Physiotherapy 90 (2004) 108–109

Abstracts

The assessment of preterm infants (born at or before 32 weeks gestation),may predict their long-term gross motor outcome

H. Palmer∗

Crystal Centre, 47, St James Road, Croydon CR0 2UR, UK

Objective The aim of this study was to determine if thescore obtained on the Joan Lacey Longitudinal AssessmentScale (JLLAS—Lacey JL, Henderson-Smart DJ, EdwardsDA, Storey B. Neurological assessment of the preterm in-fant. In: The special care nursery and the diagnostic sig-nificance of the asymmetrical tonic neck reflex. Austr JPhysiother 1987;33:135–42) predicted long-term gross mo-tor outcome in preterm infants who were re-assessed againat 6/7 years of age using the Gross Motor Function Measure(GMFM—Russell DJ, Rosenbaum PL, Gowland C, HardyS, Lane M, Plews N, et al. The gross motor function mea-sure manual, 2nd ed., Ontario, Canada, 1993). The ability topredict future problems with gross motor skills may enableappropriate advice or early intervention programmes to beprovided for at risk preterm infants.

Design A study was carried out to determine if there wasan association between the JLLAS scores recorded at birthand the GMFM scores obtained at aged 6/7 years.

Participants Infants were identified from hospital physio-therapy records. The inclusion criteria were documented JL-LAS score and one of the following (1) born at or before32 weeks gestation (2) a birth weight of 1500 g or less (3)intrauterine growth retardation as shown on ultrasound scan(4) evidence of interventricular haemorrhage and/or periven-tricular leucomalacia.

∗ Corresponding author. Tel.:+0208-274-6853 (O).E-mail address: hilary.palmer@croydonpct.nhs.uk (H. Palmer).doi:10.1016/j.physio.2004.02.001

Thirty-five infants, who met the inclusion criteria, wereidentified of which 18 parents/children gave their consent totake part.

Outcome measures The children’s JLLAS scores were ob-tained retrospectively from physiotherapy records. The mo-tor skills of these children were reassessed using the GMFM.

Parents were asked for details of their child’s medicalhistory and development by filling in an information sheet.

Results It was found that there was no association betweenthe JLLAS scores and the GMFM scores.

Fifteen infants scored below 80% on the JLLAS and thisdelay persisted in the first years of life in eight of the chil-dren. When reassessed at 6/7 years of age, the majority ofthe children scored near maximum points on the GMFM(median 97.65). Three children had a diagnosis of cerebralpalsy and four other parents indicated that their children hadslight motor difficulties.

Conclusions The results of the GMFM indicated that thir-teen children were considered to have relatively ‘normal’gross motor skills at age 6/7 years. One explanation forthese findings is that the children’s motor development had‘caught up’ in the intervening years. The information sug-gested that some of the children had subtle motor difficultiesand it may be that the GMFM was not sufficiently sensitiveto detect these difficulties.