Search

The objective of this study was to evaluate whether prosthetic fitting before the age of one year is associated with better outcomes in children with unilateral congenital below-elbow deficiency compared to children fitted after the age of one. Twenty subjects aged 6–21 years were recruited (five prosthetic users and 15 non-users). The Child Amputee Prosthetics Project-Prosthesis Satisfactory Inventory (CAPP-PSI) and the Prosthetic Upper Extremity Functional Index (PUFI) were used to assess patient satisfaction and functional use of the prosthesis. Videotapes were used to assess motor performance. Initial prosthetic fitting before one year of age was related to use of a prosthesis for at least four years. Age at first fitting was not associated with satisfaction with the prosthesis, functional use of the prosthesis or motor skills. Discrepancies between ease of performance with prosthesis and usefulness of the prosthesis as well as between capacity and performance of activities were found. The video assessments showed impaired movement adaptation to some tasks in six subjects. In conclusion, early prosthetic fitting seems to have a limited impact on prosthesis use during later stages of life. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate longitudinal applicability of the gross motor function measure (GMFM) in infants younger than 2 years., Methods: Twelve infants at very high risk for cerebral palsy were enrolled between 1 and 9 months corrected age. The children were assessed 4 times during 1 year with the GMFM-66, GMFM-88, and other neuromotor tests., Results: Longitudinal use of the GMFM in infancy was hampered by age and function-specific limitations. The GMFM-66 differentiated less at lower-ability levels than at higher-ability levels. The GMFM-88 demonstrated flattening of the developmental curve when infants had developed more motor abilities. We formulated adaptations for the longitudinal use of GMFM in infancy., Conclusions: To facilitate use of the GMFM in infancy, an adapted version may be an option. Further research is required to assess reliability and validity, and in particular, the sensitivity to change of the suggested adaptations.

Purpose: The study aim was to describe and quantify physical therapy interventions for infants at high risk for developmental disorders., Methods: An observation protocol was developed based on knowledge about infant physical therapy and analysis of directly observable physiotherapeutic (PT) actions. The protocol's psychometric quality was assessed. Videos of 42 infant physical therapy sessions at 4 or 6 months of corrected age were analyzed., Results: The observation protocol classified PT actions into 8 mutually exclusive categories. Virtually all PT actions during treatment could be classified. Inter- and intrarater agreements were satisfactory (intraclass correlations, 0.68-1.00). Approximately 40% of treatment time was spent challenging the infant to produce motor behavior by themselves, whereas approximately 30% of time facilitation techniques were applied. Tradition-based sessions could be differentiated from function-oriented ones., Conclusions: It is possible to document PT actions during physical therapy treatment of infants at high risk for cerebral palsy in a systematic, standardized, and reliable way.

Objective: Neuromotor function in infancy can be evaluated in various ways. Assessment instruments are used for early detection of children with a high risk for developmental disorders. Early detection enables clinicians to provide intervention at a young age when plasticity of the nervous system is high. The assessments may also be used to monitor intervention. The present article will review the psychometric properties of methods to assess neuromotor function in infancy., Method: A literature search was performed in PubMed, Medline, and PsycINFO (1966-2007) on instruments to assess neuromotor functioning of infants., Results: Fifteen instruments were included and classified into 4 groups: (1) Comprehensive neurological examinations (n = 4). These techniques are widely used, though little is known about their reliability. Their validity in predicting major developmental disorders such as cerebral palsy is good; their predictive validity for minor motor disorders is moderate at best. (2) Procedures with standardized scoring (n = 7). These have good reliability, but only moderate predictive validity for major developmental disorders. No data available for prediction of minor developmental disorders. (3) Observation of milestones (n = 2). Its predictive validity for major developmental disorders is only moderate, whereas reliability is good. (4) Assessment of quality of motor behavior or motor patterns (n = 2). These instruments have the best predictive validity for major and minor developmental motor disorders, but current methods are only useful under the age of 4 months., Conclusion: Prediction of developmental outcome at an early age is difficult. In medical evaluations of high-risk infants, the best predictions are achieved through a combination of multiple, complementary tools, that is, achieved milestones, neurological examination and assessment of the quality of motor behavior.