Kimura-Ohba Shihoko, Sawada Akiko, Shiotani Yuka, Matsuzawa Shigeyuki, Awaya Tomonari, Ikeda Hiroko, Okada Masako, Tomiwa Kiyotaka
Osaka Research Group, Japan Children's Study, Japan Science and Technology Agency, Osaka, Japan.
Pediatr Int. 2011 Dec;53(6):950-5. doi: 10.1111/j.1442-200X.2011.03423.x.
Gross motor development is usually assessed in terms of age of achievement of motor milestones. Although there is generally an impression of faster development if the milestones are achieved at younger ages, no longitudinal studies have been done on the associations between the milestones, especially in Japan. As a part of the Japan Children's Study, the purpose of the present study was to determine whether the achievement of gross motor milestones in infancy is related with the age of walking.
This was a prospective cohort study of 290 healthy and term infants born in a district of Osaka City, Japan. Three milestones (rolling over, sitting, and crawling) were observed in the laboratory for infants aged at 4 and 9 months by a pediatrician and a developmental psychologist, and the age of walking was confirmed in questionnaires filled in by the parents at 18 and 27 months.
Children who could roll over at 4 months, and sit and crawl at 9 months, walked earlier than children who could not roll over, sit and crawl, respectively. With regard to crawling, children who were creeping had a 1 month delay in walking, and those who could not move forward had a 2 month delay compared to typical crawlers. On multiple regression analysis these three milestones were positively associated with walking: rolling over (β= 0.567), sitting (β= 1.973) and crawling (β= 1.473).
The age and the patterns of sitting, crawling and rolling over were all related to the age of independent walking among Japanese infants. Consideration of milestone definition and variations is essential in medical check-up.
粗大运动发育通常根据运动里程碑的达成年龄来评估。尽管一般认为如果在较小年龄达成里程碑意味着发育更快，但尚未有关于这些里程碑之间关联的纵向研究，尤其是在日本。作为日本儿童研究的一部分，本研究的目的是确定婴儿期粗大运动里程碑的达成是否与开始走路的年龄有关。
这是一项对日本大阪市某区出生的290名健康足月儿进行的前瞻性队列研究。由一名儿科医生和一名发育心理学家在实验室对4个月和9个月大的婴儿观察三个里程碑（翻身、坐立和爬行），并通过父母在18个月和27个月时填写的问卷确认开始走路的年龄。
在4个月时能翻身、9个月时能坐立和爬行的儿童，分别比不能翻身、坐立和爬行的儿童走路更早。关于爬行，与典型爬行的儿童相比，正在匍匐前进的儿童走路延迟1个月，而不能向前移动的儿童走路延迟2个月。多元回归分析显示，这三个里程碑与走路呈正相关：翻身（β=0.567）、坐立（β=1.973）和爬行（β=1.473）。
在日本婴儿中，坐立、爬行和翻身的年龄及方式均与独立行走的年龄有关。在体检中考虑里程碑的定义和差异至关重要。
