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Biomedical subjects

L Vaivre-Douret

Publications and source records attributed to L Vaivre-Douret.

8 recordsLinked to original sources

Effect of positioning on the incidence of abnormalities of muscle tone in low-risk, preterm infants.

UNLABELLED: BACKGROUND. The preterm infant is subject to the force of gravity: when its body lies pressed against the mattress on which it is placed. AIMS: The purpose of this study was to investigate short-term effects of varied post-natal lying positions in order to prevent neuromuscular and postural abnormalities. METHODS: 60 low risk preterm infants of 31-36 weeks gestational age were enrolled for this randomised clinical trial. Initially each child underwent neurological and psychomotor assessments which included tonus and reflex protocols as well as behavioral, sensory motor and postural examinations. The lying positions of the treated group were varied (back, prone, and side) using a specially designed moldable mattress that maintained the functional position of the infant's body. The control group was placed on their stomachs, (the standard lying position used in 1994) with a standard orthopaedic bolster support under their hips. All infants underwent a second round of examinations upon discharge to assess any changes in neurological and psychomotor outcomes. RESULTS: The sensory-motor skills examinations showed significant abnormalities in the control group: (1) dominance of the extensor muscles due to muscle shortening, (2) hyper abduction and flexion of the arms, and (3) global neuromuscular rigidity. Psychomotor and neurological exams of the control and treatment groups showed delayed developmental muscular acquisitions for infants in the control group. CONCLUSION: Regular changes in posture, while retaining correct functional positions, allowed maintenance of normal neuromuscular and osteo-articular function and permitted the development of spontaneous and functional motor activity in low-risk perterm infants.

Female↗

A more robust predictor of ideomotor dyspraxia: study on an alternative scoring method of the Bergès-Lézine's Imitation of Gestures test.

Use of the traditional Bergès-Lézine standardization [Test d'imitation de gestes (1963).] allowed us to confirm praxic disorders in children who are encountering obvious motor difficulties. However, in comparison to other neuropsychological assessments carried out on these children, it does not enable us to precociously pinpoint disorders in praxic organization. By means of a newly evaluated method (1997) developed on the basis of the Bergès-Lézine Imitation of Gestures test (1963), we retroactively assessed a group of children (N=10) who had been observed in a longitudinal study at the age of 3-5 years and at 7-8 years and assessed with the Bergès-Lézine version (1963) of the Imitation of Gestures test. Our revised test (1997) takes into account the quantitative factor of success, as well as the qualitative factor of movement planning. It facilitates the early detection of motor organization disorders, in correlation with other neuropsychological assessments carried out on these children. Comparative clinical findings with the same group of children tested using the Bergès-Lézine version and ours indicate that our version detects, more robustly, children encountering difficulties resulting from ideomotor dyspraxia, not identified by the Bergès-Lézine test (1963). Our alternative scoring method of Bergès-Lézine's test contributes largely to early detection of instrumental difficulties in children. Additionally, its predictive capacity makes it possible to apprehend disorders in distal and digital neuromotor functions.

Journal Article↗

Development of a global motor rating scale for young children (0-4 years) including eye-hand grip coordination.

A comparative study of the eight motor rating scales available in Western countries demonstrated methodological differences in the choice of items and standardization. We have developed a global motor rating scale that includes items which measure postural-motor, locomotor (PML) and eye-hand grip coordination (EHGC), and which allows the assessment of an average of motor function level (MFL), PML and EHGC development. Scores obtained were used to define the acquisition of motor age based on the skills completed. The items were selected on the basis of the average age at which the function developed in two populations of healthy full-term French infants, followed from birth to 4 months (n = 60) and from 4 months to 4 years (n = 63). Recent French developmental standards (mean age and standard deviation) of acquisition allow the identification of neuro-psychomotor deviations from normal motor behaviour. This includes both static and dynamic motor coordination sequences. Inter-examiner correlations (n = 3) for 15 randomly selected children indicated a coefficient of 0.90. The scale revealed a sequence in the organization of learned postural-motor, locomotor and eye-hand gripping skills which can contribute to the understanding of brain areas implicated in this maturation process.

Child Development↗

[Mothers' behavior regarding infant sleep position: effects of the last public campaign to prevent sudden infant death syndrome].

BACKGROUND: To define infant care practices in maternity units and those subsequently adopted at home. Using these data, we evaluated the acceptance and application of recommendations issued by the previous public education campaign on infant sleeping position as related to sudden infant death syndrome. PATIENTS AND METHODS: A survey was carried out in two maternity units (Port-Royal and Créteil) and in one pediatric consultation unit (affiliated with Port-Royal maternity). RESULTS: The mixed position (side or back) is used equally with, respectively, 47% at Port-Royal and 45% at Créteil. The supine sleeping position (French public health recommendations) is used by 12% of the mothers at Port-Royal and by 40% at Créteil. It appears that hospital nurseries play an important role in determining the mother's preference for the sleeping position (64% at Port-Royal and 54% at Créteil), but it does not adequately explain all mothers' responses. However, as the infants mature (> two months old), the more spontaneously they changed their sleeping position. All the infants placed in a side sleeping position moved to a supine sleeping position during the night. Upon awakening, infants were found mostly in the supine position (in contrast to the national public education campaign). CONCLUSION: Our results show that mothers and hospital nurseries were distressed in terms of ensuring the supine sleeping position of the infant. New choices of sleeping positions were initiated by mothers. For example, they used the side position after feedings essentially in the case of reflux or during the daytime. The supine position was used when the mothers were assured that any problems had been avoided or only during the night.

Adult↗

Neuromotor development and language processing in developmental dyspraxia: a follow-up case study.

A longitudinal study of a child (MV) with developmental verbal dyspraxia was conducted to determine to what extent language development and motor performance in this clinical diagnosis followed a similar course of maturation. Patient MV was observed for two years from the age of 5 years and 6 months. Initially, this young patient exhibited unintelligible and atypical speech production (multiword utterances without consonants), delay in balance and coordination, and impairments in rhythmic tasks; but she was otherwise developing normally with no intellectual impairment or behavioral disorder. MRI scans showed moderately enlarged ventricles, a thin, incompletely myelinated corpus callosum and intact basal ganglia. Two years later, MV's performance was nearly normal only in comprehension aspects of language. In contrast, production aspects of language and speech and neuromotor development showed very little improvement after two years. These observations first suggest that development of receptive and expressive domains within language may be asynchronous, and that the progression of motor control of language appears to follow a parallel course to neuromotor development.

Apraxias↗

[Kangaroo method and care].

The kangaroo-mother method was initiated by colombian pediatricians in 1979. The method is based on a permanent skin to skin contact of low birth weight infants with their mother. It has spread out in many developing countries as an alternative cheap method for the care of low birth weight infants with several advantages: temperature regulation, prolonged breast-feeding, promotion of mother-infant interaction, decreased mortality. The kangaroo method has been adapted in European countries as kangaroo care that consists in daily mother-infant skin to skin contact during few hours. Introducing the incubator in the mother's room is an other derivative of the method which allows prolonged early contact of the mother with her infant. A major interest of these methods is that they favour parent-infant interaction; however this requires qualified and devoted staffs.

Body Temperature Regulation↗

Language and motor development in pre-term children: some questions.

A cohort of 37 pre-term children was assessed for both morphosyntactical and for vocabulary skills at the age of 2 and again at the age of 3 years and 6 months. They were compared with two comparison groups of full-term children (adjusted age and chronological age). The results indicated (1) a clear asynchrony between the two components of language production assessed at both ages, (2) an accurate prediction of language delay at age 2 for pre-term children (35% of pre-term children were detected for morphosyntax as measured by Mean Length of Utterance and 27% of pre-term children were detected for vocabulary as measured by the number of different words) and, (3) no evidence on the relationship of language and motor development as measured by formal tests. Such findings strongly challenge the validity of standardized developmental tests and support to a certain extent the hypothesis that language development is independent of motor skills. A neurodevelopmental assessment is suggested.

Child, Preschool↗

Relation of early neuromotor and cranial signs with neuropsychological outcome at 4 years.

The persistence and predictive value at 3-5 years of age of three signs detected within the first 18 months of life were investigated: phasic stretch reflex in one or both gastrocnemius muscles, imbalance in passive axial tone with an excess of dorsal extension, and a ridge on the squamous sutures. Phasic stretch reflex and at least one of the other signs were found in 14 children during repeated assessments within the first 18 months. The progress of these children was compared with that of 14 matched controls who had repeatedly normal neurological assessments during the first 18 months in the same clinic in Paris. At the age 3-5 years all the children were then assessed blindly by the second author from a pediatric neurological viewpoint and by two psychologists and two psychomotor therapists as well. The parents of the affected children reported significantly more problems in motor/praxis skills, language development and attention. Abnormal neurological signs were also significantly more frequent than in the controls. Suboptimal cognition did not reach significance. The neurological inclusion criteria were still present at 3-5 years old in 86% (vs. respectively 100% and 93% during the first 18 months of life) of this small group of children, while the cranial suture sign was still present in only 28% (vs. 64%). Findings of these three signs during the first 18 months of life may help in predicting long-term neurobehavioral or long-term neuropsychological problems.

Age Factors↗