Test Of Infant Motor Performance Scores Research Articles

Impact of massage therapy on motor outcomes in very low‐birthweight infants: Randomized controlled pilot study

The purpose of the present study was to determine the effects of massage therapy on motor development, weight gain, and hospital discharge in preterm very low-birthweight (VLBW) newborns. Twenty-four preterm VLBW newborns (<34 weeks and <1500 g) were enrolled in this randomized controlled pilot study. The intervention group (n = 12) received massage therapy starting at 34 weeks post-conceptional age (15 min daily, 5 days/week for 4 weeks). The infants in the sham treatment group (n = 12) received similar duration of light still touch. Test of Infant Motor Performance (TIMP) score gain, weight gain, and post-conceptional age at discharge were compared between the two groups after intervention using Mann-Whitney U-test. No significant between-group difference in TIMP score gain and weight gain was identified when all subjects were analyzed. In subgroup analysis, among those with below-average pre-treatment TIMP score (<35), the intervention group (n = 6) achieved significantly higher TIMP score gain (P = 0.043) and earlier hospital discharge (P = 0.045) than the sham treatment group (n = 5). These same infants, however, also had significantly shorter duration of total parenteral nutrition than their counterparts in the sham treatment group (P = 0.044). Massage therapy might be a viable intervention to promote motor outcomes in a subgroup of VLBW newborns with poor motor performance. A larger randomized controlled trial is required to further explore the effects of massage therapy in this high-risk group.

The Test of Infant Motor Performance: Reliability in Spinal Muscular Atrophy Type I

The aim of this article was to determine reliability of the Test of Infant Motor Performance (TIMP) in infants with spinal muscular atrophy, type I (SMA-I). Interrater reliability training was undertaken by 17 physical therapist evaluators using 6 infants with hypotonia and weakness (5 videotaped, 1 live). Eight trained evaluators then conducted a test-retest reliability study at their own center, performing 2 tests approximately 1 month apart on each of 11 infants with genetically confirmed SMA-I (5 boys, 6 girls; age range 37-501 days; 3 on pulmonary support). The interrater reliability training session had an overall weighted Kappa of 0.61 (95% confidence interval 0.59-0.63). For the test-retest reliability study, the intraclass correlation coefficient for the TIMP Total Score was 0.85 (95% confidence interval: 0.54-0.96). The test scores were not significantly different between the 2 sessions (Bradley-Blackwood test was nonsignificant). TIMP scores can be reliably obtained in infants with SMA-I.

Population-Based Age Standards for Interpreting Results on the Test of Motor Infant Performance

The goals of this study were establishment of age standards for the Test of Infant Motor Performance (TIMP) and evaluation of possible group differences based on sex, medical risk for poor developmental outcome, and race/ethnicity. Subjects were 990 infants with a range of risk for poor outcome from 11 geographic locations across the United States that were recruited to reflect the distribution of race/ethnicity in the US population of low birth weight infants. Between 67 and 97 infants were tested in each two-week age range from 34-35 weeks' postconceptional age through 16-17 weeks after term. Boys made up 52% of the subjects. Fifty-eight percent of the sample was white, 25% black, and the remainder were of other ethnicities. Scores for all infants in each age group were averaged to form age expectations for each two-week period. Multiple regression was used to explore the effect on TIMP scores of sex, risk, and race/ethnicity. Means ranged from 49 (standard deviation = 15) at 34-35 weeks' postconceptional age through 120 (standard deviation = 16) at 16-17 weeks after term. High-risk infants scored significantly lower than other infants (beta = -0.133, P < 0.0001). Latino infants scored lower than infants of all other ethnicities (beta = -0.052, p < 0.006). Performance did not differ by sex. CONCLUSIONS/CLINICAL IMPLICATIONS: These standards for performance on the TIMP can be used to identify infants with delayed motor development.

Responsiveness of the Test of Infant Motor Performance (TIMP) in Infants Born Preterm

The responsiveness of the Test of Infant Motor Performance (TIMP) was examined in infants born preterm. Infant variables predictive of changes in TIMP scores were also identified. Twenty-five infants born <or=30 weeks' gestational age were assigned a risk score and administered the TIMP at 32 and 36 weeks postconceptional age (PCA). Paired t-tests and analyses of variance examined differences between TIMP scores across time and between groups. Correlations and regression analyses determined the relationship between infant variables and TIMP score changes. TIMP scores significantly increased between 32 and 36 weeks PCA. A significant effect of time for risk groups was found. No significant correlations between infant variables and TIMP score changes were revealed. The TIMP was responsive to changes in infants born preterm but did not discriminate based on risk classification. The infant variables did not predict changes in TIMP scores. Further research with a larger sample size is warranted.

Predicting Motor Outcome at Preschool Age for Infants Tested at 7, 30, 60, and 90 Days After Term Age Using the Test of Infant Motor Performance

Accurate and diagnostic measures are central to early identification and intervention with infants who are at risk for developmental delays or disabilities. The purpose of this study was to examine (1) the ability of infants' Test of Infant Motor Performance (TIMP) scores at 7, 30, 60 and 90 days after term age to predict motor development at preschool age and (2) the contribution of the home environment and medical risk to the prediction. Sixty-one children from an original cohort of 90 infants who were assessed weekly with the TIMP, between 34 weeks gestational age and 4 months after term age, participated in this follow-up study. The Peabody Developmental Motor Scales, 2nd edition (PDMS-2), were administered to the children at the mean age of 57 months (SD=4.8 months). The quality and quantity of the home environment also were assessed at this age using the Early Childhood Home Observation for Measurement of the Environment (EC-HOME). Pearson product moment correlation coefficients, multiple regression, sensitivity and specificity, and positive and negative predictive values were used to assess the relationship among the TIMP, HOME, medical risk, and PDMS-2 scores. The correlation coefficients between the TIMP and PDMS-2 scores were statistically significant for all ages except at 7 days. The highest correlation coefficient was at 90 days (r=.69, P=.001). The TIMP scores at 30, 60, and 90 days after term; medical risk scores; and EC-HOME scores explained 24%, 23%, and 52% of the variance in the PDMS-2 scores, respectively. The TIMP score at 90 days after term was the most significant contributor to the prediction. The TIMP cutoff score of -0.5 standard deviation below the mean correctly classified 80%, 79%, and 87% of the children using a cutoff score of -2 standard deviations on the PDMS-2 at 30, 60, and 90 days, respectively. The results compare favorably with those of developmental tests administered to infants at 6 months of age or older. These findings underscore the need for age-specific test values and developmental surveillance of infants before making referrals.

Predictive Validity of the Test of Infant Motor Performance as Measured by the Bruininks-Oseretsky Test of Motor Proficiency at School Age

As the survival rate of infants who are born prematurely increases, the need for accuracy in early identification and prediction of developmental outcome in these infants is imperative. This study examined the predictive validity of the Test of Infant Motor Performance (TIMP) and the relationship between perinatal risk and motor performance in children who are of school age. A stratified, random sample of 35 children was selected from subjects who had been examined using the TIMP and the Problem-Oriented Perinatal Risk Assessment System (POPRAS). The subjects were between 32 weeks gestational age and 4 months postterm (mean age=10 days postterm). The stratification was based on age at the time of TIMP administration (AGE) and on POPRAS scores. The Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) was administered to the children at a mean age of 5.75 years. Predictive values were calculated and correlation and regression analyses were conducted to examine the relationship between the TIMP and POPRAS scores and the BOTMP score. Using the receiver operating characteristic curve and a cutoff z score of -1.6, the TIMP's sensitivity, specificity, and positive and negative predictive values were.50, 1.00, 1.00, and.87, respectively. The correlation between TIMP and BOTMP scores, with AGE controlled, was.36, and the correlation between POPRAS and BOTMP scores was -.55. Thirty-seven percent of BOTMP variance was accounted for collectively by POPRAS scores, TIMP scores, and AGE. The TIMP and POPRAS may be viable instruments that can be used together to identify infants who are at risk for poor long-term motor performance.

Validity of the Test of Infant Motor Performance for prediction of 6-, 9- and 12-month scores on the Alberta Infant Motor Scale.

The Test of Infant Motor Performance (TIMP) is a test of functional movement in infants from 32 weeks' post-conceptional age to 4 months postterm. The purpose of this study was to assess in 96 infants (44 females, 52 males) with varying risk, the relation between measures on the TIMP at 7, 30, 60, and 90 days after term age and percentile ranks (PR) on the Alberta Infant Motor Scale (AIMS). Correlation between scores on the TIMP and the AIMS was highest for TIMP tests at 90 days and AIMS testing at 6 months (r=0.67, p=0.0001), but all comparisons were statistically significant except those between the TIMP at 7 days and AIMS PR at 9 months. In a multiple regression analysis combining a perinatal risk score and 7-day TIMP measures to predict 12-month AIMS PR, risk, but not TIMP, predicted outcome (21% of variance explained). At older ages TIMP measures made increasing contributions to prediction of 12-month AIMS PR (30% of variance explained by 90-day TIMP). The best TIMP score to maximize specificity and correctly identify 84% of the infants above versus below the 10th PR at 6 months was a cut-off point of 1 SD below the mean. The same cut-off point correctly identified 88% of the infants at 12 months. A cut-off of -0.5 SD, however, maximized sensitivity at 92%. A negative test result, i.e. score above -0.5 SD at 3 months, carried only a 2% probability of a poor 12-month outcome. We conclude that TIMP scores significantly predict AIMS PR 6 to 12 months later, but the TIMP at 3 months of age has the greatest degree of validity for predicting motor performance on the AIMS at 12 months and can be used clinically to identify infants likely to benefit from intervention.

Validity of the Test of Infant Motor Performance for prediction of 6‐, 9‐ and 12‐month scores on the Alberta Infant Motor Scale

The Test of Infant Motor Performance (TIMP) is a test of functional movement in infants from 32 weeks’post‐conceptional age to 4 months postterm. The purpose of this study was to assess in 96 infants (44 females, 52 males) with varying risk, the relation between measures on the TIMP at 7, 30,60, and 90 days after term age and percentile ranks (PR) on the Alberta Infant Motor Scale (AIMS). Correlation between scores on the TIMP and the AIMS was highest for TIMP tests at 90 days and AIMS testing at 6 months (r=0.67,p=0.0001), but all comparisons were statistically significant except those between the TIMP at 7 days and AIMS PR at 9 months. In a multiple regression analysis combining a perinatal risk score and 7‐day TIMP measures to predict 12‐month AIMS PR, risk, but not TIMP, predicted outcome (21% of variance explained). At older ages TIMP measures made increasing contributions to prediction of 12‐month AIMS PR (30% of variance explained by 90‐day TIMP). The best TIMP score to maximize specificity and correctly identify 84% of the infants above versus below the 10th PR at 6 months was a cut‐off point of 1 SD below the mean. The same cut‐off point correctly identified 88% of the infants at 12 months. A cut‐off of‐0.5 SD, however, maximized sensitivity at 92%. A negative test result, i.e. score above ‐0.5 SD at 3 months, carried only a 2% probability of a poor 12‐month outcome. We conclude that TIMP scores significantly predict AIMS PR 6 to 12 months later, but the TIMP at 3 months of age has the greatest degree of validity for predicting motor performance on the AIMS at 12 months and can be used clinically to identify infants likely to benefit from intervention.