4.6 Article

Early spontaneous movements and spatiotemporal gait characteristics in preterm children

Journal

EUROPEAN JOURNAL OF PEDIATRICS
Volume 182, Issue 6, Pages 2913-2923

Publisher

SPRINGER
DOI: 10.1007/s00431-023-04949-7

Keywords

Gait; Walking; General movements; Premature birth; Children

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This study aimed to analyze the spatiotemporal gait characteristics of preterm children from 3 to 4 years old and examine their relationship with general movements assessment. The results showed that extremely preterm and very preterm children had shorter step lengths, while moderate to late preterm children had greater step length variability. The study concluded that the early movement patterns of preterm children may be a marker of later neurodevelopmental dysfunction.
This study aimed to analyze spatiotemporal gait characteristics of preterm children from 3 to 4 years of age according to different gestational age groups and to examine the relationship between the detailed general movements assessment and spatiotemporal gait characteristics. A total of 74 preterm children, 32 extremely preterm and very preterm (EP-VP, < 32 weeks gestational age) and 42 moderate to late preterm (MLP, 32 to < 37 weeks gestational age), were included in this prospective study, along with 38 term children. Early spontaneous movements of preterm children were assessed from videos at 9-20 weeks post-term according to the general movements assessment, which determines the Motor Optimality Score-Revised (MOS-R). The spatiotemporal gait characteristics of all children were evaluated using the GAITRite((R))electronic walkway at self-selected walking speeds. EP-VP children walked with shorter step lengths (p = 0.039), and MLP children walked with greater step length variability (p = 0.003) than their term peers. The MOS-R results were related to step length (r = 0.36, p = 0.042), step length variability (r = -0.56, p = 0.001), and base of support (r = -0.37, p = 0.038) in EP-VP children. The MOS-R subcategories, age-adequate movement repertoire, and postural patterns were related to some of the spatiotemporal gait characteristics, including step length, step length variability, and base of support (p < 0.05).Conclusion: EP-VP and MLP children might catch up to their term peers at 3 to 4 years of age in terms of most gait parameters. In addition to the MOS-R, age-adequate movement repertoire and postural patterns of preterm children without cerebral palsy in early life may be a marker of later neurodevelopmental dysfunction.

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