The use of accelerometer bracelets to evaluate arm motor function over a stroke rehabilitation period - an explorative observational study.

BACKGROUND: Assessments of arm motor function are usually based on clinical examinations or self-reported rating scales. Wrist-worn accelerometers can be a good complement to measure movement patterns after stroke. Currently there is limited knowledge of how accelerometry correlate to clinically used scales. The purpose of this study was therefore to evaluate the relationship between intermittent measurements of wrist-worn accelerometers and the patient's progression of arm motor function assessed by routine clinical outcome measures during a rehabilitation period. METHODS: Patients enrolled in in-hospital rehabilitation following a stroke were invited. Included patients were asked to wear wrist accelerometers for 24 h at the start (T1) and end (T2) of their rehabilitation period. On both occasions arm motor function was assessed by the modified Motor Assessment Scale (M_MAS) and the Motor Activity Log (MAL). The recorded accelerometry was compared to M_MAS and MAL. RESULTS: 20 patients were included, of which 18 completed all measurements and were therefore included in the final analysis. The resulting Spearman's rank correlation coefficient showed a strong positive correlation between measured wrist acceleration in the affected arm and M-MAS and MAL values at T1, 0.94 (p < 0.05) for M_MAS and 0.74 (p < 0.05) for the MAL values, and a slightly weaker positive correlation at T2, 0.57 (p < 0.05) for M_MAS and 0.46 - 0.45 (p = 0.06) for the MAL values. However, no correlation was seen for the difference between the two sessions. CONCLUSIONS: The results confirm that the wrist acceleration can differentiate between the affected and non-affected arm, and that there is a positive correlation between accelerometry and clinical measures. Many of the patients did not change their M-MAS or MAL scores during the rehabilitation period, which may explain why no correlation was seen for the difference between measurements during the rehabilitation period. Further studies should include continuous accelerometry throughout the rehabilitation period to reduce the impact of day-to-day variability.

Study on the Impact of Implementing an Exercise Program Using Fitlight Technology for the Development of Upper Limb Coordinative Abilities in Basketball Players.

The aim of this study was to evaluate the impact of implementing a basketball-specific exercise program using Fitlight technology on the coordinative abilities (reactive coordination, reactive reaction time, and reactive movement combination capacity) of U14 and U16 junior basketball players. This study included 70 male basketball players, 36 subjects U14 and 34 subjects U16, divided into two equal groups for each age category: the experimental group (EG) and the control group (CG). This study included an initial and a final test, between which, training was conducted over a period of 18 weeks. For the EG, the program aimed to develop coordinative abilities through an experimental program that utilized Fitlight technology, while the control groups underwent an identically timed program, but their training did not include the use of technology. Four tests were adapted and applied: the Reactive Reaction Test, Choice Reactive Reaction Test, Reactive Hand-Eye Coordination Test, and a test to evaluate the reactive capacity for combining movements. The results of this study showed statistically significant progress between the initial and final tests for the experimental group, p < 0.05. The Cohen's d values for the experimental groups were above 0.8, indicating a very large effect size, while for the control group, these values were small to medium. The comparative analysis of the experimental groups U14 and U16 and control groups shows statistically significant differences in favor of the experimental groups U14 and U16. This study highlights the effectiveness of implementing specific training programs that use modern technologies in developing coordinative abilities in the training and evaluation process of junior basketball players.

The Pull-to-Sit Task: Examining Infant Postural Development in Autism Spectrum Disorder.

OBJECTIVE: To evaluate the predictive relationship between early trajectories of postural and head control during a pull-to-sit task and later autism diagnostic and developmental outcomes. STUDY DESIGN: Using a prospective longitudinal design, postural skills of 100 infants at elevated and low familial likelihood of autism spectrum disorder (ASD) were evaluated using a pull-to-sit task monthly from age 1 month to 6 months. At age 24 months, infants were seen for a developmental and diagnostic evaluation completed by examiners masked to participant group. Latent growth curve models were used to compare early trajectories of pull-to-sit performance in infants later diagnosed with ASD and typically developing infants and to predict developmental outcomes. RESULTS: Pull-to-sit trajectories did not differ in infants with an elevated likelihood of ASD or infants with ASD compared with low-likelihood and typically developing infants, but infants with ASD were more likely to exhibit a head lag by age 4 months. In addition, pull-to-sit trajectories were predictive of social and speech skills 2 years later. CONCLUSIONS: These findings highlight the link between very early pull-to-sit skills and later social and language outcomes. Atypical postural development and persistent presence of head lag may be important early indicators of social and language vulnerabilities, including ASD.

A novel tablet-based motor coordination test performs on par with the Beery VMI subtest and offers superior temporal metrics: findings from children with pediatric acute-onset neuropsychiatric syndrome.

Neuropsychiatric and neurodevelopmental disorders are often associated with coordination problems. Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) constitutes a specific example of acute and complex symptomatology that includes difficulties with motor control. The present proof-of-concept study aimed at testing a new, bespoke tablet-based motor coordination test named SpaceSwipe, providing fine-grained measures that could be used to follow-up on symptoms evolution in PANS. This test enables computationally precise and objective metrics of motor coordination, taking into account both directional and spatial features continuously. We used SpaceSwipe to assess motor coordination in a group of children with PANS (n = 12, assessed on in total of 40 occasions) and compared it against the motor coordination subtest from the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) 6th edition, traditionally used to follow-up symptomatology. Using a bivariate linear regression, we found that 33 s of the directional offset from tracking a moving target in SpaceSwipe could predict the Beery VMI motor coordination (VMI MC) raw scores (mean absolute error: 1.75 points). Positive correlations between the predicted scores and the VMI MC scores were found for initial testing (radj = 0.87) and for repeated testing (radj = 0.79). With its short administration time and its close prediction to Beery VMI scores, this proof-of-concept study demonstrates the potential for SpaceSwipe as a patient-friendly tool for precise, objective assessment of motor coordination in children with neurodevelopmental or neuropsychiatric disorders.

The relation between clinically diagnosed and parent-reported feeding difficulties in children with and without clefts.

A cleft lip and/or palate (CL/P) is one of the most common craniofacial malformations, occurring worldwide in about one in 600-1000 newborn infants. CL/P is known to influence the feeding process negatively, causing feeding difficulties in 25-73% of all children with CL/P. Because there is a risk for serious complications in these children regarding feeding difficulties, there is often a need for intensive medical counseling and treatment. At this moment, adequate diagnosis and measurement remain a challenge and often lead to a delayed referral for professional help. Since parents play a big part in reporting feeding difficulties, it is important to help objectify parents' experiences, as well as the use of a frontline screening instrument for routine check-ups during medical appointments. The aim of this study is to investigate the relationship between parent perspective and standardized observation by medical professionals on feeding difficulties in 60 children with and without clefts at the age of 17 months. We focus on the information from parents and health professionals by comparing the Observation List Spoon Feeding and the Schedule for Oral Motor Assessment with the validated Dutch translation of the Montreal Children's Hospital Feeding Scale.  Conclusion: There is a need for timely and adequate diagnosis and referral when it comes to feeding difficulties in children with CL/P. This study underscores the importance of combining both parental observations and measurements of oral motor skills by healthcare professionals to enable this. What is Known: • Early identification of feeding difficulties can prevent adversely affected growth and development. • Clefts increase the probability of feeding difficulties; however, the diagnostic trajectory is unclear. • The Observation List Spoon Feeding (OSF) and Schedule for Oral Motor Assessment (SOMA) are validated to measure oral motor skills. The Montreal Children's Hospital Feeding Scale Dutch version (MCH-FSD) has been validated for the parental perception of infant feeding difficulties. What is New: • Parents of children with CL/P experience relatively few feeding problems in their child on average. • Oral motor skills for spoon feeding are associated with oral motor skills for solid foods in children with CL/P. • The extent of the cleft is associated with experiencing more feeding difficulties in children with CL/P.

Predictive value of Bayley-III Motor Index for later motor difficulties in children born extremely preterm.

AIM: To investigate the predictive ability of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) Motor Index, in children born extremely preterm (<27 gestational weeks) without cerebral palsy. METHODS: Children from the EXPRESS study (all extremely preterm births in Sweden, 2004-2007) without neurosensory impairments assessed with Bayley-III at 2.5 years corrected age and Movement Assessment Battery for Children, Second Edition (MABC-2), at 6.5 years comprised the eligible study population (n = 282). Motor difficulty was defined as MABC-2 ≤5th percentile. RESULTS: Motor difficulties were found in 57 of 282 children (20.2%) at 6.5 years. The Bayley-III explained 18.0% of the variance in the MABC-2 (p < 0.001). The area under the receiver operating curve was 0.71 (95% confidence interval 0.64-0.79, p < 0.001). At a Bayley-III cut-off value of 85, sensitivity, specificity and positive and negative predictive values for motor difficulties were 26.3% (15.5-39.7), 92.9% (88.1-95.9), 48.4% (33.0-64.0) and 83.3% (80.9-85.4). Likelihood ratios were inconclusive. CONCLUSION: The Bayley-III at 2.5 years corrected age was a modest predictor of motor outcome in children born extremely preterm at 6.5 years, and underestimated the rate of motor difficulties. Children require follow-up beyond preschool age.

Cultural Adaptation of the MABC-2 Checklist as a Screening Tool for Developmental Coordination Disorder in Schools.

The purpose of this study was to adapt the MABC-2 Checklist to Czech primary schools by examining of its content validity and feasibility. The content validity achieved the satisfactory level in the second round of panels of experts on child motor development. The evidence on feasibility was obtained from classroom teachers who described this tool as clear, objective and having logical structure and its administration as comprehensible and fast. The MABC-2 Checklist is applicable instrument for the Czech school environment, but its adaptation to various countries should consider the items representing the common motor skills in local children.

Infant Reaching in the First Year of Life: A Scoping Review of Typical Development and Examples of Atypical Development.

AIMS: Our objective was to identify the most common variables used for infant reaching assessment, describe values of these variables across the first year of life, and identify methodological considerations and knowledge gaps for future research. METHODS: Studies were included if they met the following criteria: (1) assessed infant reaching in any position, (2) included a sample of infants with typical development: healthy, full-term, with no known impairments, (3) infants were under one year old at the first data collection, and (4) counted successful reaches resulting in object contact. RESULTS: We identified 6 commonly assessed kinematic reaching variables: frequency, duration, movement units, peak velocity, average velocity, and straightness index. Methodological inconsistencies limit our ability to interpret values of these variables across studies. CONCLUSIONS: Eliminating inconsistencies in study design and data analysis methods is the next step to defining a normative reference standard for reaching development. Establishing a normative reference standard for reaching in the first year of life will be important for assessment of typical and atypical reaching development.

Muscle torques and joint accelerations provide more sensitive measures of poststroke movement deficits than joint angles.

The whole repertoire of complex human motion is enabled by forces applied by our muscles and controlled by the nervous system. The impact of stroke on the complex multijoint motor control is difficult to quantify in a meaningful way that informs about the underlying deficit in the active motor control and intersegmental coordination. We tested whether poststroke deficit can be quantified with high sensitivity using motion capture and inverse modeling of a broad range of reaching movements. Our hypothesis is that muscle moments estimated based on active joint torques provide a more sensitive measure of poststroke motor deficits than joint angles. The motion of 22 participants was captured while performing reaching movements in a center-out task, presented in virtual reality. We used inverse dynamic analysis to derive active joint torques that were the result of muscle contractions, termed muscle torques, that caused the recorded multijoint motion. We then applied a novel analysis to separate the component of muscle torque related to gravity compensation from that related to intersegmental dynamics. Our results show that muscle torques characterize individual reaching movements with higher information content than joint angles do. Moreover, muscle torques enable distinguishing the individual motor deficits caused by aging or stroke from the typical differences in reaching between healthy individuals. Similar results were obtained using metrics derived from joint accelerations. This novel quantitative assessment method may be used in conjunction with home-based gaming motion capture technology for remote monitoring of motor deficits and inform the development of evidence-based robotic therapy interventions.NEW & NOTEWORTHY Functional deficits seen in task performance have biomechanical underpinnings, seen only through the analysis of forces. Our study has shown that estimating muscle moments can quantify with high-sensitivity poststroke deficits in intersegmental coordination. An assessment developed based on this method could help quantify less observable deficits in mildly affected stroke patients. It may also bridge the gap between evidence from studies of constrained or robotically manipulated movements and research with functional and unconstrained movements.

Model invariance of the Motor Competence Assessment (MCA) from early childhood to young adulthood.

The Motor Competence Assessment (MCA) is an innovative instrument to assess motor competence along the lifespan. The MCA model and normative values were recently established from the age of 3-to-23 years old. The purpose of this study was to validate MCA from early childhood to young adulthood.One thousand participants representing four age groups (3-6, 7-10, 11-16, 17-22 years) with 250 participants each, were assessed. Invariance of the MCA model along the age groups - configural, metric and structural - was tested using multigroup CFA.The MCA model showed to fit well all age groups. The multigroup unconstrained model showed a very good fit (NFI=0.99; TLI=0.99; CFI=0.99; RMSEA=0.03). A formal test for the invariance of loading coefficients returned a non-satisfactory goodness-of-fit adjustment and a significant difference with the unconstrained model (Δχ2 = 539.57; Δdf = 18; p= .00) . The structural invariance testing did not show formal invariance between factor correlations (Δχ2 = 73.04; Δdf = 9; p= .00) but the fit of the model was acceptable (above 0.96 and a RMSEA of 0.05), indicating that correlation values inter factors are stable.This study adds information for the validation of the MCA as a useful instrument for assessing motor competence throughout the life cycle.

Comparison of motor competence in children aged 6-9 years across northern, central, and southern European regions.

The present study aimed to examine differences in motor competence (MC) in children aged 6-9 years old in northern, central, and southern European regions using the Körperkoordinationstest für Kinder (KTK). The secondary aim of the study was to examine interactions between region and children's age, sex, and weight status (determined as healthy weight or overweight/obese). Data were pooled from independent studies conducted in Finland (mean age 7.81 ± 1.19 years, n = 690), Belgium (mean age 8.25 ± 1.09 years, n = 1896), and Portugal (mean age 8.31 ± 1.02 years, n = 758) between 2008 and 2016. Cross-cultural differences in MC and interaction effects were tested using ANOVAs and ANCOVAs. Age, sex, and BMI percentile were used as covariates. Geographical region significantly explained 19% of the variance in MC, while BMI (5%), sex (3%), and age (0.3%) were significant covariates. The interaction effect of region and age (5%), region and sex (0.6%), and region and BMI (0.2%) on MC was also significant. Cross-cultural differences in children's MC increased substantially across age, independent of weight status. Girls slightly underperformed in MC compared to boys in regions where the overall level of MC was lower. Interestingly, the association between body weight status and MC was relatively consistent across the regions. Future cross-cultural studies should further explore the influence of individual (eg, physical activity) and environmental (eg, physical activity and sport policy) factors on MC development.

Wearable Inertial Sensors for Range of Motion Assessment.

This paper presents the design and development of wearable inertial sensors (WIS) for real-time simultaneous triplanar motion capture of the upper extremity (UE). The sensors simultaneously capture in the frontal, sagittal, and horizontal planes UE range of motion (ROM), which is critical to assess an individual's movement limitations and determine appropriate rehabilitative treatments. Off-the-shelf sensors and microcontrollers are used to develop the WIS system, which wirelessly streams real-time joint orientation for UE ROM measurement. Key developments include: 1) two novel approaches, using earth's gravity (EG approach) and magnetic field (EGM approach) as references, to correct misalignments in the orientation between the sensor and its housing to minimize measurement errors; 2) implementation of the joint coordinate system (JCS)-based method for triplanar ROM measurements for clinical use; and 3) an in-situ guided mounting technique for accurate sensor placement and alignment on human body. The results 1) compare computational time between two orientation misalignment correction approaches (EG approach = 325.05 µs and EGM approach = 92.05µs); 2) demonstrate the accuracy and repeatability of measurements from the WIS system (percent deviation of measured angle from applied angle is less than ±6.5% and percent coefficient of variation is less than 11%, indicating acceptable accuracy and repeatability, respectively); and 3) demonstrate the feasibility of using the WIS system within the JCS framework for providing anatomically-correct simultaneous triplanar ROM measurements of shoulder, elbow, and forearm movements during several upper limb exercises.

Specific Motor and Cognitive Performances Predict Falls during Ward-Based Geriatric Rehabilitation in Patients with Dementia.

The aim of this study was to identify in-hospital fall risk factors specific for multimorbid hospitalized geriatric patients with dementia (PwD) during hospitalization. Geriatric inpatients during ward-based rehabilitation (n = 102; 79.4% females; 82.82 (6.19) years of age; 20.26 (5.53) days of stay) were included in a comprehensive fall risk assessment combining established clinical measures, comprehensive cognitive testing including detailed cognitive sub-performances, and various instrumented motor capacity measures as well as prospective fall registration. A combination of unpaired t-tests, Mann-Whitney-U tests, and Chi-square tests between patients with ("in-hospital fallers") and without an in-hospital fall ("in-hospital non-fallers"), univariate and multivariate regression analysis were used to explore the best set of independent correlates and to evaluate their predictive power. In-hospital fallers (n = 19; 18.63%) showed significantly lower verbal fluency and higher postural sway (p < 0.01 to 0.05). While established clinical measures failed in discriminative as well as predictive validity, specific cognitive sub-performances (verbal fluency, constructional praxis, p = 0.01 to 0.05) as well as specific instrumented balance parameters (sway area, sway path, and medio-lateral displacement, p < 0.01 to 0.03) significantly discriminated between fallers and non-fallers. Medio-lateral displacement and visuospatial ability were identified in multivariate regression as predictors of in-hospital falls and an index combining both variables yielded an accuracy of 85.1% for fall prediction. Results suggest that specific cognitive sub-performances and instrumented balance parameters show good discriminative validity and were specifically sensitive to predict falls during hospitalization in a multimorbid patient group with dementia and an overall high risk of falling. A sensitive clinical fall risk assessment strategy developed for this specific target group should include an index of selected balance parameters and specific variables of cognitive sub-performances.

A Wearable System to Objectify Assessment of Motor Tasks for Supporting Parkinson's Disease Diagnosis.

Objective assessment of the motor evaluation test for Parkinson's disease (PD) diagnosis is an open issue both for clinical and technical experts since it could improve current clinical practice with benefits both for patients and healthcare systems. In this work, a wearable system composed of four inertial devices (two SensHand and two SensFoot), and related processing algorithms for extracting parameters from limbs motion was tested on 40 healthy subjects and 40 PD patients. Seventy-eight and 96 kinematic parameters were measured from lower and upper limbs, respectively. Statistical and correlation analysis allowed to define four datasets that were used to train and test five supervised learning classifiers. Excellent discrimination between the two groups was obtained with all the classifiers (average accuracy ranging from 0.936 to 0.960) and all the datasets (average accuracy ranging from 0.953 to 0.966), over three conditions that included parameters derived from lower, upper or all limbs. The best performances (accuracy = 1.00) were obtained when classifying all the limbs with linear support vector machine (SVM) or gaussian SVM. Even if further studies should be done, the current results are strongly promising to improve this system as a support tool for clinicians in objectifying PD diagnosis and monitoring.

An fMRI Compatible Smart Device for Measuring Palmar Grasping Actions in Newborns.

Grasping is one of the first dominant motor behaviors that enable interaction of a newborn infant with its surroundings. Although atypical grasping patterns are considered predictive of neuromotor disorders and injuries, their clinical assessment suffers from examiner subjectivity, and the neuropathophysiology is poorly understood. Therefore, the combination of technology with functional magnetic resonance imaging (fMRI) may help to precisely map the brain activity associated with grasping and thus provide important insights into how functional outcomes can be improved following cerebral injury. This work introduces an MR-compatible device (i.e., smart graspable device (SGD)) for detecting grasping actions in newborn infants. Electromagnetic interference immunity (EMI) is achieved using a fiber Bragg grating sensor. Its biocompatibility and absence of electrical signals propagating through the fiber make the safety profile of the SGD particularly favorable for use with fragile infants. Firstly, the SGD design, fabrication, and metrological characterization are described, followed by preliminary assessments on a preterm newborn infant and an adult during an fMRI experiment. The results demonstrate that the combination of the SGD and fMRI can safely and precisely identify the brain activity associated with grasping behavior, which may enable early diagnosis of motor impairment and help guide tailored rehabilitation programs.

Intra- and Inter-Rater Reliability of the Infant Motor Profile in Infants in Primary Health Care.

AIM: To explore intra-rater and inter-rater reliability of the Infant Motor Profile (IMP). The IMP is a video-based method assessing movement quality (movement variation, adaptability, symmetry and fluency) and motor skills in infants aged 3 to 18 months. METHOD: The IMP assessment was performed on 50 infants aged 3 to 12 months recruited in connection with health control in primary health care, mean gestational age at birth 39.4 weeks, mean birthweight 3462 g. Seven infants had a moderately increased risk of developmental disorders. Three pediatric physiotherapists performed independent rating of the video recordings. One rater assessed the video recordings twice with a four-week interval. RESULTS: Intraclass correlation coefficient (ICC) for intra-rater reliability was found satisfactory for the total IMP score (ICC = 0.95), and the domains: performance (ICC = 0.98), variation (ICC = 0.74), adaptability (ICC = 0.93) and fluency (ICC = 0.86). The ICC value for symmetry was 0.65. For inter-rater reliability, ICC values were satisfactory for the total IMP score (ICC = 0.86-0.91), and the domains: performance (ICC = 0.98), variation (ICC = 0.71-0.82), adaptability (ICC = 0.99) and fluency (ICC = 0.82-0.81). The ICC values for symmetry varied between 0.13-0.35. CONCLUSION: In this sample, including mostly low-risk infants, satisfactory intra- and inter-rater reliability for all domains were demonstrated, except for symmetry.

The Neurological Exam of a Comatose Patient: An Essential Practical Guide.

A thorough examination of a comatose patient is essential given the spectrum of clinical diagnoses. The most immediate threat to patients is airway, breathing and circulation. All attending physician should employ a structured and focused approach in dealing with a comatose patient. It is important to recognise the urgent steps needed at the time to prevent further deterioration, followed by the final diagnosis of patient's neurologic status. Here we provide the essential practical guide to the neurological exam of a comatose patient that would assist to determine the aetiology, location and nature of the neurological lesion.

Accuracy of MDS-UPDRS section IV for detecting motor fluctuations in Parkinson's disease.

BACKGROUND: In a precedent paper, we validated part IV of the Unified Parkinson's Disease Rating Scale (UPDRS) for detecting motor fluctuations in Parkinson's Disease (PD) patients using a 12-h Waking-Day Motor Assessment (WDMA) as gold standard, showing a high sensitivity (> 80%) and a lower specificity (< 45%). The aim of this study was to validate the Movement Disorder Society-UPDRS (MDS-UPDRS) part IV, especially items 4.3 and 4.5, using the same methodology. METHODS: PD patients attending the Movement Disorders Clinic at the University Hospital in Catania were consecutively enrolled in the study. A diurnal WDMA was performed to detect motor fluctuations. At each time interval, the motor impairment was evaluated using the motor section of the MDS-UPDRS. Presence or absence of motor fluctuations and the type of motor fluctuation were assessed by four blinded expert raters in movement disorders, by evaluating the graphical representations of the WDMA. We evaluated sensitivity and specificity together with 95% Confidence Interval (CI) of items 4.3 and 4.5, using WDMA as gold standard. RESULTS: We estimated for item 4.3 of the MDS-UPDRS a sensitivity of 74.3% (95% CI 56.7-87.5) and a specificity of 70.6% (95% CI 44-89.7), while for item 4.5, a sensitivity of 67.9% (95% CI 47.6-84.1) and a specificity of 66.7% (95% CI 44.7-84.4). CONCLUSIONS: The present showed a higher specificity level for MDS-UPDRS with respect to the UPDRS, while a slightly lower sensitivity mainly for predictable OFF.

Association of uncoordinated sucking pattern with developmental outcome in premature infants: a retrospective analysis.

BACKGROUND: Stress signals during sucking activity such as nasal flaring, head turning, and extraneous movements of the body have been attributed to incoordination of sucking, swallowing, and respiration (SSR) in premature infants. However, the association of uncoordinated sucking pattern with developmental outcomes has not yet been investigated. The aim of this study was to investigate whether uncoordinated sucking pattern during bottle-feeding in premature infants is associated with the developmental outcomes at 8-12 and 18-24 months of age (corrected for prematurity). METHODS: We retrospectively reviewed the medical records and video recordings for the Neonatal Oral-Motor Assessment Scale (NOMAS) of premature infants and divided them into two groups based on the presence or absence of incoordination. The Bayley-III cognition composite scores of the incoordination-positive and incoordination-negative group were compared at 8-12 and 18-24 months of age. RESULTS: Seventy premature infants exhibited a disorganized sucking pattern according to the NOMAS. The average Bayley-III cognition composite scores at 8-12 months of age were 92.5 ± 15.6 and 103.0 ± 11.3 for the incoordination-positive (n = 22) and incoordination-negative groups (n = 48), respectively (p = 0.002). The average Bayley-III cognition composite scores at 18-24 months were 90.0 ± 17.9 and 100.7 ± 11.5 for the incoordination-positive (n = 21) and incoordination-negative groups (n = 46), respectively (p = 0.005). A multiple linear regression analysis indicated that the presence of uncoordinated sucking pattern, grade 3 or 4 germinal matrix hemorrhage-intraventricular hemorrhage, and moderate to severe bronchopulmonary dysplasia were independently associated with cognitive development at 18-24 months of age. CONCLUSIONS: Uncoordinated sucking pattern in premature infants was independently associated with a higher risk of abnormal developmental outcome in the cognitive domain of the Bayley-III at both 8-12 and 18-24 months. There may be a need for periodic follow-up and early intervention for developmental delay when incoordination of SSR that results in stress signals on the NOMAS is observed before 40 weeks postmenstrual age.

Motor tests for primary school aged children: A systematic review.

Motor testing in education has gained in relevance in light of recent developments in educational systems (Köller & Baumert, 2012). The purpose of this systematic review was to identify studies using motor tests in primary school children aged 4 to 12 years and to synthetize information about the quality and application of the test instruments used. A systematic review of 910 records identified by a search of nine databases yielded 144 papers reporting motor testing in primary school age children, including 25 articles reporting on the quality of 20 test instruments. In the selected articles, tests grounded on the constructs of "motor abilities" and/or "motor skills" are the most frequent and are mostly used for monitoring purposes or for impact research. Tests based on the construct "motor competencies" have become popular only recently, being relevant for educational motor testing due to their curricular validity. The test instruments have been investigated towards their validity and reliability to different extents. However, for several test instruments factorial validity has not been established and more validation studies are needed to improve their psychometric quality especially if used in educational contexts.