Affiliations: [a] College of Medicine, MUSC, Charleston, SC, USA | [b] Division of Occupational Therapy, College of Health Professions, Charleston, SC, USA | [c] Department of Pediatrics, MUSC, Charleston, SC, USA | [d] Department of Radiology and Radiological Sciences and the Center for Advanced Imaging Research, MUSC, Charleston, SC, USA
Correspondence:
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Corresponding author: Patty Coker-Bolt, Division of Occupational Therapy, Medical University of South Carolina, 151 Rutledge Ave., Charleston, SC 29403, USA. Tel.: +1 843 792 7491; E-mail:cokerpc@musc.edu
Abstract: PURPOSE: This study used kinematic analysis to identify a reliable and rapid
assessment method for abnormal patterns of motor development in preterm
infants. METHODS: In a retrospective analysis, we examined video of n= 35 preterm
infants at 3mo corrected age (CA) who had concurrent Test of Infant Motor
Performance (TIMP) scores. Hyperflexion at the hip produces common gait
anomalies seen in children with CP, therefore we analyzed hip angle in the
prone head lift position at 3 months CA. Magnetic Resonance Spectroscopy
(MRS) was performed at term equivalent (n= 23) and Bayley-III
neurodevelopmental tests were performed at 1 year (n= 28). We correlated hip
angles with TIMP and Bayley-III scores, and MRS neuronal metabolites. RESULTS: Hip angle positively correlated with TIMP at 3 months (r= 0.642,
p≤ 0.001), but not with Bayley-III at 1 year (r= 0.122, p= 0.529). Hip angle
correlated negatively with myo-inositol (mI) ratios in frontal white matter
tracts (mI/Cr r= -0.520, p= 0.011). CONCLUSIONS: These results suggest prone hip angle may be a quantitative
proxy for the 42-item TIMP at 3 months, and that hypertonicity in the hip
flexor musculature is a manifestation of white matter metabolic
abnormalities (elevated mI ratios) that may indicate occult white matter
injury.
