Quality Of Motor Performance Research Articles

Structured Observation of Motor Performance in Infants: Level and quality associated with later motor development.

The aim of this study was to investigate the level of motor development and the quality of motor performance during the first 10months in relation to the Bayley Scales of Infant Development-third edition (Bayley-III) motor index at 2.5years. Children born very preterm from a population-based study (n=113) were assessed with the Structured Observation of Motor Performance in Infants (SOMP-I) at 2, 4, 6 and 10months corrected age and the Bayley-III motor index at 2.5years corrected age (n=98). Logistic regressions were performed to investigate the independent association of each SOMP-I domain to Bayley-III motor index. There were significant associations between the SOMP-I-scores and Bayley-III motor index per every assessment age. At 4months, both level and quality were independently associated with a later motor outcome, OR for level was 1.26 (95% CI=1.08-1.50, P=.002) and for quality, 0.75 (95% CI=0.63-0.90, P=.002). Quality was independently associated with the Bayley-III motor index at 6 and 10months: OR 0.080 (95% CI=0.67-0.95 P=.010) and 0.79 (95% CI=0.64-0.97, P=.026). Both SOMP-I domains, level and quality, are markers to identify motor problems early. Quality became more important with age.

The Structured Observation of Motor Performance in Infants can detect cerebral palsy early in neonatal intensive care recipients

BackgroundThe detection of motor problems in infancy requires a detailed assessment method that measures both the infants' level of motor development and movement quality. AimsTo evaluate the ability of the Structured Observation of Motor Performance in Infants (SOMP-I) to detect cerebral palsy (CP) in neonatal intensive care recipients. Study designProspective cohort study analyzed retrospectively. Subjects212 (girls: 96) neonatal intensive care recipients (mean gestational age 34weeks, range: 23–43). Twenty infants were diagnosed with CP. Outcome measuresThe infants were assessed using SOMP-I at 2, 4, 6 and 10months' corrected age. Accuracy measures were calculated for level of motor development, quality of motor performance and a combination of the two to detect CP at single and repeated assessments. ResultsAt 2months, 17 of 20 infants with CP were detected, giving a sensitivity of 85% (95% CI 62–97%) and a specificity of 48% (95% CI 40–55%), while the negative likelihood ratio was 0.3 (95% CI 0.1–0.9) and the positive likelihood ratio was 1.6 (95% CI 1.3–2.0). At 6months all infants with CP were detected using SOMP-I, and all infants had repeatedly been assessed outside the cut-offs. Specificity was generally lower for all assessment ages, however, for repeated assessments sensitivity reached 90% (95% CI 68–99%) and specificity 85% (95% CI 79–90%). ConclusionsSOMP-I is sensitive for detecting CP early, but using the chosen cut-off can lead to false positives for CP. Assessing level and quality in combination and at repeated assessments improved predictive ability.

The Structured Observation of Motor Performance in Infants has convergent and discriminant validity in preterm and term infants.

Methods are needed to evaluate the level of early motor development and quality of motor performance in infants. We examined the convergent and discriminant validity of the Structured Observation of Motor Performance in Infants (SOMP-I) for evaluating the level of motor development and quality of motor performance in preterm and term infants. A regional cohort of 111 preterm infants with a gestational age of <32 weeks and 72 healthy term born infants were assessed with the SOMP-I, at two, four, six and 10 months of corrected age. Convergent validity was analysed with a mixed model analysis of the motor performance over time. Discriminant validity was analysed with the Mann-Whitney U-test in groups with different neonatal characteristics. Convergent validity was supported, as the level of motor development increased with age and the quality of motor performance improved over time. The method discriminated for both level and quality between the preterm and the term infants. The preterm infants demonstrated different quality deficits regardless of the level of motor development. Convergent validity and discriminant validity of the SOMP-I were supported in preterm and term infants and facilitates early identification of infants with atypical motor development.

PO-0425 Motor Development And Quality Of Motor Performance In Relation To Cognitive Ability In Very Preterm Children

<h3>Background and aim</h3> Early motor and cognitive development are interdependent. Poor motor ability decreases possibility to explore and interact with the surrounding environment. Very preterm infants (VPT) and extremely preterm infants (EPT) frequently display atypical motor performance during their first year but little is known whether this predicts later cognitive ability. Is level of motor development (LMD) and quality of motor performance (QMP) at 10 months corrected age (CA), with regards to gestational age (GA) and gender, associated with cognitive ability at 2 ½ years CA. <h3>Method</h3> Very preterm infants (n = 85, 48 boys, 37 girls) born 2004–2007, with a mean of 28.5 (22.3–31.9) gestational weeks (EPT n = 30, VPT n = 55) and birth weight 1188 (520–2030 g). Structured Observation of Motor Performance in Infants (SOMP-I), which measures LMD and QMP separately, was performed at 10 months CA. Cognitive ability was assessed with Bayley Scales of Infant Development III (BSID III) at age 2 ½. <h3>Results</h3> Statistically significant associations were shown between LMD (r = 0.344; p = 0.001) and QMP (r=- 256; p = 0.018), respectively, and BSID III cognitive scaled scores. When separated for gender and GA significant associations were shown for boys (r = 0.392; p = 0.006) and EPT children (r = 0.531; p = 0.003) for LMD only. <h3>Conclusion</h3> Motor development at 10 months is associated with cognitive development at 2½ years. Level of motor performance had a stronger correlation with cognition than QMP, and when analysed for subgroups, was present only in boys and children born extremely preterm.

Motor performance in very preterm infants before and after implementation of the newborn individualized developmental care and assessment programme in a neonatal intensive care unit

To compare motor performance in supine position at the age of 4-months corrected age (CA) in very preterm (VPT) infants cared for in a neonatal intensive care unit (NICU) before and after the implementation of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Assessments of motor performance in supine position according to level of motor development and quality of motor performance were made, using the Structured Observation of Motor Performance in Infants (SOMP-I). VPT infants cared for in a NICU at a Swedish university hospital before, Group A (n = 68), and after, Group B (n = 58), the implementation of developmentally supportive care based on NIDCAP. The infants who were treated after the introduction of NIDCAP showed higher level of motor development in the arms/hands and trunk. No significant group differences were noted in total deviation score for the respective limbs, but lower frequency of lateral flexion in head movements, extension-external rotation-abduction, extension-internal rotation-adduction and varus and valgus position in the feet was found in the NIDCAP group, compared with those treated before the introduction. The infants who were treated after NIDCAP care had been implemented showed a higher level of motor development in arms/hand and trunk and fewer deviations in head, legs and feet at 4-months CA than infants treated before NIDCAP implementation. The observed changes may be due to NIDCAP and/or improved perinatal and neonatal care during the studied time period.

Perfil psicomotor de niños de 5 a 12 años diagnosticados clínicamente de trastorno por déficit de atención/hiperactividad en Colombia

One of the comorbid alterations of attention deficit hyperactivity disorder (ADHD) affects motricity, to the point where the quality of motor performance during the first 5-6 years of life could constitute a predictor of the later appearance of symptoms of the disorder. Moreover, the association between motor clumsiness and ADHD results in a poorer prognosis of the condition. Nevertheless, few studies have examined the evolution of motricity in children affected with this pathology.To characterise the psychomotor profile of children between 5 and 12 years of age who were clinically diagnosed with ADHD in the town of Manizales (Colombia) and to compare it with healthy children of the same age.A cross-sectional descriptive study was conducted with a sample of 846 children (422 diagnosed with ADHD and 424 healthy controls).Although the values for all the motricity factors were within ranges that are considered to be normal, they were significantly poorer (p < 0.000) in diagnosed children at all ages.The psychomotor profile of children diagnosed with ADHD was eupraxic and is classified within the same category as the healthy children, although quantitatively it was lower.

Robotic Therapy and Botulinum Toxin Type A

The combined effects of robotic therapy and botulinum toxin type A (BTX-A) on upper-limb movement and function were studied in an 8(1/2)-yr-old child with hemiplegic cerebral palsy. Robotic therapy comprising repetitive, goal-directed reaching tasks was administered two times per week for 8 wks. Clinical measures included the Modified Ashworth Scale, the Quality of Upper Extremity Skills Test, and the Fugl-Meyer Assessment (upper-limb section). Improvements in upper-limb coordination and quality of motor performance were apparent throughout the robotic therapy trial. The observed gains are comparable with those attained from conventional occupational therapy combined with BTX-A. A parent questionnaire indicated that the amount of paretic arm use also improved during daily activities at home. This preliminary study indicates that robotic therapy may be a useful clinical tool when combined with BTX-A injections for improving upper-limb coordination and quality of motor performance in children with cerebral palsy.

The assessment of motor recovery: A new look at an old problem

After nervous system damage, functional recovery usually occurs. It is of great clinical importance to follow the course of recovery and, when possible, predict the extent. This measurement and prediction of recovery is one of the main challenges facing clinicians today. The majority of assessment procedures currently employed, however, are impairment-oriented; that is, these procedures are oriented primarily at the disease or organ level. Until now, few procedures have been available that focus at the disability or behavioural level. This lack of disability-oriented assessment procedures hinders the development and evaluation of rehabilitation programmes, as impairment-oriented assessment scores have little relevance for the prediction of daily functioning. In this paper, a preliminary task-set is presented that may function as an impetus for the development of novel disability-oriented assessment procedures in neurological rehabilitation. Motor behaviour is not assessed in vacuo, rather as the end result of a continuous interaction between motor, sensory and cognitive processes. With this task set, it is possible to evaluate the changing influence of sensory and cognitive factors on the quality of motor performance over time. These changes, it is argued, are a crucial component of functional recovery.

Effect of Chronic Aerobic Exercise and Progressive Relaxation on Motor Performance and affect following Acute Stress

The effects of a 10-week aerobic exercise and progressive relaxation training program on somatic, emotional, and behavioral responses to acute stress, as determined by quality of motor performance and affect, were examined. The participants consisted of 60 unfit male university undergraduate students with no previous training in stress management who were randomly and evenly assigned to engage in one of four treatments over 10 weeks: (a) moderate aerobic exercise, (b) progressive relaxation, (c) a placebo group that engaged in group discussion but did experience acute stress, and (d) a nonintervention control group that did not experience stress while performing the motor task. Acute stress consisted of "losing" against a competitor of the opposite sex on the criterion motor task while receiving unpleasant information about their performance over 30 preintervention and 30 postintervention trials. Analyses indicated that aerobic exercisers, in comparisons with the other groups, responded to acute stress with more positive affect, lower stressor task heart rate, reduced systolic (but not diastolic) blood pressure, and superior motor performance. Progressive relaxation markedly reduced systolic blood pressure but did not favorably influence performance or affect in response to acute stress. Placebo and control groups were statistically similar on all measures. The findings indicated support for the use of chronic aerobic exercise as a strategy for improved coping with acute stress.

Structured observation of motor performance (SOMP-I) applied to preterm and full term infants who needed neonatal intensive care. A cross-sectional analysis of progress and quality of motor performance at ages 0-10 months.

A new protocol for Structured Observation of Motor Performance in Infants, SOMP-I, designed to describe both progress and quality of motor performance, was evaluated concerning its ability to describe and to discriminate between the motor performance observed in different groups of infants. Sixty-eight infants born at < 32 completed weeks (c.w.) of gestation formed group I, 81 infants born at 32-37 c.w. group II and 77 infants born at > 37 c.w. group III. Seventy-two neonatally healthy full term infants served as controls (group IV). The detailed assessment of level (progress) of motor development at 0, 2, 4, 6 and 10 months of age corrected for preterm birth disclosed few differences in mean level between the groups. Most were found between group I and the control group. In contrast, the quality of motor performance, expressed as proportion of infants with deviations, type of deviation, and total number of deviations per infant, showed many differences, especially between groups I and III, respectively, and the control group. Thus, the SOMP-I protocol permits a detailed assessment both of the level of motor development and the quality of motor performance but has a better discriminative ability for the latter.

Structured observation of motor performance (SOMP-I) applied to neonatally healthy fullterm infants at the ages of 0–10 months

A new protocol for structured observation of motor performance in infants, SOMP-I, was applied to 72 neonatally healthy fullterm infants at 0, 2, 4, 6 and 10 months of age. It contains 13 items, formed as ascending scales, consisting of detailed descriptions of motor performance in different body positions and body parts. The observed motor performance is assessed regarding level of development (progress), and degree and type of deviation from the described performance (quality). When observed according to the new protocol, the infants' motor performance corresponded to higher levels of motor development with increasing age and agreed with descriptions in other standardized developmental scales. With age, the motor performance observed was distributed over more levels in the different scales and the number of infants with deviations from the described performance increased in most positions, but decreased in the prone position. The item for the head, at 2 months, showed the largest number of infants with deviations. The total number of deviations in each infant was small. In conclusion, the SOMP-I protocol can describe motor performance in a group of infants who were healthy at birth and is detailed enough to identify differences regarding progress of motor development and quality of motor performance. The assessment is easily performed.

A protocol for structured observation of motor performance in preterm and term infants.

A new protocol for structured observation of motor performance has been designed for assessment of the progress and quality of motor development in preterm and term infants. A detailed scale of motor development based on the present knowledge of motor development in healthy term infants has been constructed. The motor performance is observed in each part of the infant's body in the supine and prone positions and in the whole body with the infant sitting, standing and during locomotion, and is evaluated in relation to defined levels of motor performance. If the quality of motor performance is optimal for a certain level, no deviation is noted. Any deviation from the motor performance described in the protocol for the level in question is graded as suspected or clear and classified by type. All observations are recorded on videotape for documentation. In a study of inter- and intraobserver agreement, such recordings from 17 infants were reassessed on two occasions more than one year apart. The interobserver agreement ranged between 73 and 87% and the intraobserver consistency between 77 and 88%. The protocol is currently being used in a follow-up study.

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

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.

42 NEUROLOGICAL DEVELOPMENT AT AGE 7–10: SIGNIFICANCE OF CHRONOLOGICAL AGE, HANDEDNSS, SEX, PREMATURITY AND CEREBRAL PALSY

Development of repetitive, alternating and sequential movements was studied longitudinally in 276 term and preterm children. Speed, quality of motor performance and amount and type of associated movements were recorded for 11 motor tasks (methods according to Denckla DMCN 15, 1973; Wolff DMCN 25, 1983). Results were as follows: 1) Age-related improvement of timed performances and of quality of performance and decrease of associated movements; 2) Superior performance of the dominant extremity in 9 of 11 tasks, exceptions being alternating heel- toe tapping and sequential finger-thumb opposition; 3) Left banders tended to perform less well than right handers in the preterm group only; 4) Girls outperformed boys on speed, quality and amount of associated movements; 5) Performances of neurologically unimpaired preterm children were comparable to those of term children (age corrected for prematurity); 6) Impact of cerebral palsy decreased with maturation of motor functions.

Infants with Delayed Motor Performance

In judging an infant’s motor competency, one must consider achievement of motor milestones, quality of motor performance, status of infantile reflexes, tone and strength, and family history. When an infant is found to have abnormal or delayed motor performance, it is essential to use a systematic approach to evaluation that delineates whether the underlying problem is progressive or nonprogressive, and to determine the neuroanatomic site of the lesion.