Influence of intrinsic and extrinsic constraints on head movements during eye-head coordination in fullterm and preterm infants among 1 to 4 months
Influence of age and prematurity (instrinsic constraints) and body orientations (supine, semiflexion and reclined postures - extrinsic constraints) on head movements during eye-head coordination in fullterm from 1 to 4 months of age and preterm healthy infants among 1 to 4 months of corrected age measured by kinematical analysis.
Carolina Daniel de Lima-Alvarez
40 participants
Sep 1, 2010
Interventional
Conditions
Summary
The current study aim to investigate the influence of different body orientations (extrinsic constraint) on continuous (mean velocity; head range of motion: flexion-extention, inclination and rotation) and categorical (head movement frequency; head trajectory – side-to-midline, midline-to-side and side-to-side; initial head position – right, left and midline) variables of head movements in the period when head control is developing (0-4 months of age considered an intrinsic constraint) in both: fullterm and pre-term infants.
Eligibility
Inclusion Criteria3
- Twenty healthy full-term infants free from neurological or musculoeskeletal pathologies, with gestational age between 37 and 40 weeks, birth weight higher than 2.500 g, Apgar in the first minute higher than 7 and in the fifth minute higher than 9.
- Twenty healthy pre-term infants free from neurological or musculoeskeletal pathologies, with gestational age between 30 and 36 weeks, birth weight adequated for gestational age, Apgar in the first minute highter than 7 and in the fifth minute higher than 9.
- These convenience sample will be selected based on maternity medical records information.
Exclusion Criteria6
- congenital defects in the central nervous system (anencephaly, spina bifida, micro / macrocephaly, hydrocephalus, among others);
- signs of neurological damage (hypoxic-ischemic encephalopathy grades: I, II and III, intracranial hemorrhage, neonatal seizures, spasticity, abnormalities in
- reflexes and hypotonia), and 3) musculoskeletal (congenital torticollis, arthrogryposis multiplex, achondroplasia), 4) diagnostic of genetic syndromes (Down syndrome or any syndrome deletion chromosome) or symptoms of withdrawal symptoms associated with maternal report of abuse of alcohol and drugs, 5) congenital infections (toxoplasmosis, rubella, cytomegalovirus, syphilis,
- humam imunodeficiency virus (HIV), hepatitis A, B or C) reported by mothers whose serology, as described in the handbook
- motherhood, is positive, 6) have sensory deficits (auditory and visual), detected by thorough pediatric examination performed after the birth at the Maternity and signs of retinopathy of prematurity, grade: II and III, 7) cardio-respiratory problems, 8) hyaline membrane syndrome, sepsis or whose mothers have submitted episode
- pre-eclampsia or eclampsia. Will be excluded infants who do not attend for the first evaluation on the given date.
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Interventions
All infants (fullterm and pre-term) will be evaluated in three conditions (supine, semiflexion and reclined) in every assessment (1, 2, 3 and 4 months). The infant will be exposed in three conditions: 1) Condition supine, the chair will be positioned parallel to horizontal plane. 2) Condition semiflexion, the chair will be positioned parallel to horizontal plane and an infant pillow (25X20 cm), having a small concavity in the center, maintained the infant’s neck semiflexed to about 15 degrees. The concavity on the pillow did not restricte head movement. 3) Condition reclined, the chair will be positioned 20 degrees from the horizontal and infant’s neck remained semiflexed. The sequence order of conditions exposure will be arranged in three predetermined groups: 1) supine-semiflexion-reclined; 2) reclined-semiflexion-supine; and 3) semiflexion-reclined-supine. In all conditions, the infant will be presented with a black and white happy face card (10X10 cm), which will be placed in front of his/her face at eyes’ height and at a distance of 25-40 cm. The card will be moved slowly (manually, always by the same examiner) in a crosswise direction as soon as the infant had gazed it. When visual contact with the card were lost, it will be presented again, as many times as necessary, within the 2-min period determined for each condition. Visual contact during head movement will be monitored through the reflection of the card image in the infant’s pupil.
Locations(1)
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ACTRN12610000825055