A Comparison of the Leg Coordination Patterns of Preterm and Fullterm Infants: A Meta-Analysis

早產兒與足月產嬰兒踢腳動作之整合研究

陳祐蘋(Yu-Ping Chen) ； Linda Fetters

《物理治療》 27卷6期 (2002/12) Pp. 303-313

摘要

背景與目的：本研究的目的為(1)研究早產與嬰兒踢腳動作之相關程度，(2)檢驗測試年齡、研究類型、發表與否、以及研究國度與踢腳動作有效尺度(effect size)的關聯。方法：總共找到了34篇文章，其中只有6篇符合收案條件用作分析。利用r指標來分別代表在各項動力學因子中低危險群早產兒與足月產嬰兒間，以及高危險群嬰兒與足月產嬰兒間的有效尺度。結果：整體而言，早產與嬰兒踢腳動作只有弱相關之相關程度，唯一例外的是在高危險群早產兒與足月產嬰兒間的肢體內協調度(intralimb coordination)有中度至高度相關。進一步分析顯示，在比較高危險群早產兒與足月產嬰兒間的協調度時，若是受測嬰兒年齡小於4個月大時，僅為小的有效尺度；但若是大於4個月時，則為大的有效尺度。相反的，在比較低危險群早產兒與足月產嬰兒時，若是年齡小於4個月時，為中度的有效尺度；但若是大於4個月時，有效尺度則幾乎為0。結論：經由本整合研究的發現，建議可利用四個月大之後的肢體內關節協調度來區分哪些嬰兒為日後有發展遲緩的高危險群。

關鍵字

整合研究 ； 腳部動作 ； 早產兒 ； 足月兒 ； 發展

並列摘要

Background and Purposes: The purposes of this meta-analysis were (1) to investigate the relation between prematurity and the parameters of infant kicking, and (2) to examine to what degree the effect size varies as a function of age, study type, publication type, and country of origin. Methods: Six studies met all the inclusion criteria and were used for this meta-analysis. A r-indicator was used to represent the effect size indicating the difference between low-risk preterm and full term infants and the difference in kinematic variables between high-risk preterm and full term infants. A fixed-effect model was assumed in this study. To determine whether the r-indicators were derived from a common population, a heterogeneity analysis (Q) was computed for each kinematic variable. Potential moderators (study type, publication type, country of origin, and age) were analyzed for each variable. Results: Overall, there was a consistent moderate to large effect size for intra-limb coordination variables between high-risk preterm and full term infants. For other kicking parameters, there was a small effect size between preterm infants (both low-risk and high-risk groups) and full term infants. From the moderator analyses, studies testing high-risk infants younger than 4 months had a small positive effect for the measures of intralimb coordination, the hip-knee and hip-ankle joint correlations; whereas studies testing infants older than 4 months had a large positive effect on these hip-knee and hip-ankle pairs. On the contrary, studies testing low-risk infants younger than 4 months had a medium positive effect; whereas studies testing low-risk infants older than 4 months showed no effect. Conclusion: The results suggest that intralimb coordination parameters after 4 months of age may be early indicators of atypical coordination since low-risk infants resolved their differences after 4 months of age but high-risk infants sustained the atypical intralimb coordination.

並列關鍵字

Meta-analysis ； Leg movements ； Preterm ； Full term ； Development