Alberta Infant Motor Scale Scores Research Articles

Investigation of the relationship between oral motor feeding development and gross motor development between preterm and term infants at 10- to 12-month postnatal age

BackgroundImmature central nervous system, extended stay in the neonatal intensive care unit, and sensory experience deficiency may contribute to oral and gross motor delay in preterm infants. Current study aimed to investigate oral and motor development in preterm infants.MethodsTwenty-nine preterm infants and 28 term infants were evaluated within the scope of the study. Oral motor feeding development was assessed with the Schedule for Oral Motor Assessment, and motor development was evaluated with the Alberta Infant Motor Scale. All analyses were performed using SPSS 22. The study was approved by the Gazi University Clinical Researches Ethics Committee (no: 25901600–23).ResultsThere was a correlation between the Schedule for Oral Motor Assessment categories (solid, semisolid, cracker, puree, bottle, and cup) and the Alberta Infant Motor Scale score (p < 0.05). There was a significant difference between groups in the Schedule for Oral Motor Assessment’s solid, semisolid, cracker, and puree categories and total score (p < 0.05). There was a significant difference between groups regarding the Alberta Infant Motor Scale score (p < 0.05).ConclusionPreterm infants come behind their term peers in motor and oral motor feeding performance. These two areas of development can influence each other. For this reason, oral motor feeding problems should be emphasized as well as motor problems in physiotherapy rehabilitation evaluations.

KONJENİTAL SANTRAL HİPOVENTİLASYON SENDROMU VE SEREBRAL PALSİLİ OLGUDA FİZYOTERAPİ VE REHABİLİTASYON PROGRAMININ ETKİSİNİN İNCELENMESİ: BİR OLGU SUNUMU

Congenital Central Hypoventilation Syndrome is a rare genetic disorder that presents from birth and prevents automatic control of respiration. Our aim in this study was to examine the effectiveness of a 6-month physical therapy program applied to a patient with Congenital Central Hypoventilation Syndrome and cerebral palsy. A 6-month-old patient who was diagnosed with Congenital Central Hypoventilation Syndrome and subsequently developed Cerebral Palsy due to asphyxia was included in the study. The case was enrolled in a physical therapy program for 2 days a week for 6 months in the home environment where they lived. The case was evaluated before and after treatment. In our case, the Modified Ashworth Scale, the Alberta Infant Motor Scale, the Hammersmith Infant Neurological Examination, Test of Sensory Functions in Infants, and the Face, Legs, Activity, Cry, Consol ability scale were used. In our case, pre-treatment and post-treatment scores were as follows, respectively: Alberta Infant Motor Scale score 3-8, Hammersmith Infant Neurological Examination score 6-17, Test of Sensory Functions in Infants score 2-9, and Face, Legs, Activity, Cry, Consol ability scale score 8-3. In our case, there was a significant improvement in Modified Ashworth Scale scores before and after treatment. Additionally, at the conclusion of the study, it was noted that the heightened pain and sensitivity resulting from the patient's extended stay in the intensive care unit reduced with the treatment. We believe that the administered physiotherapy and rehabilitation program offered support to the patient in achieving neuro-motor and sensory integration, underscoring the essential role of physiotherapy in rare diseases.

Improving access to assessments of early motor development in local languages: polish adaptation of the Early Motor Questionnaire

A child’s motor development progresses very dynamically. It is crucial to develop freely available parent-report measures of motor development that can be easily used globally to measure motor skills and identify children in need of interventions. This paper presents the adaptation and validation of the Early Motor Questionnaire, which consists of gross motor (GM), fine motor (FM), and perception–action integration (PA) subscales, to the Polish language (EMQ-PL). Study 1 (online, cross-sectional, N = 640) assessed psychometric properties of the EMQ-PL and its value in identifying children referred to physiotherapy. Results reveal excellent psychometric properties of the EMQ-PL and differences in GM and total age-independent scores between children that were and were not referred for physiotherapy. Study 2 (in-person assessment, longitudinal, N = 100) showed high correlations of GM and total scores with Alberta Infant Motor Scale.Conclusion: Overall, the EMQ can be easily adapted to local languages and has the potential for use as a screening tool in global health contexts.What is Known:• Parent-report questionnaires - especially those available free of charge - can potentially improve the rapid assessment of motor skills in young children worldwide.• Translation, adaptation and validation of freely available parent-report measures of motor development to local languages are important for local populations.What is New:• Early Motor Questionnaire can be easily adapted to local languages and has the potential for use as a screening tool in global health contexts.• The polish version of the Early Motor Questionnaire has excellent psychometric properties and highly correlates with infants’ age and Alberta Infant Motor Scale scores.

Natural History of Aromatic L-Amino Acid Decarboxylase Deficiency in Taiwan.

Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare inherited disorder of monoamine neurotransmitter synthesis; this deficiency leads to psychomotor delay, hypotonia, oculogyric crises, dystonia, and extraneurological symptoms. This study aimed to provide further insight into the clinical course of AADC deficiency in Taiwan. We present a retrospective, descriptive, single-center study of 37 children with a confirmed diagnosis of AADC deficiency. Their medical histories were reviewed for motor milestones, motor development, DDC mutation, and body weight. The termination point for each patient in this study was defined as no further follow-up, death, or enrollment in a gene therapy trial. The median age of the study patients at the end of the study was 4.39years (1.28-11.30). Of the 37 patients, 36 did not develop full head control, sitting ability, standing ability, or speech at any time point from birth to the termination points. Motor scales were administered to 22 patients. Their Alberta Infant Motor Scale scores were below the fifth percentile, and their Peabody Developmental Motor Scales, Second Edition, scores were below the first percentile. Their body weights were normal in the first few months of life, but severe growth retardation occurred at later ages. The mutation c.714+4A>T (IVS6+4A>T) accounted for 76% of all their DDC mutations. In this chapter, we report the clinical course of AADC deficiency in Taiwan. Our data will help guide the development of treatment strategies for the disease.

Subcutaneous fat accumulation in early infancy is more strongly associated with motor development and delay than muscle growth

Physical growth in neurologically healthy preterm infants affects motor development. This study investigated the separate relationships between muscle and fat in infancy and later motor development and physical growth. Muscle thickness and subcutaneous fat thickness of the anterior thigh were measured using ultrasound images obtained from neurologically healthy preterm infants at birth, 3, 6, 12 and 18months' corrected age. We also obtained the Pediatric Evaluation of Disability Inventory and Alberta Infant Motor Scale scores at 18months' corrected age to assess motor ability and motor delay. Thirty preterm infants completed the study protocol. There was a significant positive correlation between motor ability and increments in subcutaneous fat thickness during the first 3 and 6months' corrected age (r=0.48 and 0.40, p<0.05, respectively), but not between motor ability and muscle thickness growth in any of the periods. A secondary, logistic regression analysis showed that increments in subcutaneous fat thickness during the first 3months were a protective factor for motor delay. Subcutaneous fat accumulation in early infancy is more strongly associated with motor development and delay than muscle growth.

Reference curves for the Brazilian Alberta Infant Motor Scale: percentiles for clinical description and follow-up over time

To compare Alberta Infant Motor Scale scores for Brazilian infants with the Canadian norm and to construct sex-specific reference curves and percentiles for motor development for a Brazilian population. This study recruited 795 children aged 0 to 18 months from a number of different towns in Brazil. Infants were assessed by an experienced researcher in a silent room using the Alberta Infant Motor Scale. Sex-specific percentiles (P5, P10, P25, P50, P75 and P90) were calculated and analyzed for each age in months from 0 to 18 months. No significant differences (p > 0.05) between boys and girls were observed for the majority of ages. The exception was 14 months, where the girls scored higher for overall motor performance (p = 0.015) and had a higher development percentile (0.021). It was observed that the development curves demonstrated a tendency to nonlinear development in both sexes and for both typical and atypical children. Variation in motor acquisition was minimal at the extremes of the age range: during the first two months of life and from 15 months onwards. Although the Alberta Infant Motor Scale is widely used in both research and clinical practice, it has certain limitations in terms of behavioral differentiation before 2 months and after 15 months. This reduced sensitivity at the extremes of the age range may be related to the number of motor items assessed at these ages and their difficulty. It is suggested that other screening instruments be employed for children over the age of 15 months.

Prevalence and predictors of idiopathic asymmetry in infants born preterm

BackgroundAn idiopathic asymmetry in posture of the head is recognized as a risk factor to develop a deformational plagiocephaly (DP). In our neonatal follow-up clinic, an IA is often observed in infants born preterm at term-equivalent age (TEA). AimsTo explore (1) the prevalence of an idiopathic asymmetry in 192 infants (gestational age ≤32.0weeks) at TEA and 6months corrected age (CA), (2) whether demographical, perinatal, and medical factors were predictors of the asymmetry, and (3) differences in motor maturation between infants with and without asymmetry. MethodsIn a retrospective study, frequencies of idiopathic asymmetry and DP, putative predictors, and Alberta Infant Motor Scale scores at 6months CA were abstracted and analyzed with Chi2, Mann–Whitney, logistic regression and T-test. ResultsThe prevalence rate of a positional preference of the head at TEA was 44.8% (n=86), 10.4% (20/192) had a DP at TEA and 13% (25/192) at 6months CA. Positional preference, multiple birth and male gender predicted the presence of DP (p<.05, odds ratio 3.0, 3.2, and 3.1 respectively). Gross motor maturity at 6months CA was less developed in infants with a positional preference at TEA compared to preterm norms (p=0.01). ConclusionsThe high prevalence of a positional preference in infants born preterm at term equivalent age requires extra alertness to prevent the development of a deformational plagiocephaly, especially in boys and twins. Although, considering the lower prevalence of plagiocephaly at 6months CA, therapists should be aware of over treating these infants.

The impact of antibodies on clinical outcomes in diseases treated with therapeutic protein: Lessons learned from infantile Pompe disease

PurposeEnzyme replacement therapy with rhGAA (Myozyme®) has lead to improved survival, which is largely attributable to improvements in cardiomyopathy and skeletal muscle function. However, crossreactive immunologic material-negative patients have a poor clinical response to enzyme replacement therapy secondary to high sustained antibody titers. Furthermore, although the majority of crossreactive immunologic material-positive patients tolerize or experience a downtrend in anti-rhGAA antibody titers, antibody response is variable with some crossreactive immunologic material-positive infants also mounting high sustained antibody titers. MethodsWe retrospectively analyzed 34 infants with Pompe disease: 11 crossreactive immunologic material-negative patients, nine high-titer crossreactive immunologic material-positive patients, and 14 low-titer crossreactive immunologic material-positive patients. Clinical outcome measures were overall survival, ventilator-free survival, left ventricular mass index, Alberta Infant Motor Scale score, and urine Glc4 levels. ResultsClinical outcomes in the high-titer crossreactive immunologic material-positive group were poor across all areas evaluated relative to the low-titer crossreactive immunologic material-positive group. For the crossreactive immunologic material-negative and high-titer crossreactive immunologic material-positive groups, no statistically significant differences were observed for any outcome measures, and both patient groups did poorly. ConclusionOur data indicate that, irrespective of crossreactive immunologic material status, patients with infantile Pompe disease with high sustained antibody titer have an attenuated therapeutic response to enzyme replacement therapy. With the advent of immunomodulation therapies, identification of patients at risk for developing high sustained antibody titer is critical.

Prospective follow-up study of children with univentricular heart: Neurodevelopmental outcome at age 12 months

Despite recent advances in the treatment of children with univentricular heart, their neurodevelopmental outcome remains a major concern. This prospective follow-up study evaluated the neurodevelopmental outcome of 23 patients with hypoplastic left heart syndrome, 14 with other forms of univentricular heart, and 46 healthy control subjects at a median age of 12.2 months. The Griffiths Developmental Scale and Alberta Infant Motor Scale served for developmental evaluation. The mean Griffiths developmental quotient of children with hypoplastic left heart syndrome was significantly less (91.6) than that of control children (106.8, P < .001). Patients with univentricular heart scored significantly lower than control subjects only in the gross motor domain (P = .001) but not in overall development (100.6). Alberta Infant Motor Scale scores were significantly lower in children with hypoplastic left heart syndrome (37.5, P < .001) and univentricular heart (43.5, P = .011) than in control subjects (53.3). In linear regression a diagnosis of hypoplastic left heart syndrome (P = .016), a clinical history of seizure (P = .002), and the highest plasma lactate level after the bidirectional Glenn operation (P = .045) were significantly associated with the developmental quotient. At age 1 year, the level of development of children with univentricular heart was significantly lower than for control subjects only in motor skills, whereas children with hypoplastic left heart syndrome had a more widespread developmental delay. The diagnosis, a clinical seizure history, and increased plasma lactate levels after the bidirectional Glenn operation emerged as risk factors.

Early gross motor development of preterm infants according to the Alberta Infant Motor Scale

To systematically examine gross motor development in the first 18 months of life of preterm infants. A total of 800 preterm infants (356 boys), ages between 1 and 18 months and corrected for degree of prematurity, were assessed with the use of the Alberta Infant Motor Scale. Comparison of the mean Alberta Infant Motor Scale scores of the preterm infants with the norm-referenced values derived from term infants revealed that as a group, the preterm infants scored significantly lower at all age levels, even with full correction for degree of prematurity. In general, preterm infants exhibit different gross motor developmental trajectories compared with term infants in the first 18 months of life. The gross motor developmental profile of preterm infants may reflect a variant of typical gross motor development, which seems most likely to be specific for this population. As a consequence, adjusted norms should be used for proper evaluation and clinical decision-making in relation to preterm infants.

Long-term intravenous treatment of Pompe disease with recombinant human alpha-glucosidase from milk.

Objective. Recent reports warn that the worldwide cell culture capacity is insufficient to fulfill the increasing demand for human protein drugs. Produc- tion in milk of transgenic animals is an attractive alter- native. Kilogram quantities of product per year can be obtained at relatively low costs, even in small animals such as rabbits. We tested the long-term safety and effi- cacy of recombinant human -glucosidase (rhAGLU) from rabbit milk for the treatment of the lysosomal stor- age disorder Pompe disease. The disease occurs with an estimated frequency of 1 in 40 000 and is designated as orphan disease. The classic infantile form leads to death at a median age of 6 to 8 months and is diagnosed by absence of -glucosidase activity and presence of fully deleterious mutations in the -glucosidase gene. Cardiac hypertrophy is characteristically present. Loss of muscle strength prevents infants from achieving developmental milestones such as sitting, standing, and walking. Milder forms of the disease are associated with less severe mu- tations and partial deficiency of -glucosidase. Methods. In the beginning of 1999, 4 critically ill pa- tients with infantile Pompe disease (2.5- 8 months of age) were enrolled in a single-center open-label study and treated intravenously with rhAGLU in a dose of 15 to 40 mg/kg/week. Results. Genotypes of patients were consistent with the most severe form of Pompe disease. Additional mo- lecular analysis failed to detect processed forms of -glu- cosidase (95, 76, and 70 kDa) in 3 of the 4 patients and revealed only a trace amount of the 95-kDa biosynthetic intermediate form in the fourth (patient 1). With the more sensitive detection method, 35S-methionine incorpora-

The Relationship Between Awake Positioning and Motor Performance Among Infants Who Slept Supine

The purpose of this study was to describe the gross motor development of infants who slept supine and spent different amounts of time in the prone position when awake. Thirty infants who were six months old and slept supine were evaluated using the Alberta Infant Motor Scale (AIMS) and then divided into two groups: prone (n = 16) and no prone (n = 14) based on the number of times per day they were placed in prone position while awake. The prone group scored higher than the no prone group on the AIMS total scores (U = 36, p = 0.004), total percentile scores (U = 42, p = 0.003), and prone subscale scores (U = 25, p < 0.001). Gross motor performance as measured by the AIMS was more advanced in infants who slept supine and had been placed in the prone position when awake than in infants who slept supine but had limited or no experience in the prone position while awake. The influence of awake positioning needs to be considered when interpreting the developmental motor performance of infants who are six months old.