Characteristics of spontaneous movements and effects of infant pillow in extremely low-birth weight infants

早産児の自発運動の特徴や、介入による効果を検証した報告は少ない。そこで、神経学的異常のない超低出生体重児8名(平均出生体重729±144g、平均在胎期間24.6±2.0週)、正期産児8名を対象に、乳児自発運動評価を目的に開発された三次元動作解析機器Kinectを用いて修正月齢1か月時の自発運動の特徴、新生児枕による即時的影響を検証した。結果、超低出生体重児の自発運動は正期産児と同様の平均速度、流暢性、突発性であったが、正期産児と比較し非対称性を示した。また、新生児枕の使用により非対称性が即時的に改善された。超低出生体重児は正期産児とは異なる形態や姿勢により非対称性を呈すが、正期産児と同様の自発運動を有していることが考えられた。よっで、新生児期～乳児期初期の自発運動が発達を促進させることを鑑みると、超低出生体重児の非対称な自発運動を改善する目的に早期より発達支援の介入を行う必要がある。[Introduction] In general, infant development is promoted through their own early spontaneous movements. However, it is unclear the characteristics of spontaneous movements and effects of interventions in extremely low-birth weight (ELBW) infants. The purpose of this study is to reveal the characteristics of spontaneous movements and effects of an infant pillow in ELBW infants at 1 month corrected age. [Methods] We evaluated spontaneous movements with and without a pillow in 8 ELBW infants and 8 term infants. The ELBW infants of mean gestational week and birth weight were 24.6 weeks and 729g, respectively. The ELBW infants were evaluated in the NICU at Tokyo Women\u27s Medical University at 1 month corrected age. The term infants were evaluated at their home at 1 month after birth. Spontaneous movements were analyzed using the Microsoft Kinect depth sensor. The Kinect was developed to evaluate infant spontaneous movements. The recorded spontaneous movements were quantified 4 movement indices (velocity. laterality index, jerk index and kurtosis of acceleration). The results were calculated from 3D trajectories of both arms. (Results] The indices of velocity, jerk index and kurtosis of acceleration showed no significant differences between the groups with and without a pillow. The indices of laterality index were higher in the ELBW infants than in the term infants without a pillow (p=O.O01), but there were no significant differences between the groups with a pillow. [Conclusion] Our results suggest that ELBW infant spontaneous movements are more asymmetrical than term infant spontaneous movements. Infant pillow makes the ELBW asymmetrical movements improve.首都大学東京, 2017-03-25, 修士（理学療法学）首都大学東