽尼察)的150名儿童及其母亲。所有相关数据均通过问卷收集。130名儿童(86.6%)使用过婴儿学步车。开始使用婴儿学步车的平均年龄为7个月。婴儿学步车的日均使用时间为1小时49分钟。23名儿童有各种运动障碍,其中13名(56.5%)使用过婴儿学步车。因使用婴儿学步车造成的轻度损伤有17例(11.3%)。83名母亲(55.3%)知晓婴儿学步车的有害影响。
在我们的环境中,婴儿学步车的使用已广泛传播。母亲们对婴儿学步车有害影响的认知与她们的实际做法之间存在显著差异。对有运动障碍的婴儿使用婴儿学步车尤其有害。尽管婴儿学步车有害,但使用它的主要原因是母亲忙于日常家务。有必要让健康专业人员参与反学步车运动(在婴儿学步车上贴警示标签、开展公共教育项目等)。我们推荐更安全的儿童日托替代方案,如固定活动中心(所谓的“围栏游戏花园”)。