MOTOR PERFORMANCE IN PRETERM AND TERM INFANTS USING A PROTOCOL FOR STRUCTURED OBSERVATION

Abstract

In order to assess both progress and quality of motor performance in preterm and term infants a new protocol was designed to be used in a follow up study of infants who needed neonatal intensive care. Four groups of infants were assessed, 1 = < 32 gestational weeks, n=68; 2= 32-36 w, n = 81; 3= 37-42 w, n=77; and 4= a control group of healthy fullterm infants, n=72. The assessments were made at term, 2, 4, 6 and 10 months corrected age (± 1 week).The movements of the infants were compared to ascending scales of motor performance for each part of the body (head, arms and hands, trunk, legs and feet) in supine and prone position and for the whole body in sitting, standing and during locomotion. The achieved level of motor performance and deviations (suspected or clear) from the described motor performance on this level were determined. The examinations of each infant were recorded on videotape, which made it possible to measure inter- and intra-observer agreement (73% - 88%).A lower mean level of motor performance was found in group 1 than in group 4 at 2 and 4 months. With increasing age motor performance was distributed over more levels and the difference in mean level became smaller. In legs and feet deviations from the described levels of motor performance were more often seen in group 1 (75%) than in group 4 (30%). At 6 month the corresponding values were 50 and 42% respectively.Thus, this structured observation of progress and quality of motor performance allows assessment of differences between term and preterm infants.