Quality of movement may improve early detection of fine motor difficulties in premature infants.
Motion quality adds detail beyond landmarks
Assessing movement quality may enhance growth monitoring in preterm infants by identifying motor characteristics that landmark-based tools do not fully capture, according to a longitudinal study that followed infants up to corrected 18 months of age.
Achieving motor milestones remains a key element in the clinical follow-up of preterm infants, but the study highlights an important limitation: Milestones indicate whether a task was accomplished, while movement quality helps show how the task was performed. This distinction may be clinically relevant for infants who appear to meet gross motor expectations but show decreased adaptability, fluency, variability, or other specific signs of early motor impairment.
The prospective cohort included 90 premature infants evaluated at the corrected ages of 8, 12, and 18 months. Movement quality was assessed using the Infant Motor Profile (IMP), while achievement of motor milestones was measured using the Alberta Infant Motor Scale (AIMS). Associations between IMP and AIMS scores were examined longitudinally, and outcomes were compared between moderate to late preterm and extremely preterm infants.
The quality of movement varies depending on gestational age
At 8 and 18 months corrected, IMP scores, except for symmetry, were positively correlated with AIMS scores, with correlation coefficients ranging from 0.23 to 0.90. These results suggest that movement quality and achievement of motor milestones often agree, especially at these assessment points.
However, the relationship was not consistent across development. At 12 months, adaptability and total IMP scores were negatively associated with AIMS scores, with correlation coefficients of minus 0.57 and minus 0.26, respectively. This age-dependent pattern suggests that achievement alone may not provide a complete picture of motor development in preterm infants.
Differences between subgroups for gestational age were also evident. Very much so Premature They had lower total IMP, adaptability, fluency, and AIMS scores at 8 months, lower AIMS scores at 12 months, and lower total IMP, adaptability, fluency, and AIMS scores at 18 months compared with moderate to late preterm infants.
Implications for early motor vehicle monitoring
The results support a combined approach to early motor monitoring, especially for clinicians monitoring preterm infants at risk for subtle motor dysfunction. Assessment of movement quality appears to differentiate between preterm subgroups earlier than they achieve milestones and captured characteristics that are not fully reflected in AIMS scores.
Incorporating movement quality into follow-up programs may help clinicians identify infants who need close monitoring or timely intervention, especially when conventional motor parameters appear reassuring. For pediatric, neonatal and developmental care teams, the study reinforces the importance of assessing what infants can do and how they move.
reference
Hsieh CH et al. Relationships between movement quality and motor milestones in preterm infants: a longitudinal study up to 18 months. Early hum development. 2026;222:106612.
Featured image: Alessandro Grandini on Adobe Stock.
