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Early spontaneous movements and spatiotemporal gait characteristics in preterm children

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Abstract

This study aimed to analyze spatiotemporal gait characteristics of preterm children from 3 to 4 years of age according to different gestational age groups and to examine the relationship between the detailed general movements assessment and spatiotemporal gait characteristics. A total of 74 preterm children, 32 extremely preterm and very preterm (EP-VP, < 32 weeks gestational age) and 42 moderate to late preterm (MLP, 32 to < 37 weeks gestational age), were included in this prospective study, along with 38 term children. Early spontaneous movements of preterm children were assessed from videos at 9–20 weeks post-term according to the general movements assessment, which determines the Motor Optimality Score-Revised (MOS-R). The spatiotemporal gait characteristics of all children were evaluated using the GAITRite®electronic walkway at self-selected walking speeds. EP-VP children walked with shorter step lengths (p = 0.039), and MLP children walked with greater step length variability (p = 0.003) than their term peers. The MOS-R results were related to step length (r = 0.36, p = 0.042), step length variability (r =  −0.56, p = 0.001), and base of support (r =  −0.37, p = 0.038) in EP-VP children. The MOS-R subcategories, age-adequate movement repertoire, and postural patterns were related to some of the spatiotemporal gait characteristics, including step length, step length variability, and base of support (p < 0.05).

  Conclusion: EP-VP and MLP children might catch up to their term peers at 3 to 4 years of age in terms of most gait parameters. In addition to the MOS-R, age-adequate movement repertoire and postural patterns of preterm children without cerebral palsy in early life may be a marker of later neurodevelopmental dysfunction.

What is Known:

• Preterm children walk with a wider step width, a greater step length asymmetry and step time, and a shorter stride length at 18 to 22 months of age compared with term children at a self-selected speed, while these differences disappear in children 4.5–5 years old and older.

What is New:

• Early spontaneous movements were related to some spatiotemporal gait characteristics.

• Preterm children might catch up to term children at 3–4 years of age in spatiotemporal gait characteristics while walking at a self-selected speed.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request. The data are not publicly available due to privacy or ethical restrictions.

Abbreviations

CP:

Cerebral palsy

EP-VP:

Extremely preterm and very preterm

GMA:

General movements assessment

MLP:

Moderate to late preterm

MOS:

Motor optimality score

MOS-R:

Motor optimality score – revised

VP:

Very preterm

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Acknowledgements

The authors would like to thank the children and parents who participated in the study.

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Authors and Affiliations

  1. Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye

    Yusuf Topal, Bilge Nur Yardımcı-Lokmanoğlu & Akmer Mutlu

  2. Gait Analysis Laboratory, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye

    Semra Topuz

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  1. Yusuf Topal
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  2. Bilge Nur Yardımcı-Lokmanoğlu
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Contributions

Yusuf Topal and Bilge Nur Yardımcı-Lokmanoğlu conceived and designed the study, analyzed and interpreted the data, and drafted and revised the manuscript; Semra Topuz and Akmer Mutlu assisted with the overall study design and implementation, interpreted the results, and reviewed and revised the manuscript; all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Yusuf Topal.

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Ethics approval and consent to participate

The study was approved by the Non-Interventional Clinical Research Ethics Board, Hacettepe University (GO 21/1006). The study protocol was in accordance with the Declaration of Helsinki. All parents gave written informed consent before the study.

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The authors declare no competing interests.

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Communicated by Gregorio Milani.

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Topal, Y., Yardımcı-Lokmanoğlu, B.N., Topuz, S. et al. Early spontaneous movements and spatiotemporal gait characteristics in preterm children. Eur J Pediatr 182, 2913–2923 (2023). https://doi.org/10.1007/s00431-023-04949-7

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