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Pediatric Physical Therapy:
doi: 10.1097/01.pep.0000346055.95672.dd
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Prediction of Motor and Functional Outcomes in Infants Born Preterm Assessed at Term

Sargent, Barbara PT, MEd, PCS

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Author Information

Department of Rehabilitation, Children’s Hospital of Orange County, Orange, CA and; Division of Biokinesiology and Physical Therapy University of Southern California, Los Angeles, CA; Linda Fetters, PT, PhD, FAPTA; Division of Biokinesiology and Physical Therapy University of Southern California, Los Angeles, CA

“How could I apply this information?”

“What should I be mindful about in applying this information?”

“How can I apply this information when talking to parents of prematurely born infants?”

Parents can be given a hopeful message about the potential development of their child.

Although their infant born preterm may demonstrate delays on an infant assessment at term and may have undergone a complicated medical course in the neonatal intensive care unit, it does not necessarily mean that their infant will demonstrate poor motor and functional outcomes in the future. This study is in agreement with previous literature which suggests that prediction from newborn and very early behavior and medical events to later motor performance is not very accurate. In this study, assessments of infants born preterm conducted at term and perinatal risk factors explain only 4% to 16% of the variance in motor and functional outcome scores of infants born preterm at 12 months adjusted age. This means that more than 80% of the variability in outcome at 1 year of age arises from factors other than the early medical course and early behaviors. There are many factors that could potentially influence developmental outcomes including the family context and the availability and quality of resources that foster development.

“How can I apply this information when assessing a preterm infant at term?”

The factors most highly associated with motor and functional outcomes at 12 months adjusted age are the General Movements Assessment (GMsA) categories, Test of Infant Motor Proficiency (TIMP) scores, the presence of an intraventricular hemorrhage (IVH), and the duration of ventilation. Therefore, this information should be considered when assessing a preterm infant at term to determine referrals for early intervention. Infants born preterm who may benefit from direct therapeutic intervention include infants categorized as “cramped synchronized” on the GMsA, infants classified as “far below average” on the TIMP, infants with a grade III or IV IVH, and infants who were on a ventilator for over 23 days. This early information may be more useful in determining the next step in care for an infant than in making longer term predictions.

Barbara Sargent, PT, MEd, PCS

Department of Rehabilitation, Children’s Hospital of Orange County, Orange, CA and

Division of Biokinesiology and Physical Therapy University of Southern California, Los Angeles, CA

Linda Fetters, PT, PhD, FAPTA

Division of Biokinesiology and Physical Therapy University of Southern California, Los Angeles, CA

© 2009 Lippincott Williams & Wilkins, Inc.

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