扭动运动全身运动评估在极低出生体重早产儿运动发育随访中的应用研究

目的研究扭动运动全身运动整体和细化评估在极低出生体重早产儿运动发育随访中的应用,为全身运动在临床的应用进一步拓展和补充。方法 2009-2014年接受全身运动评估和定期随访至1周岁以上的极低出生体重早产儿共50例,以1周岁运动结局为金标准计算全身运动整体评估对于运动发育结局的预测效度;采用"早产儿和足月儿全身运动细化评分表"获得细化评估的最优性评分,采用Peabody运动发育量表评定1周岁的运动发育能力,计算两者之间相关性。结果扭动阶段全身运动整体评估对于异常运动发育结局(脑瘫和运动发育迟缓)的预测效度为敏感度100%、特异度33.3%,阳性预测值29.7%,阴性预测值100%。痉挛-同步性的全身运动对于脑瘫发育结局的预测效度为敏感度55.6%、特异度97.6%,阳性预测值83.3%,阴性预测值90.9%。50例研究对象的扭动运动细化评分的中位数为24,全身运动细化评分与婴儿1周岁运动发育评分之间具有中等程度的相关性。结论在极低出生体重早产儿的运动发育随访中,可以采用扭动阶段全身运动评估作为早期评估指标。

Application of writhing general movement assessment in very low birth weight infant follow-up for motor development

Objective To study the application of the general and detailed assessment of writhing movement in very low birth weight (VLBW) infants follow-up for motor development. Methods A total of 50 VLBW infants ranging from December of 2009 to December of 2014 included in the Rehabilitation Department of Children's Hospital of Fudan University participated in the study.The motor development outcomes of the infants at 1 year old were determined according to clinical diagnoses and PDMS-2.The motor optimality score was assessed according to the detailed assessment of "Preterm and Term General Movement".The motor developmental score of the infants at 1 year old and the correlation coefficients between the motor optimality score and PDMS score were calculated. Results The predictive value of GMs assessment for neurological deficits (CP and motor retardation) was as followingsensitivity 100%, specificity 33.3%, positive predictive value 29.7%, and negative predictive value 100%; The predictive value of CS for CP was as followingsensitivity 55.6%, specificity 97.6%, positive predictive value 83.3%, and negative predictive value 90.9%.The median value of the 50 infants' motor optimality score was 24.The correlation degree between the motor optimality score and PDMS score of the infants at 1 year old was moderate. Conclusion In the motor developmental follow-up of VLBW infants, the writhing general movement assessment can be used as early indicators.