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Development of walking in preterm and term infants: Age of onset, qualitative features and sensitivity to resonance
Suh-Fang Jengab, Tin-Wai Lauc, Wu-Shiun Hsiehd, Hong-Ji Luoa, Pei-Shan Chenb, Kwan-Hua Lina, Jeng-Yi Shiehb Gait and Posture
Quote:
An increasing number of studies have examined the development of walking in preterm infants; however, the results concerning those who had no major neonatal disease were inconclusive. This study was therefore aimed to examine the age of onset, the quality of early walking movement, and the sensitivity to resonant period of the force-driven harmonic oscillator (FDHO) model in preterm infants who had no major neonatal disease and normal term infants. Twenty-nine preterm infants and 29 term infants were prospectively examined for their age of onset of independent walking and were subsequently assessed the qualitative features of walking at 18 months of corrected age using kinematic analysis. Kinematic variables examined included spatio-temporal organization, inter-joint coordination, and inter-limb coordination. The anthropometric data were used to calculate the resonant period. The results demonstrated that the preterm infants attained independent walking at significantly older ages than the term infants when corrected for prematurity. The preterm infants manifested similar walking characteristics, except for shorter stride lengths, at 18 months of corrected age compared with the term infants. Furthermore, the stride periods of both groups were accurately predicted by the resonant period of the FDHO model. We conclude that preterm birth without accompanied major neonatal disease may affect infants’ age of onset and spatial organization but not their sensitivity to resonance during the early stage of walking development.
Given the last 4-6 weeks of in uterine development the babe's proprioceptors are being formed and tested out, this makes sense.
When we see these premmies toe walking, spinning, bumping into things, making contact with every surface they can, we can only conclude that they missed out on this important moment in development.
There is also a a train of thought that the stride change/ground contact time is due to the child not wanting to fully contact the surface of the ground due to the number of heel pricks that they have had when in NICU. They have been exposed to so much pain at such a young age, this is remembered and subconsciously they do not want to put their feet to the ground. A few physio's I have worked with over the years subscribe to this thought process and we have used various cushioning within shoes and even opsite with some kids to assist in encouraging these kids to make ground contact.
This is one of those area's that I think the OT's/physio excel at explaining and working with this babes at an early age is integral. We have so much more to learn.
There is also a a train of thought that the stride change/ground contact time is due to the child not wanting to fully contact the surface of the ground due to the number of heel pricks that they have had when in NICU. They have been exposed to so much pain at such a young age, this is remembered and subconsciously they do not want to put their feet to the ground. A few physio's I have worked with over the years subscribe to this thought process and we have used various cushioning within shoes and even opsite with some kids to assist in encouraging these kids to make ground contact.
Wow, that's a really interesting concept. It's amazing the memory that is retained in our "cells" from our earliest days.
Must do some more reading on that.
The pre-term Arena'ettes were both up and walking well before their first birthday:
__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________ God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University This is where I am, where are you?
Development of walking in preterm infants
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