The Effects of Training in Infants with Neonatal Stroke
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Purpose: Infant stroke occurs in approximately 1/2300 full-term births. These infants are at a higher risk for developmental delays, motor deficits, and cerebral palsy. This study focuses on an early intervention training program to improve reaching in these infants. Methods: Six infants with neonatal stroke and four typically developing infants were recruited for this study. Infants came into the lab at eight weeks of age and again after a 14 week training program. Reflective markers were placed on the hands that allowed for capture and analysis of biomechanical variables. A toy was placed at midline for three trials of 30 seconds to encourage reaching. After visit one, the Pre Training session, infants with neonatal stroke were randomly assigned to be in one of two groups: a Movement group or a Social group. The Movement group participated in the at-home training program while the Social group served as a control. Infants then came into the lab for every other week until visit seven (Post Training). Results: Behavioral variables including number of hand-toy contacts (frequency) and length of contact duration (seconds) were analyzed in addition to biomechanical variables including average hand-toy distance (mm) and average velocity (mm/s). The Movement group had a higher contact frequency Post Training (8.11±3.60) than the Social group (4.11±3.56) but less than Typically Developing infants (13.08±7.99). Movement infants had longer contact durations (1.387±0.46) than both the Social (0.670±0.69) and Typically Developing groups (0.799±0.33). Hand-toy distance did not vary among the three groups. The Typically Developing group had an average velocity (160.63±87.91) that was 2.29 fold faster than the Movement group (70.00±9.442) and 1.8-fold faster than the Social group (93.16±35.712). Conclusions: Behavioral and biomechanical variables can be utilized to distinguish motor differences between different populations of infants. In addition, an early intervention movement training program may aid in improving reaching skills, especially contact duration, of infants with neonatal stroke.