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Commentary on “Ankle Movements During Supine Kicking in Infants Born Preterm”

Kim, Jeongah PT, MS; Sargent, Barbara PT, PhD, PCS

Pediatric Physical Therapy: October 2016 - Volume 28 - Issue 3 - p 303
doi: 10.1097/PEP.0000000000000277
CLINICAL BOTTOM LINE
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University of Southern California Los Angeles, California

The authors declare no conflicts of interest.

“How should I apply this information?”

This study provides evidence that infants born full-term and preterm exhibit differences in active ankle movement that may be influenced by passive gastrocnemius/soleus muscle tendon unit (g/s MTU) length. For infants born preterm younger than 12 weeks corrected-age, clinicians may consider measuring g/s MTU length and maximum active plantarflexion and dorsiflexion range of motion to monitor how passive g/s MTU length influences active ankle movement. If an infant born preterm consistently exhibits a shortened g/s MTU length, excessive active ankle plantarflexion, and reduced active ankle dorsiflexion, clinicians may consider including the following in the child's intervention plan: active/passive stretching of the g/s MTU, activities to encourage active selective dorsiflexion, and activities to encourage age-appropriate ankle movements in supported standing positions and during early gait activities.

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

Clinicians should be mindful that this study does not provide evidence that a shortened g/s MTU length, excessive active ankle plantarflexion, and reduced active ankle dorsiflexion during supine kicking in early infancy contribute to later functional limitations, including the emergence of toe-walking. In addition, although infants in this study were born preterm, they were classified as low risk for developmental problems, implying that differences in g/s MTU length and active ankle movement may resolve with time and not significantly impact a child's developmental trajectory. To inform clinical practice, further research of infants born preterm at high risk for developmental issues is recommended to determine the relationship between passive g/s MTU length, active ankle movement during infancy, and the emergence of toe-walking.

Jeongah Kim, PT, MS

Barbara Sargent, PT, PhD, PCS

University of Southern California

Los Angeles, California

Copyright © 2016 Academy of Pediatric Physical Therapy of the American Physical Therapy Association