663 - Longitudinal Motor Assessments: The Movement Assessment Battery for Children and Neuromotor Score in Preterm Children

Publication Number: 2646.663

Jadine P. Knight Lawes, Bustamante Hospital for Children, Kingston 8, Saint Andrew, Jamaica; Jessie van Dyk, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada; Elke H. Roland, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada; Vann Chau, The Hospital for Sick Children, Toronto, ON, Canada; Jill G. Zwicker, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada; Ruth Grunau, Unversity of British Columbia, Vancouver, BC, Canada; Steven P,.. Miller, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada; Thiviya Selvanathan, University of British Columbia, Vancouver, BC, Canada

Background: Children born preterm are at increased risk of motor impairment. Early detection of subtle motor impairments is essential, as they may affect long-term function. The Movement Assessment Battery for Children, 2nd edition (MABC-2) and Neuromotor Score (NMS) assess different motor domains which may lead to discrepancies in identifying impairment. The NMS involves clinical evaluation of cranial nerves, power, tone and reflexes while MABC-2 assesses balance, manual dexterity and coordination. Understanding how these scores change over time and what clinical factors contribute to discordant results may improve assessment and interventions.

Objective: To examine longitudinal changes in NMS and MABC-2 scores among preterm infants and to identify clinical and socioeconomic factors associated with differences between these measures at 8 years of age.

Design/Methods: A prospective cohort study of very preterm infants was recruited at a tertiary NICU with follow-up to 8 years. Detailed data of clinical illness and brain injury were collected. Motor outcomes were assessed with NMS and MABC-2 at 4 and 8 years. Cognition was assessed using Weschler Primary and Preschool Scale of Intelligence full-scale IQ (FSIQ).

Results: Of 164 participants who returned for 8-year assessment, 143 (87%) completed both NMS and MABC-2 (79 males [55%]). 77 (54%) had normal NMS and MABC-2 scores, 63 (44%) had normal NMS but abnormal MABC-2 scores, and 3 (2%) were abnormal on both. These three children had cerebral palsy and after excluding them, those with normal NMS but abnormal MABC-2 scores had lower birth gestational ages (p=0.002) with lower birth weights (p < 0.001), and more chorioamnionitis (p=0.01), postnatal infection (p=0.04), and chronic lung disease (p=0.02; Table 1). There were no significant differences in FSIQ between children with and without motor concerns (p=0.06). One-third of children with abnormal MABC-2 scores at 8 years had normal scores at 4 years with no clinical factors predicting those who developed motor impairment consistent with developmental coordination disorder (DCD) at 8 years. Children with abnormal NMS scores had abnormal scores across all aspects of the examination.

Conclusion(s): One-third of children with motor impairment at 8 years had normal MABC-2 scores at 4 years, emphasizing the need for continued follow-up. The NMS alone may miss mild deficits, highlighting the importance of standardized motor testing. While NMS better predicts cerebral palsy, the MABC-2 is more sensitive to identify motor difficulties consistent with DCD, which remain highly prevalent in this population.

Table 1. Clinical characteristics of children in cohort study by motor outcome group at 8 years of age with the cohort, excluding the children with cerebral palsy.
Data presented as median (interquartile range) or no. (%).
*p value <0.05 using Fisher exact test or Kruskal-Wallis test