Test Of Infant Motor Performance Research Articles

Association between maternal stress and premature milk cortisol, milk IgA, and infant health: a cohort study.

Maternal stress is pervasive in the neonatal intensive care unit (NICU). Maternal stress is associated with changes in human milk (HM) immunomodulatory agents, which may impact neonatal health. We sought to determine the association between maternal stress, HM immunoglobulin A (IgA) and cortisol, and to assess how these milk components correlate with infant immune and neurodevelopmental outcomes. We then compared how these associations persist over time. The study design involved a cohort study of exclusively breastfeeding mothers and their singleton moderately preterm (28-34 weeks) infants admitted to the NICU. We collected maternal serum, maternal saliva, and first-morning whole milk samples, and administered maternal stress questionnaires at 1 and 5 weeks postpartum. We analyzed the samples for HM IgA (using a customized immunoassay in skim milk) and for HM and salivary cortisol (using a chemiluminescent immunoassay). Infant illness was assessed using the Score for Neonatal Acute Physiology II (SNAP II) and SNAP II with Perinatal Extension (SNAPPE II), and infant neurodevelopment were assessed using the Test of Infant Motor Performance. We analyzed changes in HM IgA and cortisol over time using paired t-tests. Furthermore, we performed correlation and regression analyses after adjusting for gestational age (GA), corrected GA, and infant days of life. In our study, we enrolled 26 dyads, with a mean maternal age of 28.1 years, consisting of 69% white, 19% Black, and 8% Hispanic. Cortisol: Salivary and HM cortisol were closely associated in week 1 but not in week 5. Though mean salivary cortisol remained stable over time [2.41 ng/mL (SD 2.43) to 2.32 (SD 1.77), p = 0.17], mean HM cortisol increased [1.96 ng/mL (SD 1.93) to 5.93 ng/mL (SD 3.83), p < 0.001]. Stress measures were inversely associated with HM cortisol at week 1 but not at week 5. IgA: HM IgA decreased over time (mean = -0.14 mg/mL, SD 0.53, p < 0.0001). High maternal stress, as measured by the Parental Stressor Scale: neonatal intensive care unit (PSS:NICU), was positively associated with HM IgA at week 5 (r = 0.79, P ≤ 0.001). Higher IgA was associated with a lower (better) SNAP II score at week 1 (r = -0.74, p = 0.05). No associations were found between maternal stress, salivary cortisol, HM cortisol, or HM IgA and neurodevelopment at discharge (as assessed using the TIMP score). Furthermore, these relationships did not differ by infant sex. Maternal stress showed associations with HM cortisol and HM IgA. In turn, HM IgA was associated with lower measures of infant illness.

Agreement between Hammersmith Neonatal Neurological Examination (HNNE) and Test of Infant Motor Performance (TIMP) in neurodevelopmental assessment of preterm infants

ObjectivesTo determine the agreement between HNNE and TIMP at TCA for preterm infants born <32+0 weeks' gestation, and to evaluate their correlation to PDMS-2 at 12-month corrected age (CA). MethodsInfants born between November 2013 to June 2022 who had both HNNE and TIMP performed at TCA of 37+0–41+6 weeks gestation, and motor outcome assessed using the PDMS-2 at 12-month old were enrolled. The HNNE and 12-month PDMS-2 findings were categorized as optimal vs sub-optimal. TIMP was categorized as typical vs atypical. Cohen's kappa was used to determine the agreement between HNNE and TIMP. Sensitivity analysis and Receiver Operating Characteristic (ROC) curves were used to evaluate the predictive values of HNNE and TIMP on motor outcome at CA of 12-months. ResultsHNNE and TIMP done on 125 infants at TCA do not show reliable agreement. HNNE demonstrated slight and fair agreement with the 12-month Total Motor Quotient (TMQ) and Fine Motor Quotient (FMQ) of the PDMS-2 respectively. TIMP at TCA demonstrated fair agreement with all sub-domains of motor function on PDMS-2 at 12-months. In comparison with TIMP, HNNE at TCA is more sensitive at predicting suboptimal total, gross and fine motor outcomes at 12-month CA with sensitivity of 68.4 %, 51.9 %, and 83.3 % vs 44.4 %, 31.8 % and 53.3 % respectively. Atypical TIMP at TCA is more specific for suboptimal total, gross and fine motor outcomes at 12-month CA with specificity of 90.3 %, 89 % and 90.5 % respectively.Neurobehavioral assessments at TCA using HNNE and TIMP were predictive of suboptimal fine motor quotient at CA of 12-months with AUC of 0.760 (p = 0.011) and 0.718 (p = 0.032) respectively. The difference in AUC between the 2 instruments of 0.042 was not statistically significant (p = 0.741). ConclusionsWhile the HNNE and TIMP done at TCA did not demonstrate significant agreement, suboptimal HNNE and atypical TIMP at TCA were predictive of suboptimal FMQ on PDMS-2 at 12-month CA.

Protocol for a randomized controlled trial to evaluate a year-long (NICU-to-home) evidence-based, high dose physical therapy intervention in infants at risk of neuromotor delay.

Developmental disabilities and neuromotor delay adversely affect long-term neuromuscular function and quality of life. Current evidence suggests that early therapeutic intervention reduces the severity of motor delay by harnessing neuroplastic potential during infancy. To date, most early therapeutic intervention trials are of limited duration and do not begin soon after birth and thus do not take full advantage of early neuroplasticity. The Corbett Ryan-Northwestern-Shirley Ryan AbilityLab-Lurie Children's Infant Early Detection, Intervention and Prevention Project (Project Corbett Ryan) is a multi-site longitudinal randomized controlled trial to evaluate the efficacy of an evidence-based physical therapy intervention initiated in the neonatal intensive care unit (NICU) and continuing to 12 months of age (corrected when applicable). The study integrates five key principles: active learning, environmental enrichment, caregiver engagement, a strengths-based approach, and high dosage (ClinicalTrials.gov identifier NCT05568264). We will recruit 192 infants at risk for neuromotor delay who were admitted to the NICU. Infants will be randomized to either a standard-of-care group or an intervention group; infants in both groups will have access to standard-of-care services. The intervention is initiated in the NICU and continues in the infant's home until 12 months of age. Participants will receive twice-weekly physical therapy sessions and caregiver-guided daily activities, assigned by the therapist, targeting collaboratively identified goals. We will use various standardized clinical assessments (General Movement Assessment; Bayley Scales of Infant and Toddler Development, 4th Edition (Bayley-4); Test of Infant Motor Performance; Pediatric Quality of Life Inventory Family Impact Module; Alberta Infant Motor Scale; Neurological, Sensory, Motor, Developmental Assessment; Hammersmith Infant Neurological Examination) as well as novel technology-based tools (wearable sensors, video-based pose estimation) to evaluate neuromotor status and development throughout the course of the study. The primary outcome is the Bayley-4 motor score at 12 months; we will compare scores in infants receiving the intervention vs. standard-of-care therapy.

Impact of the environmental layout of the neonatal intensive care unit on clinical outcomes and neurological development in very/extremely preterm infants

To investigate the impact of the environmental layout of the neonatal intensive care unit (NICU) on clinical outcomes and neurological development in very/extremely preterm infants. A total of 304 very/extremely preterm infants admitted to Children's Hospital of Chongqing Medical University between January 2021 and June 2022 within 24 hours after birth were included in this retrospective cohort study. Based on different environmental layouts in the NICU, the infants were divided into two groups: centralized layout group (n=157) and decentralized layout group (n=147). The clinical outcomes and Test of Infant Motor Performance (TIMP) scores at corrected gestational age between 34 to 51+6 weeks were compared between the two groups. The decentralized layout group had lower incidence rates of bronchopulmonary dysplasia (44.9% vs 62.4%, P<0.05) and intracranial hemorrhage (17.7% vs 28.0%, P<0.05) than the centralized layout group. The cure rate was higher in the decentralized layout group compared to the centralized layout group (68.7% vs 56.7%, P<0.05). The decentralized layout group had higher TIMP scores than the centralized layout group at corrected gestational age between 34 to 51+6 weeks (P<0.05). The decentralized layout of the NICU exhibits positive effects on the clinical outcomes and early neurological development compared to the centralized layout in very/extremely preterm infants.

Early neurological and motor function in infants born moderate to late preterm or small for gestational age at term: a prospective cohort study

BackgroundThere are inconsistent findings regarding neurological and motor development in infants born moderate to late preterm and infants born small for gestational age at term. The primary aim of this study was to compare neurological and motor function between preterm, term SGA and term AGA infants aged three to seven months corrected age using several common assessment tools. The secondary aim was to investigate their motor function at two years.MethodsIn this prospective cohort study, we included 43 infants born moderate to late preterm with gestational age 32–36 + 6 weeks, 39 infants born small for gestational age (SGA) at term with a birthweight ≤ 10th centile for gestational age, and 170 infants born at term with appropriate weight for gestational age (AGA). Neurological and motor function were assessed once in infancy between three to seven months corrected age by using four standardised assessment tools: Hammersmith Infant Neurological Examination (HINE), Test of Infant Motor Performance, General Movements Assessment and Alberta Infant Motor Scale. The Ages and Stages Questionnaire (ASQ-2) was used at two years.ResultsAt three to seven months corrected age, mean age-corrected HINE scores were 61.8 (95% confidence interval (CI): 60.5 to 63.1) in the preterm group compared with 63.3 (95% CI: 62.6 to 63.9) in the term AGA group. Preterm infants had 5.8 (95% CI: 2.4 to 15.4) higher odds for HINE scores < 10th percentile. The other test scores did not differ between the groups. At two years, the preterm group had 17 (95% CI: 1.9 to 160) higher odds for gross motor scores below cut-off on ASQ-2 compared with the term AGA group.ConclusionsThe present study found subtle differences in neurological function between preterm and term AGA infants in infancy. At two years, preterm children had poorer gross motor function. The findings indicate that moderate prematurity in otherwise healthy infants pose a risk for neurological deficits not only during the first year, but also at two years of age when compared with term AGA children.

Test of infant motor performance: Cross-cultural adaptation, validity and reliability in Persian infants

BackgroundThe Test of Infant Motor Performance (TIMP) is an appropriate tool used to measure infant motor performance in many countries and due to the importance of the TIMP in the early diagnosis of infants with developmental delay, the production of a reliable translation of the TIMP in Iran is necessary. AimsThis study was designed to evaluate the validity and reliability of the Persian version of the TIMP and cross-cultural adaptation of the TIMP to Persian. MethodTwenty- two experts were involved in translation, cross-cultural adaptation, validity and reliability. 170 Persian premature infants with post menstrual age (PMA) 34–42 weeks were tested to evaluate inter-rater and intra-rater reliability, test-retest and discriminative validity of the Persian version of the TIMP. ResultsThe content validity and face validity of the items of the Persian version of the TIMP were confirmed by a 10-expert panel and 10 therapists. High intra- and inter-rater reliability (ICC = 0.98, Kappa = 0.93), test-retest reliability (ICC = 0.98) and internal consistency (α = 0.82) were detected for the Persian version of the TIMP. Discriminative validity confirmed that the TIMP could distinguish groups of infants born with a low birth weight (p ˂ 0.001) and infants born small for gestational age (p = 0.002). ConclusionsHigh validity and reliability are reported for the Persian version of the TIMP and this test was demonstrated to be differentiate among groups of infants who are at risk of motor delay.

Factors Influencing Receipt and Type of Therapy Services in the NICU.

Understanding the type and frequency of current neonatal intensive care unit (NICU) therapy services and predictors of referral for therapy services is a crucial first step to supporting positive long-term outcomes in very preterm infants. This study enrolled 83 very preterm infants (<32 weeks, gestational age mean 26.5 ± 2.0 weeks; 38 male) from a longitudinal clinical trial. Race, neonatal medical index, neuroimaging, and frequency of therapy sessions were extracted from medical records. The Test of Infant Motor Performance and the General Movement Assessment were administered. Average weekly sessions of occupational therapy, physical therapy, and speech therapy were significantly different by type, but the magnitude and direction of the difference depended upon the discharge week. Infants at high risk for cerebral palsy based on their baseline General Movements Assessment scores received more therapy sessions than infants at low risk for cerebral palsy. Baseline General Movements Assessment was related to the mean number of occupational therapy sessions but not physical therapy or speech therapy sessions. Neonatal Medical Index scores and Test of Infant Motor Performance scores were not predictive of combined therapy services. Medical and developmental risk factors, as well as outcomes from therapy assessments, should be the basis for referral for therapy services in the neonatal intensive care unit.

Early Identification of Atypical Motor Performance of Infants With Prenatal Opioid Exposure.

To investigate the association between prenatal opioid exposure (POE) and newborn infants' motor performance to aid in the early identification of developmental delays. Nineteen infants with POE requiring pharmacological treatment, 27 infants with POE without pharmacological treatment, and 25 infants without POE were assessed via the Test of Infant Motor Performance (TIMP). Infants in both groups with POE had lower TIMP scores than infants without POE. There was no difference between the TIMP scores of infants with POE who required pharmacological treatment and infants with POE who did not require pharmacological treatment. The TIMP can detect differences in motor performance of infants with POE. Regardless of whether infants required pharmacological treatment, POE was associated with lower motor performance. Those working in hospital or early intervention settings can use the TIMP to identify early delays in infants with POE and refer for intervention.

Lutheran Children’s Hospital Neonatal Follow-Up Clinic: Risk of Developmental Delay of Preterm Neonates as a Function of Gestational Birth Age

Background/Objectives:About 1 in 10 babies are born prematurely, a number that increased from previous years because more resources are available and fertility treatments are effective. Children born prematurely have a higher risk of developmental delays that are associated physically, socially, linguistically, and neurodevelopmentally. With these delays being commonly associated with preterm infants, there is the need to continuously study the longitudinal effects caused by being born prematurely. Our objectives include creating a more comprehensive care plan, comparing gestational age with developmental delay levels, and noting correlations between delays and their respective cohort. We hypothesis the more premature the child was born, the higher the likelihood of developmental delay(s).&#x0D; Methods:Two main tests were used to look for a correlation between the delay or lack of a delay with the child’s adjusted age. TIMP, Test of Infant Motor Performance, was used at two different age intervals to measure infant motor capacity. The ASQ, Ages and Stages Questionnaire, was used to screen several different developmental areas of concern, including social and behavioral abilities.&#x0D; Results:The data shows the developmental delay decreasing over time in all preterm cohorts with an exception being the late preterm cohort, likely due to its small sample size. The Chi-square test is not significant for the TIMP1 and TIMP2 comparisons of preterm cohorts. The ASQ data sets did not have a clear consensus of data.&#x0D; Conclusions:There is an increase of developmental delay in neonatal infants in comparison to the standard developmental milestones. A positive finding is that there is an overall decrease in developmental delay as the child progresses in age.&#x0D; Potential Impact: This research may promote other hospitals to implement a NFC for patient care and research considerations.

The reliability and predictive ability of the Test of Infant Motor Performance (TIMP) in a community-based study in Bhaktapur, Nepal

AimIn a Nepalese setting, to measure the reliability of the Test of Infant Motor Performance (TIMP) and its ability to predict development scores at 6 months. MethodsNepalese infants (n = 705) were assessed by the TIMP when they were 8–12 weeks old and the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) at 6 months. Inter-rater agreement was expressed by intraclass correlation coefficients (ICCs), the internal consistency by Cronbach’s alphas and Pearson correlation coefficients. Predictive ability was estimated in linear regression models. ResultsInter-rater agreement was excellent (ICCs > 0.93). Alphas for the TIMP total scores were 0.76 for infants born to term and 0.72 in those born preterm. Correlation coefficients between TIMP total and Bayley-III subscale-scores ranged from 0.05 to 0.28 for term infants and from 0.15 to 0.43 for preterm infants. Using American norms, 56.3 % had TIMP scores within average and 43.7 % below average range. Bayley-III subscale scores were lower in children with TIMP scores below the average range, with the strongest estimates for Gross motor and Socio-emotional development. InterpretationThe reliability of the TIMP was acceptable, and the TIMP could be a feasible tool to monitor infant motor development in low-resource settings. Properties of the TIMP differed according to gestational age.

Commentary on “Early Developmental Trends in High-Risk Neonates Later Diagnosed With Autism Spectrum Disorder”

“How could I apply this information?” The number of children in the United States diagnosed with autism spectrum disorder (ASD) increased in the past 20 years from 1 in 150 in 2000 to 1 in 44 children in 2021.1 Although the disorder can be reliably diagnosed as early as 2 years or age, most children are not diagnosed until 4 years or age. This creates a substantial gap for children and families who need support. Motor skills offer an important opportunity for early interventionists, and specifically physical therapists, to screen for ASD if an association between early motor performance and later diagnosis can be established. Using the Test of Infant Motor Performance (TIMP), a well-validated early motor assessment, with a population of infants known to be at elevated risk2 may be a logical first step toward early detection. Yet, this study clearly establishes that testing of early motor performance does not detect differences in children who are later diagnosed with ASD. Specific items might have predictive value, rather than total scores. These findings support the importance of holistic developmental evaluation and the importance of advanced transdisciplinary training for providers who serve young, at-risk infants to understand how these domains interact and change across early development and in relationship to ASD. “What should I be mindful of when applying this information?” Medical management of prematurity is constantly advancing. Differences in medical care may create different risks and developmental outcomes. Longitudinal follow-up, across all developmental domains, is critical to understand these changing risks and outcomes. The authors discuss that standardized tests may not detect subtle indicators of ASD. Eye gaze and shifting, self-regulation, social interactions, and play skills should be considered. Physical therapists should continue to use assessment of motor skills, paired with screening of social, communication, and play skills, to detect signs of ASD early and refer to appropriate health care partners. Beth Ennis, PT, EdD, PCS University of St Augustine for Health Sciences St Augustine, Florida Sandra Jensen-Willett, PT, PhD, PCS Munroe-Meyer Institute University of Nebraska Medical Center Omaha, Nebraska

Test of Infant Motor Performance (TIMP)

Test of Infant Motor Performance (TIMP)

Day II: Friday, March 24, 2023; 9.00 AM Plumeria 3: Physiotherapy in Pediatric/ Neonatal conditions: AB No: 142 Motor Performance of Indian Preterm as Compared to the US Population on the Test of Infant Motor Performance (TIMP)

Day II: Friday, March 24, 2023; 9.00 AM Plumeria 3: Physiotherapy in Pediatric/ Neonatal conditions: AB No: 142 Motor Performance of Indian Preterm as Compared to the US Population on the Test of Infant Motor Performance (TIMP)

Two-year motor outcomes associated with the dose of NICU based physical therapy: The Noppi RCT

BackgroundInterventions involving both the parent and the preterm infant have demonstrated lasting effects on cognitive outcomes, but motor effects are less salient. It remains unclear when to commence early intervention and if dosages have impact on motor outcomes. AimsTo examine the effect on motor performance at 24-months corrected age following a parent-administered intervention performed with infants born preterm in the NICU. Intervention dosing and longitudinal motor performance were also analyzed. Study designSingle-blinded randomized multicenter clinical trial. Subjects153 infants born, gestational age ≤ 32 weeks at birth, were randomized into intervention or control group. Outcome measuresInfant Motor Performance Screening Test, Test of Infant Motor Performance, Peabody Developmental Motor Scales-2. ResultsNo significant difference was found between the intervention and the control group assessed with the PDMS-2 at 24-months CA. However, a significant positive association was found between dosing and the Gross Motor and Total Motor PDMS-2 scores. Analysis of longitudinal motor performance showed a decreasing motor performance between 6- and 24-months corrected age in both groups. ConclusionsThere was no difference in motor performance between groups at 24-months corrected age. However, increased intervention dosage was positively associated with improved motor outcome.

Early Developmental Trends in High-Risk Neonates Later Diagnosed With Autism Spectrum Disorder.

We hypothesized that clinical data from a neonatal intensive care unit (NICU) infant developmental follow-up clinic would identify early manifestations of autism spectrum disorder (ASD). One hundred forty-four infants were identified; 72 later diagnosed with ASD and 72 controls. Retrospective chart review provided data from the Test of Infant Motor Performance (TIMP) and the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), between 8 and 26 months of age. Between-group comparisons indicated no significant group difference in TIMP scores; however, Bayley-III scaled scores differed between the groups at 2 administration times. The within-group Bayley-III change scores declined significantly more for the ASD group in cognitive and communication subtests. High-risk neonates, due to prematurity or morbidity, later diagnosed with ASD demonstrated statistically significant differences, including a more precipitous drop in Bayley-III scores over time. Early, longitudinal developmental surveillance for neonates at risk of ASD is critical. What this adds to the evidence: Early identification of ASD is critical to optimize developmental outcomes in young children, including infants born prematurely or with neonatal morbidity, who are perceived to have an increased risk for ASD. Despite these findings, minimal research has been conducted to evaluate the utility of commonly administered norm-referenced developmental surveillance instruments to identify possible early signs of ASD in this high-risk population due to prematurity or neonatal morbidity and not familial association. The present study analyzed retrospectively collected clinical data from a NICU developmental follow-up clinic for 144 infants, 72 of which were later diagnosed with ASD and 72 sex- and gestational age-matched controls. Results demonstrated statistically significant poorer Bayley-III outcomes for the ASD group compared with controls at 2 different study time points, including a more precipitous drop in Bayley-III scaled scores over time. This study highlights the importance of early and longitudinal developmental surveillance for high-risk neonates at risk of ASD.

Predictive value of the test of infant motor performance and the Hammersmith infant neurological examination for cerebral palsy in infants

BackgroundCurrent recommendations for early detection tools for cerebral palsy (CP) include assessments that vary in feasibility and resource requirements. The predictive value of less resource-intensive tools has not been fully explored. AimsTo determine the predictive value of the Test of Infant Motor Performance (TIMP) at 3–4 months corrected age (CA) for CP, and whether administration of both the TIMP and the Hammersmith Infant Neurological Exam (HINE) improves early CP detection. Study designFive-year retrospective observational study of infants who received the TIMP and the HINE at 3–4 months CA in a high-risk follow-up clinic. TIMP and HINE cut-off scores (alone and in combination) were compared for CP discriminatory ability. SubjectsOf patients with HINE scores (n = 1389; 676 [48.7 %] female; median gestational age at birth 31 weeks [interquartile range 29–34 weeks]), 1343 had concurrent TIMP scores available. Outcome measuresClinical diagnosis of CP. ResultsHINE total score <57 had optimal CP predictive value (AUC = 0.815; 77 % sensitivity; 91 % specificity) compared to optimal TIMP cut-off (1 SD below the mean, AUC = 0.71; 52 % sensitivity; 94 % specificity) and all tested TIMP and HINE combinations (all p < 0.001). ConclusionsHINE total score <57 at 3–4 months CA had the best CP predictive value, confirming its value absent first-line detection tools. Concurrent administration of TIMP did not improve predictive value.

The Predictive Effect of Individual and Environmental Factors on Motor Performance of Low Birth Weight Infants

Objectives: Premature infants in the neonatal intensive care unit (NICU) are exposed to environmental risks that may cause developmental problems i. The present study aimed to investigate the predictive effect of individual and environmental factors on the motor performance of low birth weight preterm infants. Methods: This cross-sectional study was performed in the neonatal clinic of Shahid Akbarabadi Hospital in Tehran City, Iran. A group of 90 low birth weight infants were enrolled in the study by non-probabilistic method and according to the inclusion criteria. Test of infant motor performance (TIMP), sensory profile2 (infant section), affordance in the home environment for motor development (AHEMD), and a demographic questionnaire were used to evaluate motor performance, sensory status, home environment, and other factors (birth weight, corrected age, parent’s education, etc.), respectively. Results: TIMP elicited score was positively correlated with the infant’s age (r=0.390, P&lt;0.001) and infant’s weight (r=0.260, P=0.011), and negatively correlated with duration of hospitalization in NICU (r=-0.210, P=0.047). A significant negative correlation was observed between TIMP elicited score and total infant sensory profile2 score (r=0.391, P&lt;0.001) and a positive correlation was observed between TIMP elicited score and total affordance in the home environment for motor development score (r=0.207 P=0.049). Discussion: The present study’s results showed that elicited movement has a significant relationship with infant sensory status and home environment and demographic variables (infant’s age, gender, infant’s weight, type of delivery, NICU duration, father and mother’s age, number of family children) and the sensory status has a more predictive effect on infant motor performance than the environmental questionnaire.

Avaliação do desenvolvimento motor e do efeito da intervenção fisioterapêutica em recém-nascidos cirúrgicos em Unidade de Terapia Intensiva Neonatal

ABSTRACT This study aimed to verify the applicability of the Test of Infant Motor Performance (TIMP) in surgical neonates as a tool for evaluating motor performance and to evaluate the benefit of physical therapy. Surgical neonates, divided into group without physical therapy (n=38) and group with motor physical therapy (n=38), were evaluated by TIMP and reasssment two weeks later. The physical therapy group performed standardized exercises for motor sensory stimulation once a day, whereas the other group received the usual care from the Neonatal Intensive Care Unit. The predominant surgical diagnosis in both groups was gastroschisis, followed by congenital diaphragmatic hernia. In the initial evaluation, motor performance was equal between the groups, classified as “below average” for age, with z-score=−1.28 (p=0.992). In the reassessment, the physical therapy group presented better scores (p&lt;0.001) and a higher difference in z-score (p&lt;0.001), higher percentage of neonates classified as “within average” (44% in the physical therapy group and 2.6% in the no physical therapy group), as well as a higher weight gain percentage (p=0.038). We found a worsening of motor performance in 10.5% of the no physical therapy group (p&lt;0.001) in the reassment. Motor performance improved in 81.6% of the physical therapy group and in only 13.2% of the no physical therapy group individuals (p&lt;0.001). Conclusion: TIMP was safely and effectively applied to newborns; notably, the test must be performed by professionals experienced in care of neonates. Motor intervention was beneficial, significantly improving motor performance, and if applied early, it may adequate the motor development of these neonates, even before hospital discharge.

Translation and Cross-Cultural Adaptation of the Test of Infant Motor Performance to Colombian Spanish

Introduction: There has been growing interest in recent years in the cross-cultural adaptation of measuring instruments for various conditions treated by physiotherapy. Validation of an instrument within a target language and culture creates a final version that is conceptually and linguistically adapted to the context but remains valid and reliable. This paper describes the process of translation and cross-cultural adaptation of the Test of Infant Motor Performance (TIMP) from us English to Colombian Spanish. This was performed in accordance with international methodological guidelines. Materials and methods: A group of trained translators and field experts participated in the five stages presented herein. These stages were translation and adaptation of the instrument to Colombian Spanish, validation of its content and appearance, back-translation, revision by the original author, and, finally, a pilot test. Results: The existence of two intralingual translated and revised versions of this instrument led to a more appropriate preliminary version from conceptual, discursive, and terminological perspectives. Therefore, the adjustments made in the first stage were primarily semantic. During the second stage, field experts positively assessed the translated version and suggested adjustments to grammar, spelling, and word choices. There were no significant discursive problems during the back-translation stageso conceptual and terminological adjustments were minor. The revision stage and the pilot test weresatisfactory. Conclusion: This translation and cross-cultural adaptation was successful. The ColombianSpanish version of the measure was culturally relevant and used appropriate language, yet remained a valid and reliable tool.

Predictive Value of the Test of Infant Motor Performance and the Hammersmith Infant Neurological Examination for Cerebral Palsy in Infants

Predictive Value of the Test of Infant Motor Performance and the Hammersmith Infant Neurological Examination for Cerebral Palsy in Infants