Powls A, Botting N, Cooke R W, Marlow N
Institute of Child Health, Liverpool University, Alder Hey Children's Hospital.
Arch Dis Child Fetal Neonatal Ed. 1995 Sep;73(2):F62-6. doi: 10.1136/fn.73.2.f62.
To determine whether poor motor skills, previously identified in a cohort of very low birthweight (< 1250 g) children, born in 1980-1, have persisted or improved. Previous assessments had shown significant improvement between the ages of 6 and 8 years.
The original cohort were traced and were assessed using the Movement Assessment Battery for Children, an update of the Test Of Motor Impairment, used at 6 and 8 years. Where possible the classroom-matched controls from the original studies were assessed, otherwise new controls were selected. Teachers were also asked to identify those children whom they considered clumsy. Forty seven of the original cohort of 53 children, all but one still attending mainstream school, and 40 original and 20 new classroom-matched controls were studied.
Fifty one per cent of the cohort showed clinically important or borderline impairment. More of these children had significant impairment (16/47, 34%) than the controls (3/60, 5%). The improvement seen by 8 years of age was maintained but there was no further improvement. Girls had significantly higher overall impairment scores (median 16; interquartile range 10-21.5) than the boys (5.5 (1.5-12.5)), and on a wider variety of subtests (5/8) than the boys (3/8).
Many very low birthweight children have impaired motor skills. Despite early improvement it persists into adolescence and the deficit remains. Interventional studies may help to see if these problems can be alleviated.
确定1980 - 1年出生的极低出生体重(< 1250克)儿童队列中先前发现的运动技能较差的情况是否持续存在或有所改善。先前的评估显示,这些儿童在6至8岁之间有显著改善。
追踪原来的队列,并使用儿童运动评估量表进行评估,该量表是运动障碍测试的更新版本,曾在6岁和8岁时使用。尽可能对原始研究中与班级匹配的对照组进行评估,否则选择新的对照组。还要求教师识别他们认为动作笨拙的儿童。对原来53名儿童队列中的47名进行了研究,除一人外,其余均仍在主流学校就读,同时研究了40名原始的和20名新的与班级匹配的对照组。
该队列中有51%的儿童表现出具有临床意义或临界的损伤。这些儿童中存在显著损伤的比例(16/47,34%)高于对照组(3/60,5%)。8岁时出现的改善得以维持,但没有进一步改善。女孩的总体损伤得分(中位数16;四分位间距10 - 21.5)显著高于男孩(5.5(1.5 - 12.5)),并且在更多种类的子测试中(5/8)表现出损伤,高于男孩(3/8)。
许多极低出生体重儿童存在运动技能受损的情况。尽管早期有所改善,但这种情况持续到青春期且缺陷依然存在。干预性研究可能有助于了解这些问题是否可以得到缓解。