Abstract :
Keywords Brain injury; Cognition; Infant; Functional outcome; Motor development; School-age Highlights * IMP-scores in very high-risk infants are associated with outcome at school-age. * Initial IMP-scores and rates of change were associated with functional outcome. * In particular IMP variation and performance trajectories were associated with outcome. * The IMP is an adequate tool to monitor neurodevelopment in very high-risk infants. Abstract Background The Infant Motor Profile (IMP) is an appropriate tool to assess and monitor infant motor behaviour over time. Infants at very high risk (VHR) due to a lesion of the brain generally show impaired motor development. They may grow into or out of their neurodevelopmental deficit. Aims Evaluate associations between IMP-trajectories, summarised by IMP-scores in early infancy and rates of change, and functional and cognitive outcome at school-age in VHR-children. Study design Longitudinal study. Subjects 31 VHR-children, mainly due to a brain lesion, who had multiple IMP-assessments during infancy, were re-assessed at 7--10 years (school-age). Outcome measures Functional outcome was assessed with the Vineland-II, cognition with RAKIT 2. Associations between IMP-trajectories and outcome were tested by multivariable linear regression analyses. Results When corrected for sex, maternal education and follow-up age, initial scores of total IMP, variation and performance domains, as well as their rates of change were associated with better functional outcome (unstandardised coefficients [95% CI]): 36.44 [19.60--53.28], 33.46 [17.43--49.49], 16.52 [7.58--25.46], and 513.15 [262.51--763.79], 356.70 [148.24--565.15], and 269 [130.57--407.43], respectively. Positive rates of change in variation scores were associated with better cognition at school-age: 34.81 [16.58--53.03]. Conclusion Our study indicated that in VHR-children IMP-trajectories were associated with functional outcome at school-age, and to a minor extent also with cognition. Initial IMP-scores presumably reflect the effect of an early brain lesion on brain functioning, whereas IMP rate of change reflects whether infants are able to grow into or out of their initial neurodevelopmental deficit. Abbreviations CI, confidence interval; COPCA, COPing with and CAring for infants with special needs; CP, cerebral palsy; (c)PVL, (cystic) periventricular leukomalacia; GMFCS, Gross Motor Functioning Classification System; IMP, Infant Motor Profile; L2M, LEARN2MOVE; MND, minor neurological dysfunction; MRI, magnetic resonance imaging; NGST, Neuronal Group Selection Theory; RAKIT, Revisie Amsterdamse Kinder Intelligentie Test; TIP, typical infant physiotherapy; UMCG, University Medical Center Groningen; VABS, Vineland Adaptive Behaviour Scales Author Affiliation: (a) University of Groningen, Department of Paediatrics -- Division of Developmental Neurology, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands (b) Stichting Epilepsie Instellingen Nederland (SEIN), Dokter Denekampweg 20, 8025 BV Zwolle, the Netherlands (c) University of Groningen, University Medical Center Groningen, Department of Epidemiology, Hanzeplein 1, 9713 GZ Groningen, the Netherlands (d) Radboud University Medical Center, Department of Neurology, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands * Corresponding author at: University Medical Center Groningen, Developmental Neurology, Hanzeplein 1, 9713 GZ Groningen, the Netherlands. Article History: Received 20 April 2022; Accepted 31 May 2022 Byline: Elisabeth J.M. Straathof (a), Kirsten R. Heineman (a,b), Sacha La Bastide-van Gemert (c), Elisa G. Hamer (a,d), Mijna Hadders-Algra [m.hadders-algra@umcg.nl] (a,*)