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      Relation between hand function and gross motor function in full term infants aged 4 to 8 months

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          Abstract

          Background:

          In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately.

          Objective:

          To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object) and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age.

          Method:

          The number of reaches and the period (i.e. time) of manipulation to an object were extracted from video synchronized with the Qualisys (r) movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function.

          Results:

          Results revealed a significant increase in the number of reaches (p<0.001), the time of manipulation (p<0.001) and gross motor function (p<0.001) over time, as well as associations between reaching and gross motor function (R 2=0.84; p<0.001) and manipulation and gross motor function (R 2=0.13; p=0.02) from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant.

          Conclusion:

          The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development.

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          Most cited references84

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          The transition to reaching: mapping intention and intrinsic dynamics.

          The onset of directed reaching demarks the emergence of a qualitatively new skill. In this study we asked how intentional reaching arises from infants' ongoing, intrinsic movement dynamics, and how first reaches become successively adapted to the task. We observed 4 infants weekly in a standard reaching task and identified the week of first arm-extended reach, and the 2 weeks before and after onset. The infants first reached at ages ranging from 12 to 22 weeks, and they used different strategies to get the toy. 2 infants, whose spontaneous movements were large and vigorous, damped down their fast, forceful movements. The 2 quieter infants generated faster and more energetic movements to lift their arms. The infants modulated reaches in task-appropriate ways in the weeks following onset. Reaching emerges when infants can intentionally adjust the force and compliance of the arm, often using muscle coactivation. These results suggest that the infant central nervous system does not contain programs that detail hand trajectory, joint coordination, and muscle activation patterns. Rather, these patterns are the consequences of the natural dynamics of the system and the active exploration of the match between those dynamics and the task.
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            Structuring of early reaching movements: a longitudinal study.

            Reaches, performed by 5 infants, recorded at 19 weeks of age and every third week thereafter until 31 weeks of age, were studied quantitatively. Earlier findings about action units were confirmed. At all ages studied, movements were structured into phases of acceleration and deceleration. Reaching trajectories were found to be relatively straight within these units and to change direction between them. It was also found that at all ages, there was generally one dominating transport unit in each reach. The structuring of reaching movements changed in four important ways during the period studied. First, the sequential structuring became more systematic with age, with the dominating transport unit beginning the movement. Second, the duration of the transport unit became longer and covered a larger proportion of the approach. Third, the number of action units decreased with age, approaching the two-phase structure of adult reaching. Finally, reaching trajectories became straighter with age.
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              Development of reaching in infancy.

              The development of reaching for stationary objects was studied longitudinally in 12 human infants: 5 from the time of reach onset to 5 months of age, 5 from 6 to 20 months of age, and 2 from reach onset to 20 months of age. We used linear mixed-effects statistical modeling and found a gradual slowing of reach speed and a more rapid decrease of movement jerk with increasing age. The elbow was essentially locked during early reaching, but was prominently used by 6 months. Differences between infants were distributed normally and no evidence of different types of reachers was found. The current work combined with other longitudinal studies of infant reaching shows that the increase in skill over the first 2 years of life is seen, not by an increase in reaching speed, but by an increase in reach smoothness. By the end of the second year, the overall speed profile of reaching is approaching the typical adult profile where an early acceleration of the hand brings the hand to the region of the target with a smooth transition to a lower-speed phase where grasp is accomplished.
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                Author and article information

                Journal
                Braz J Phys Ther
                Braz J Phys Ther
                rbfis
                Brazilian Journal of Physical Therapy
                Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
                1413-3555
                1809-9246
                Jan-Feb 2015
                : 19
                : 1
                : 52-60
                Affiliations
                [1 ]Terapeuta Ocupacional, Belo Horizonte, MG, Brazil
                [2 ]Departamento de Fisioterapia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
                [3 ]Programa de Pós-graduação em Ciências da Reabilitação, UFMG, Belo Horizonte, MG, Brazil
                [4 ]Departamento de Terapia Ocupacional, UFMG, Belo Horizonte, MG, Brazil
                Author notes
                Correspondence Marisa Cotta Mancini Universidade Federal de Minas Gerais Escola de Educação Física, Fisioterapia e Terapia Ocupacional Colegiado de Pós-graduação em Ciências da Reabilitação Avenida Antônio Carlos, 6627, Campus Pampulha CEP 31270-010, Belo Horizonte, MG, Brasil e-mail: mcmancini@ 123456ufmg.br , marisacmancini@ 123456gmail.com
                Article
                10.1590/bjpt-rbf.2014.0070
                4351608
                25714437
                49bafaca-2325-489b-ac18-4d6946d280ab

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 February 2014
                : 11 June 2014
                : 01 August 2014
                Page count
                Figures: 4, Tables: 1, References: 30, Pages: 9
                Categories
                Original Articles

                child development,motor skills,motor activity,rehabilitation

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