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Delayed Development of Head Control and Rolling in Infants With Tracheostomies

机译:延迟开发头部控制和婴儿用气管造术滚动

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Objective: Advances in neonatal care lead to an increased survival rate of critically ill babies. Infantile tracheostomies are not uncommon. However, only a few studies have addressed the effect of infant tracheostomy on early motor function. By comparing the scores of the Gross Motor Function Measure-88 (GMFM) on head control and rolling of infants with and without tracheostomies, the authors aimed to evaluate the effect of infanttracheostomy on early motor development. Methods: Medical records and the GMFM of subjects were retrospectively reviewed. Thirty-three infants with tracheostomies and 132 infants without tracheostomies were matched by gestational age, birth weight, and corrected age when the GMFM was performed using propensity score matching. GMFM scores in head control and rolling in different positions were compared by using generalized estimating equation (GEE). Results: Infants with tracheostomy showed lower values for head control in the supine position and in the pull to sit maneuver in multivariate GEE (p=0.008, 0.004, respectively). However, the results of head control in a prone position and head lift while the examiner held the thorax showed no difference between the groups. Rolling from prone to supine was delayed in the infants with tracheostomy (p= 0.002), while rolling from supine to prone was not delayed compared to the non-tracheostomized group. More than half (54%) of the tracheostomy group scored better in rolling from a prone to supine position than in head control in supine position, which was a higher ratio compared to the non-tracheostomy group (p=0.00). Conclusions: Tracheostomy seems to influence early motor development in infants. In particular, head control skills related to neck flexor muscle activation and rolling from prone to supine were delayed. Interventions may be required to facilitate these activities.
机译:目的:新生儿护理的进步导致危重婴儿的生存率增加。婴儿气管造称并不少见。然而,只有少数研究已经解决了婴幼儿气管造口术对早期运动功能的影响。通过比较大型电机功能测量-88(GMFM)的分数(GMFM)对头部控制和婴幼儿的婴儿,作者旨在评估婴儿疗法对早期电机发展的影响。方法:回顾性审查医疗记录和受试者的GMFM。在使用倾向得分匹配的GMFM进行GMFM时,患有Trouchostomies和132名没有气管造术的婴儿的婴儿均符合GMFM。通过使用广义估计方程(GEE)比较使用头部控制和轧制在不同位置的GMFM分数。结果:患有气管造口术的婴儿在仰卧位和拉动中显示出较低的头部控制值,以坐在多变量GEE中的操纵(P = 0.008,0004)。然而,在验尸检查中占胸部的俯卧位和头部升降机中的头部控制结果在组之间没有差异。从俯卧到仰卧滚动被延迟在患有气管造口术(P = 0.002)的婴儿中,同时与非气管造影组相比,从仰卧到俯径滚动而不会延迟。在俯卧位于仰卧管控制中滚动的滚动术术中,越来越多(54%)的气管造口术比在仰卧管术(P = 0.00)相比的仰卧位上的俯卧位得分较高。结论:气管造口似乎影响婴儿的早期电机开发。特别地,延迟了与颈部屈肌肌肉激活和滚动的头控制技能被延迟。可能需要干预措施来促进这些活动。

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