目的:本研究的目的是调查比利时低危婴儿对运动发育的影响,印度,挪威,和美国(US)在10-16周龄后使用一般运动评估(GMA)。
方法:这是一项前瞻性纳入低危足月儿的横断面研究(n=186)。经过认证的GMA观察员对烦躁的动作进行了评级,运动模式的质量,运动曲目的年龄充分性,姿势模式,运动特性,和整体运动最优性评分-修订(MOS-R)。评估分数与性别的关联,出生体重类别,胎龄,后期年龄在视频中,和国家。
结果:大多数婴儿的烦躁不安运动正常(179/186,96.2%)。这并不因性别而异,出生体重,胎龄,后期年龄在视频中,或国家。所有婴儿均显示正常>非典型运动模式。观察到年龄充足的变异性(最佳:137/183,74.9%),姿势模式(正常>非典型:164/183,89.6%),和流畅/流畅的运动字符(138/183,75.4%)。在视频中,妊娠年龄和后期年龄与非典型姿势模式相关,但在多变量回归中,仅年龄较小的足月年龄保持显著性(OR2.94,95%CI:1.05-8.24)。年龄不足与足月年龄相关(OR13.15,95%CI:4.36-39.72),和国家(与挪威相比;比利时OR3.3895%CI:12.4-9.22;印度OR3.16,95%CI:1.01-9.87:美国不显著)。来自印度的婴儿的最佳MOS-R(25-28)比率也低于来自挪威的婴儿。
结论:躁动运动的正常和时间组织没有因性别而异,出生体重,后期年龄,或国家,这表明烦躁不安的运动没有文化和环境影响。在该队列中,大多数健康的足月婴儿在使用MOS-R测试的运动发育的所有方面都表现出正常得分。不同国家/地区的年龄充分性和MOS-R差异需要进行更大的队列调查和纵向随访。
了解典型运动发育的变化对于解释处于非典型发育风险的婴儿的运动和姿势模式至关重要。使用Prechtl的一般运动评估框架,这项研究表明,健康婴儿的运动和姿势发育受年龄和出生国家的影响,但是烦躁运动的发展似乎没有这些影响。可能需要局部规范来解释所有人群的运动最优性评分-修订,但需要对此主题进行进一步研究。
OBJECTIVE: The objective of this study was to investigate the influences on motor development in infants who are at low risk from Belgium, India, Norway, and the United States (US) using the General Movement Assessment (GMA) at 10-16 weeks post-term age.
METHODS: This was a cross-sectional study of prospectively enrolled full-term infants at low risk (n = 186). Certified GMA observers rated the fidgety movements, quality of the movement patterns, age-adequacy of the movement repertoire, postural patterns, movement character, and overall Motor Optimality Score - Revised (MOS-R). Scores were evaluated for associations with sex, birth weight category, gestational age, post-term age at video, and country.
RESULTS: The majority of infants had normal fidgety movements (179/186, 96.2%). This did not vary by sex, birth weight, gestational age, post-term age at video, or country. All infants showed normal>atypical movement patterns. Variability was seen for age adequacy (optimal: 137/183, 74.9%), postural patterns (normal>atypical: 164/183, 89.6%), and smooth/ fluent movement character (138/183, 75.4%). Gestational age and post-term age at video were associated with atypical postural patterns but in multivariable regression, only younger post-term age retained significance (OR 2.94, 95% CI: 1.05-8.24). Lack of age adequacy was associated with post-term age (OR 13.15, 95% CI: 4.36-39.72), and country (compared with Norway; Belgium OR 3.38 95% CI:12.4-9.22; India OR 3.16, 95% CI:1.01-9.87: US not significant). Infants from India also showed lower rates of an optimal MOS-R (25-28) than infants from Norway.
CONCLUSIONS: The normality and temporal organization of fidgety movements did not differ by sex, birth weight, post-term age, or country, suggesting that the fidgety movements are free of cultural and environmental influences. The majority of full-term infants who were healthy in this cohort showed normal scores for all aspects of motor development tested using the MOS-R. Differences in age adequacy and MOS-R by country warrant investigation with larger cohorts and longitudinal follow up.
UNASSIGNED: Understanding variations in typical motor development is essential to interpreting patterns of movement and posture in infants at risk for atypical development. Using the framework of Prechtl\'s General Movements Assessment, this study showed that the development of movement and posture in healthy infants were affected by age and country of birth, but the development of the fidgety movements appeared to be free of these influences. Local norms may be needed to interpret the Motor Optimality Score-Revised in all populations but further research on this topic is needed.