Fallang Bjørg, Hadders-Algra Mijna
Oslo University College, Health Sciences, Physiotherapy Programme, 0130 Oslo, Norway.
Neural Plast. 2005;12(2-3):175-82; discussion 263-72. doi: 10.1155/np.2005.175.
The present paper presents clinical and neurophysiological data of postural behavior in preterm children without CP. Clinical follow-up studies of preterm infants until toddler and school age have reported that low-risk preterm infants may have atypical postural behavior in terms of reduced amount of rotation during crawling, delayed dynamic balance, delayed onset of and a poor quality of early walking behavior. At school age, dysfunctions such as problems in standing on one leg and poor hopping are reported. Neurophysiological data of postural control at early age indicated the presence of a dysfunction in the capacity to modulate postural activity, and the postural activity has been characterized by temporal disorganization of EMG responses. Postural responses to goal-directed reaching in supine lying have been recorded and analyzed in terms of the total body center of pressure. In this study, preterm infants show less mobile postural behavior compared with full-term infants. In infancy, the less mobile postural behavior seemed to be adequate as it was related to better goal-directed reaching quality, but the results indicated that the relatively immobile postural behavior during reaching in early age was related to less favorable neuromotor behavior in school-age.
本文介绍了无脑瘫早产儿姿势行为的临床和神经生理学数据。对早产儿直至幼儿期和学龄期的临床随访研究报告称,低风险早产儿在爬行时旋转量减少、动态平衡延迟、早期行走行为起始延迟且质量较差等方面可能存在非典型姿势行为。在学龄期,有报告称存在单腿站立困难和跳跃能力差等功能障碍。早期姿势控制的神经生理学数据表明,在调节姿势活动的能力方面存在功能障碍,且姿势活动的特征是肌电图反应的时间紊乱。已记录并根据全身压力中心分析了仰卧位时对目标导向伸手动作的姿势反应。在本研究中,与足月儿相比,早产儿的姿势行为灵活性较差。在婴儿期,姿势行为灵活性较差似乎是合适的,因为它与更好的目标导向伸手动作质量相关,但结果表明,早期伸手动作时相对不灵活的姿势行为与学龄期不太理想的神经运动行为有关。