Authors (including presenting author) :
Chan OM(1), Tse TK(1), Yuen PM(1), Chan ML(1), Chan SL(1), Leung YYC(1)
Affiliation :
(1)Physiotherapy Department, Princess Margaret Hospital
Introduction :
Since 1994, the Physiotherapy Department of Princess Margaret Hospital (PMH) has been following up infants with very low birth weight (VLBW) in the High Risk Infant Program (HRIP), with the aims of monitoring developmental outcomes, detecting neurodevelopmental abnormality and providing early intervention.
Objectives :
(1) To review the gross motor (GM) outcomes of VLBW infants (2) To evaluate the effectiveness of Physiotherapy intervention on GM outcomes in VLBW infants
Methodology :
The gross motor outcomes of infants born in PMH in 2017 with birth weight <1500g and recruited into HRIP were analyzed. These infants were followed up by physiotherapists at 4, 8, 12, 18 and 24m (corrected age). Alberta Infant Movement Scale (AIMS) was used to assess GM outcome at 4m and 8m, while Peabody Developmental Motor Scale (PDMS) was used at 12, 18 and 24m.
Result & Outcome :
A total of 68 VLBW infants (gestation 29.1±2.9 weeks, birth weight 1100±335g) were reviewed. One child was reported death, one child was found to have chromosomal disorder and one child was noted to have torticollis by physiotherapist. Overall, 61.8% of children received center-based training in our Department (3.2±5.5 sessions) in addition to our scheduled assessment due to impaired motor performance and 8.8% had training in Early Educational Training Center. At 4m and 8m, 85.5% and 73.2% of infants showed “Normal” motor performance in AIMS respectively. At 12m and 18m, 91.8% and 85.4% of children showed “Average” or “Above average” motor performance in PDMS respectively. At 24m, 26.8% of children showed “Average” or “Above average” motor performance in PDMS. At 8m, among those infants who showed “Suspicious” or “Abnormal” motor performance, 93.3% received physiotherapy training (one child defaulted training). 75% could catch up with the motor performance at 12m and 81.8% had normal performance at 18m. The HRIP aids in early detection of neurodevelopmental abnormalities or orthopedic problems. Early intervention, including home-based and center-based training might be beneficial in improving the GM performance of VLBW infants. Despite center-based training and home exercises, >70% of children still showed delayed GM development at 24m, which could be related to gap in jumping skills. Early referral to preschool service or continuous hospital physiotherapy training after 24m is warranted.
