Chair and Clinic of the Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland.
Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland.
PeerJ. 2023 Jun 13;11:e15460. doi: 10.7717/peerj.15460. eCollection 2023.
Proper motor development can be influenced by a range of risk factors. The resulting motor performance can be assessed through quantitative and qualitative analysis of posture and movement patterns.
This study was designed as the cohort follow-up of the motor assessment and aimed to demonstrate, in a mathematical way, the impact of particular risk factors on elements of motor performance in the 3 month and the final motor performance in the 9 month of life. Four hundred nineteen children were assessed (236 male and 183 female), including 129 born preterm. Each child aged 3 month underwent a physiotherapeutic assessment of the quantitative and qualitative development, in the prone and supine positions. The neurologist examined each child aged 9 month, referring to the Denver Development Screening Test II and assessing reflexes, muscle tone and symmetry. The following risk factors were analyzed after the neurological consultation: condition at birth (5 min Apgar score), week of gestation at birth, intraventricular hemorrhage, respiratory distress syndrome, and the incidence of intrauterine hypotrophy and hyperbilirubinemia determined based on medical records.
A combination of several risk factors affected motor development stronger than any one of them solely, with Apgar score, hyperbilirubinemia, and intraventricular hemorrhage exhibiting the most significant impact.
Premature birth on its own did not cause a substantial delay in motor development. Nonetheless, its co-occurrence with other risk factors, namely intraventricular hemorrhage, respiratory distress syndrome, and hyperbilirubinemia, notably worsened motor development prognosis. Moreover, improper position of the vertebral column, scapulae, shoulders, and pelvis in the third month of life may predict disturbances in further motor development.
适当的运动发育会受到一系列风险因素的影响。运动表现可以通过对姿势和运动模式的定量和定性分析来评估。
本研究是运动评估的队列随访，旨在以数学方式展示特定风险因素对生命 3 个月和 9 个月运动表现元素的影响。共评估了 419 名儿童（236 名男性和 183 名女性），包括 129 名早产儿。每个 3 个月大的儿童都接受了定量和定性发育的物理治疗评估，分别处于俯卧位和仰卧位。神经科医生对每个 9 个月大的儿童进行检查，参考丹佛发育筛查测试 II，并评估反射、肌肉张力和对称性。在神经学咨询后分析了以下风险因素：出生时的状况（5 分钟 Apgar 评分）、出生时的胎龄、室管膜下出血、呼吸窘迫综合征，以及根据病历确定的宫内生长迟缓发生率和高胆红素血症。
多种风险因素的组合对运动发育的影响比任何单一因素都更强烈，Apgar 评分、高胆红素血症和室管膜下出血的影响最大。
早产本身并不会导致运动发育明显延迟。然而，它与其他风险因素（即室管膜下出血、呼吸窘迫综合征和高胆红素血症）同时发生，明显恶化了运动发育的预后。此外，生命第 3 个月时脊柱、肩胛骨、肩部和骨盆的位置不当可能预示着进一步的运动发育紊乱。
