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Boonzaaijer M1, van Maren-Suir I1, Mollema J1, Nuysink J1, Volman MJM2, Jongmans MJ2
1Institute of Human Movement Studies, HU University of Applied, Research Group Lifestyle and Health, Utrecht, Netherlands, 2Utrecht University Faculty of Social and Behavioral Sciences, Department of Pedagogical and Educational Sciences, Utrecht, Netherlands
Background: In the first two years of life, gross motor development, is an important indicator of infant developmental status. According to the dynamic systems theory, gross motor development is an ongoing product of contextual motor behavior. Multiple factors contributing to the acquisition of motor abilities have to be considered, in which both the child and its environment play crucial roles. An important element characterizing development is time. It becomes more and more apparent that multiple observations over time are needed to gain a true image of the immense variability in infant gross motor development. Therefore, results of especially longitudinal studies are of great interest and importance.
Purpose: The purpose of this study was to provide a broad overview of the body of longitudinal research on factors associated with the diversity in developmental pathways from birth until independent walking including a critical review of the quality of the included studies and a discussion of possible strands for future research.
Methods: The PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guided the conduct and reporting of this review. A literature search was conducted by an experienced librarian in PubMed, CINAHL, PsycINFO and SCOPUS from inception till February 2018. The search contained three main building blocks: motor development, infants and cohort studies with as many synonyms as possible to maximize sensitivity of the search. All articles published in English peer-reviewed journals and full text available, were included in the study. Inclusion criteria were: 1. A longitudinal design with repeated measures on gross motor development. 2. Participants are healthy infants, term or preterm born, from birth till independent walking. 3. At least one measurement of a factor (infant- or environmental) hypothesized to be associated with gross motor development. Eligible articles were assessed with the Quality in Prognostic Studies (QUIPS) to establish risk of bias. Screening abstracts, reading methods, rating risk of bias and extracting data, were performed independently by two researchers.
Results: After screening 2910 titles/abstracts, 38 studies were included. In 45% of the studies mixed populations were investigated, 40% were on term born infants and 15% examined premature born infants. Factors associated with gross motor development were grouped into:
1. Infant factors (45%) e.g., sex, anthropometry,
2. Physical environmental factors (26%) e.g., sleeping position and
3. Social environmental factors (29%). e.g. parental perceptions.
Despite the longitudinal designs, the majority of studies used cross-sectional statistical methods for analysis. Poor study attrition was the main cause for high risk of bias on the QUIPS (>50% of the studies). Due to mixed populations and a variety of investigated factors and outcome measures, performing a meta-analysis was not possible.Therefore, the results were descriptively displayed.
Conclusion(s): This systematic review confirms there is an extensive variety of factors associated with gross motor development of infants from birth until independent walking. Among the factors included in longitudinal studies on early gross motor development those related to the child itself seem most prominent.
Implications: Pediatric physical therapist need evidence-based knowledge about factors associated with infant gross motor development for clinical reasoning in practice.
Keywords: Systematic review, infant gross motor development, longitudinal research
Funding acknowledgements: The Netherlands Organization for Scientific Research (NWO) Doctoral Grant for Teachers, project number: 023.006.070, The Netherlands.
Purpose: The purpose of this study was to provide a broad overview of the body of longitudinal research on factors associated with the diversity in developmental pathways from birth until independent walking including a critical review of the quality of the included studies and a discussion of possible strands for future research.
Methods: The PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guided the conduct and reporting of this review. A literature search was conducted by an experienced librarian in PubMed, CINAHL, PsycINFO and SCOPUS from inception till February 2018. The search contained three main building blocks: motor development, infants and cohort studies with as many synonyms as possible to maximize sensitivity of the search. All articles published in English peer-reviewed journals and full text available, were included in the study. Inclusion criteria were: 1. A longitudinal design with repeated measures on gross motor development. 2. Participants are healthy infants, term or preterm born, from birth till independent walking. 3. At least one measurement of a factor (infant- or environmental) hypothesized to be associated with gross motor development. Eligible articles were assessed with the Quality in Prognostic Studies (QUIPS) to establish risk of bias. Screening abstracts, reading methods, rating risk of bias and extracting data, were performed independently by two researchers.
Results: After screening 2910 titles/abstracts, 38 studies were included. In 45% of the studies mixed populations were investigated, 40% were on term born infants and 15% examined premature born infants. Factors associated with gross motor development were grouped into:
1. Infant factors (45%) e.g., sex, anthropometry,
2. Physical environmental factors (26%) e.g., sleeping position and
3. Social environmental factors (29%). e.g. parental perceptions.
Despite the longitudinal designs, the majority of studies used cross-sectional statistical methods for analysis. Poor study attrition was the main cause for high risk of bias on the QUIPS (>50% of the studies). Due to mixed populations and a variety of investigated factors and outcome measures, performing a meta-analysis was not possible.Therefore, the results were descriptively displayed.
Conclusion(s): This systematic review confirms there is an extensive variety of factors associated with gross motor development of infants from birth until independent walking. Among the factors included in longitudinal studies on early gross motor development those related to the child itself seem most prominent.
Implications: Pediatric physical therapist need evidence-based knowledge about factors associated with infant gross motor development for clinical reasoning in practice.
Keywords: Systematic review, infant gross motor development, longitudinal research
Funding acknowledgements: The Netherlands Organization for Scientific Research (NWO) Doctoral Grant for Teachers, project number: 023.006.070, The Netherlands.
Topic: Paediatrics
Ethics approval required: No
Institution: University Medical Centre Utrecht, the Netherlands
Ethics committee: METC/ UMCU
Reason not required: Literature study, no patients involved
All authors, affiliations and abstracts have been published as submitted.
