Very low birth weight infants and the Alberta Infant Motor Scale: Article Summary
Alberta Infant Motor Scale Article Summary
Article
“Using the Alberta Infant Motor Scale to early identify very low-birth-weight infants with cystic periventricular leukomalacia,” Lin-Yu Wang, Yu-Lin Wang, Shan-Tair Wang, Chao-Ching Huang, Brain and Development, Volume 35, Issue 1, 2013, Pages 32-37
Purpose
The purpose of the study is to determine if the Alberta Infant Motor Scale can determine if very low birthweight infants who are preterm have cystic periventricular leukomalacia. This study is done in a longitudinal context starting as early as six months corrected age and at 12 and 18 months respectively.
Population
The population included 35 preterm infants with very low birth weight and cystic periventricular leukomalacia, 70 preterm infants with very low birthweight and no signs of cystic periventricular leukomalacia, and 76 healthy control infants without cystic periventricular leukomalacia that were full term and birth weight within normal limits. The selection criteria for preterm infants includes infants from 6 nearby hospital in Taiwan, birthweight less than 1500 grams, no genetic syndromes or brain malformations, no cerebral hemorrhage or in the ventricles of the brain, no “transient periventricular hyperechoic lesions,” and survived until discharge at their respective neonatal intensive care unit.
Outcome Measure
The outcome measure used for this study, the Alberta Infant Motor Scale (AIMS) is used because of its wide use to evaluate motor development in full term infants, preterm infants, at risk infants, and infants with cerebral palsy. It can be done by observation only in 20 minutes. The AIMS evaluates spontaneous early movement up to walking making it appropriate for the age group being assessed. This study is a further investigation into whether this AIMS may be used to identify very low birthweight infants with cystic periventricular leukomalacia.
Methods
The methods include using the Alberta Infant Motor Scale to evaluate the groups of infants in Taiwan: 35 infants with very low birth weight and cystic periventricular leukomalacia, 70 preterm infants without cystic periventricular leukomalacia, and 76 health control infants. Preterm Infants with cystic periventricular leukomalacia were confirmed using cranial ultrasonography and this is important because cystic periventricular leukomalacia can often lead to cerebral palsy diagnosis. The AIMS was conducted by two physiotherapists trained in administering the AIMS who rated each child independently from all three groups and blind to the other physiotherapists’ results. The AIMS was administered at 6 months, 12 months, and 18 months. The corrected age was used for preterm infants. Infants were evaluated prone, supine, sitting and standing.
No Interventions were used in this research.
Results
The results indicated:
At 6 months, preterm infants with cystic periventricular leukomalacia (CPVL) had significantly lower subscale scores on the AIMS in prone, supine, sitting than their preterm counterpart. The preterm infants without CPVL had significantly lower AIMS score than their healthy control counterparts.
At 12 months, preterm infants with cystic periventricular leukomalacia had significantly lower subscale scores on the AIMS in prone, supine, sitting, and standing than their preterm counterparts while preterm infants without CPVL only were significantly lower than healthy control infants on the standing subscale on the AIMS.
At 18 months, preterm infants with cystic periventricular leukomalacia had significantly lower subscale scores on the AIMS in prone, supine, sitting, and standing than their preterm counterparts, while preterm infants without CPVL showed no significant difference in their AIMS score than their healthy counterparts.
At 2 years old a pediatric neurologist diagnosed all 35 children with CPVL with cerebral palsy.
Conclusion
AIMS may assist pediatricians in diagnosing very low birth weight infants with CPVL as early as 6 months old enabling early intervention.
Strengths of this Article
This study gives us significant statistical data to suggest that the AIMS can be used as a diagnostic tool to aid pediatric neurologists in the diagnosis of very low wight preterm infants with cystic periventricular leukomalacia who have not otherwise had imaging done. Also, there was no previously published data on AIMS score for very low wight preterm infants with cystic periventricular leukomalacia and this is a start to that collection of data.
Weaknesses of the Article
More research needs to be done including in across cultures and ethnicities before such conclusive conclusions may be widely accepted and considered global.
Overall Conclusion
Health care providers may use the AIMS may be able to identify very low wight preterm infants with cystic periventricular leukomalacia as early as 6 months and can make a necessary referral to pediatric neurologist and beginning early intervention strategies for this population may be warranted before the age of 2.
One response to “Very low birth weight infants and the Alberta Infant Motor Scale: Article Summary”
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This is a very interesting study. I did not think the AIMS would be effective for children this young. I wonder research in different cultures and ethnicities would show and if it would show any differences. This is very useful if we ever have to use the AIMS in out future practice.