Padrão e ritmo de aquisição das habilidades motoras de lactentes nascidos pré-termo saudáveis

Abstract

This research aimed to point out and identify the pattern and the rhythm of motor development of a group of healthy Brazilian preterm infants during de first year of corrected age, as well as, to compare these aspects through a healthy Brazilian infant group borned fullterm and with normative data of the instruments used through the Test Infant Motor Performance TIMP and the Alberta Infant Motor Scale AIMS. In this way, two studies were elaborated: in the first study, twelve preterm infants participated, (MD=33,6 GA , ± 1,25) and ten fullterm infants (MD=39,1 GA , ± 0,73). This infants was assessed with the TIMP once a month (0 - 4), in their home environments. The motor performance increased in both groups, verifying the variability in the total scores in all the ages. The preterm group showed rhythm of motor acquisition higher from 0 to 1 than 3 to 4 months (p= 0,016). Based on the results, it was possible to conclude that the healthy preterm infants, with gestational age bigger than 32 weeks, showed a pattern of acquisition of the motor skills similar to the typical infants when related to the sequence, but with an own rhythm of acquisition, which is possible to consider like a variation at the spectrum of normality. At the second study, thirteen preterm infants participated, (MD=33,5 GA weeks, ± 1,33) and fifteen fullterm infants (MD=39,1 GA weeks, ± 0,65). This infants was assessed with the TIMP at 0 4 months and with the AIMS at 6, 9 and 12 months of age, in their home environments. The preterm group showed a superior intermediate score compared to the fullterm group from 6 (p=0,03) to 12 (p=0,006) months. It was evidenced, at the first four months, that there was a higher acquisition through the interval from 2 to 3 months related to the others intervals (1-2 and 2-3 p=0,05; 2-3 and 3-4 p=0,01). At the second semester, the interval from 6 to 9 months showed a bigger acquisition in both groups (preterm, p= 0, 001 and fullterm, p=0,03). Both of them showed inferior performance contrasted to the amounts established by the TIMP at the first month (preterm, p < 0,008 and fullterm, p < 0,001) and only the fullterm group at the second month (p = 0,005). Related to the second semester, the preterm group presented superior amounts compared to the amount of 50% at the AIMS during all the months, meanwhile, only at the 12 month this difference was significant (p= 0,003). The results showed peculiar characteristics related to the rhythm of motor skills acquisition during the first year of corrected age, and the motor development quality, showed at the third month, can be used like an indication to future deficit motors. It is suggested that the interventions should be initiated as soon as possible, in a way that makes possible to benefit from those observed moments a higher predisposition to the acquisition of motor skills (from 2 to 3 and form 6 to 9 months).