Movement Training Advances the Emergence of Reaching in Infants Born at Less Than 33 Weeks ...

Movement Training Advances the Emergence of Reaching in Infants Born at Less Than 33 Weeks ...

13 Pages · 2008 · 477 KB · English

each visit, infants were allowed six 30-second opportunities to contact a midline toy. Results. The FT-S and PT-M groups reached earlier and more consistently than the PT-S group. Specifically, the subjects in the FT-S group . laboratories on the role of experi- ence in the emergence of reaching.

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Movement Training Advances the Emergence of Reaching in Infants Born at Less Than 33 Weeks of Gestational Age: A Randomized Clinical Trial Jill C Heathcock, Michele Lobo, James C (Cole) Galloway Background and Purpose This study had 2 purposes: (1) to compare the emergence of reaching in infants born fullterm and infants born at less than 33 weeks of gestational age and (2) to evaluate the effectiveness of a movement training program on the emergence of reaching in this preterm population Participants Twentysix infants born at less than 33 weeks of gestational age and with a birth weight less than 2,500 g were randomly assigned to receive 20 minutes of daily movement training (PTM group) or daily social training (PTS group) and were compared with 13 infants born fullterm (FTS group) Methods Reaching and handobject interactions were tested every other week for 8 weeks At each visit, infants were allowed six 30second opportunities to contact a midline toy Results The FTS and PTM groups reached earlier and more consistently than the PTS group Speci?cally, the subjects in the FTS group contacted the toy for longer durations and with an open, ventral surface of their hand The PTM group demonstrated increases in the number of handobject contacts, the number of consistent reaches, and the percentage of time interacting with the toy and the surface of handobject contact Discussion and Conclusion This project demonstrates that there are early gross motor skill differences in infants born at less than 33 weeks of gestational age A caregiverbased daily training program, however, is effective at lessening some, but not all, of these differences over the short term JC Heathcock, PT, PhD, is Assistant Professor, The Ohio State Univer sity, 453 Atwell Hall, Columbus, OH 43210 (USA) Address all cor respondence to Dr Heathcock at: [email protected] M Lobo, PT, PhD, is Postdoctoral Researcher, University of Dela ware, Newark, Del JC Galloway, PT, PhD, is Associate Professor, University of Delaware [Heathcock JC, Lobo M, Galloway JC Movement training advances the emergence of reaching in in fants born at less than 33 weeks of gestational agePhys Ther 2008; 88:310 –322] © 2008 American Physical Therapy Association Research Report Post a Rapid Response or ?nd The Bottom Line: wwwptjournalorg 310fPhysical Therapy Volume 88 Number 3March 2008 Downloaded from https://academicoupcom/ptj/articleabstract/88/3/310/2742381 by guest on 29 June 2019 R eaching emerges over the ?rst months of life from the interplay of multiple factors These factors include developmental changes in head and postural control, 1,2 handeye coordination, 3 interest in objects, 4 knowledge about object affordances, 5 antigravity strength (forcegenerating capacity) and control of the upper ex tremities, 6?1 0 and social interactions with caregivers11In the second half of the ?rst year, infants contact objects more often, for longer durations, with a smoother hand path, and with a more controlled speed 6,7,12,13 Prior to reach onset, infants move their arms hundreds of times per day 14,15 These ?prereaching? move ments are of interest for several rea sons First, they shape and, in turn, are shaped by the brain areas thought to contribute to purposeful reach ing 1 6?1 9 Second, prereaching move ments provide the sensorimotor ex periences by which infants learn to control their arms and upper body 7,20?24 Third, these movements provide infants with multimodal infor mation about how their bodies func tion in the surrounding physical and social environments 23,25?28 Lastly, and most importantly for pediatric neurorehabilitation, is that our recent work has suggested that movement and postural training provided during the prereaching period advances the emergence of reaching and object ex ploration in infants who are develop ing typically 12?29 In general, infants born at younger gestational ages (GAs) and with lower birth weights have a higher risk for longterm functional impair ments, such as those associated with cerebral palsy (CP), than infants born fullterm Infants born preterm and weighing less than 2,500 g are termed ?low birth weight? and are at increased risk for longterm motor impairments 30 Infants born preterm and weighing less than 1,500 g (?very low birth weight?) and thoseweighing less than 1,000 g (?ex tremely low birth weight?) are of particular concern because they are at the highest risk for the more se vere motor impairments associated with CP 3 1?3 6 In addition to GA and birth weight, infants with more com plicated medical histories, such as the presence of hemorrhages, are at higher risk for disability These per manent impairments include mod erate

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