Citas solicitadas como urgentes: impacto en la consulta y características clínicas / Appointments requested as urgent: Impact on the clinics and clinical characteristics

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Valoración de la coordinación y el equilibrio en niños prematuros / Evaluation of coordination and balance in preterm children

INTRODUCCIÓN: Estudios recientes demuestran que muchos niños prematuros sin secuelas neurológicas aparentes presentan dificultades en diferentes áreas, como la coordinación o el equilibrio, durante la etapa escolar. El Movement Assessment Battery for Children-2 (MABC-2) constituye una herramienta validada para la valoración de la coordinación, mientras que la estabilometría sería la prueba gold standard para el equilibrio. Pacientes y método: Estudio de casos y controles realizado en niños prematuros de 7-10 años y controles sanos nacidos a término de la misma edad. En ambos grupos se aplicó la franja de edad número 2 del MABC-2 y se analizó el equilibrio estático mediante estabilometría. RESULTADOS: Se incluyeron 89 sujetos: 30 prematuros de peso al nacimiento ≤ 1.500 g, 29 prematuros de peso > 1.500 g y 30 controles. Los prematuros obtuvieron peores puntuaciones totales de forma global en destreza manual y equilibrio en el MABC-2, independientemente del peso al nacimiento. La menor edad gestacional supuso la obtención de peores puntuaciones en destreza manual y scores totales en el MABC-2. El equilibrio fue similar mediante la estabilometría, independientemente de la prematuridad. CONCLUSIONES: Algo más de un 10% de prematuros y controles podría tener trastornos de la coordinación o estar en riesgo de desarrollarlos empleando el MABC-2. A pesar de que la coordinación visomotriz fue similar, los prematuros podrían tener mayores dificultades en destreza manual, mientras que en ausencia de comorbilidad neurológica, el equilibrio postural parece ser equiparable al de los controles sanos de su misma edad

INTRODUCTION: Recent studies show that many preterm children without apparent neurological sequelae present some difficulties in different areas, such as coordination or balance during their school years. The Movement Assessment Battery for Children-2 (MABC-2) has demonstrated to be a useful tool to validate the coordination, while the stabilometric platform was the reference standard test for validating the balance. PATIENTS AND METHOD: Case-control study carried out on preterm children from 7 to 10 years old and healthy term infant controls of the same ages. The same age band of MABC-2 was applied and the static balance by the stabilometric platform was analysed. RESULTS: A total of 89 subjects were included, 30 preterm children ≤ 1,500 g birthweight, 29 preterm children > 1,500 g birthweight, and 30 controls. Preterm children obtained the lowest scores on an overall basis in hand dexterity and balance tests in MABC-2, regardless of their birthweight. Lower gestational age was associated with poorer outcomes in hand dexterity and total scores in MABC-2. Balance results were similar using the stabilometric platform, regardless of prematurity. CONCLUSIONS: A little more than 10% preterm and term children could have coordination disorders or be at risk of developing them using the MABC-2. Despite the visual-motor coordination being similar, preterm children could face greater difficulties in hand dexterity while, in the absence of neurological comorbidity, preterm and term children balance could be comparable

[Evaluation of coordination and balance in preterm children]. / Valoración de la coordinación y el equilibrio en niños prematuros.

INTRODUCTION: Recent studies show that many preterm children without apparent neurological sequelae present some difficulties in different areas, such as coordination or balance during their school years. The Movement Assessment Battery for Children-2 (MABC-2) has demonstrated to be a useful tool to validate the coordination, while the stabilometric platform was the reference standard test for validating the balance. PATIENTS AND METHOD: Case-control study carried out on preterm children from 7 to 10 years old and healthy term infant controls of the same ages. The same age band of MABC-2 was applied and the static balance by the stabilometric platform was analysed. RESULTS: A total of 89 subjects were included, 30 preterm children≤1,500g birthweight, 29 preterm children>1,500g birthweight, and 30 controls. Preterm children obtained the lowest scores on an overall basis in hand dexterity and balance tests in MABC-2, regardless of their birthweight. Lower gestational age was associated with poorer outcomes in hand dexterity and total scores in MABC-2. Balance results were similar using the stabilometric platform, regardless of prematurity. CONCLUSIONS: A little more than 10% preterm and term children could have coordination disorders or be at risk of developing them using the MABC-2. Despite the visual-motor coordination being similar, preterm children could face greater difficulties in hand dexterity while, in the absence of neurological comorbidity, preterm and term children balance could be comparable.

Ultrasound evaluation of lumbar spine anatomy in newborn infants: implications for optimal performance of lumbar puncture.

An ultrasound evaluation of lumbar spine anatomic landmarks relevant for lumbar puncture was performed in 199 newborn infants. Effects of 6 patient positions and gestational age on interspinous process distance, subarachnoid space width, predicted needle entry angle, and needle insertion depth were assessed. Our results identify optimized conditions for lumbar puncture: sitting the infant with hips flexed, a needle entry angle of 65-70 degrees, and proper needle insertion depth (calculated as 2.5 × weight in kilograms + 6 in millimeters).