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L de Groot

Publications and source records attributed to L de Groot.

34 records · Page 2Linked to original sources

Motor asymmetries in preterm infants at 18 weeks corrected age and outcomes at 1 year.

Persisting asymmetries in the motility and posture of preterm infants after term age is a common finding, but their diagnostic and prognostic significance has proved to be difficult to interpret. It has been claimed that if an asymmetry is of central origin, then it should be most prominently detectable in infantile reactions that persist beyond the age when they should have disappeared. We hypothesis that motor asymmetries in preterm infants without a major risk for neurological problems may stem from a high degree of active muscle power in the trunk that continues to be present after 12 weeks corrected age. In order to test this hypothesis, 34 preterm infants with a low risk for neurological complications were compared to a group of 17 fullterm infants at 18 weeks of (corrected) age for the presence or absence of motor asymmetries. None of the full-term infants showed asymmetrical motor behaviour, while within the preterm group a significant number did, in particular those who were small for gestational age. A significant relationship between motor asymmetries and a high degree of muscle power in the trunk at this age was found in the preterm group. Asymmetrical active muscle power at 18 weeks had a good predictive value for asymmetrical locomotor, hand and eye functions at 52 weeks.

Eye Movements↗

Cross-cultural variations and changes in food-group intake among elderly women in Europe: results from the Survey in Europe on Nutrition and the Elderly a Concerted Action (SENECA).

To study cross-cultural variations and changes in intake of food groups in elderly Europeans, longitudinal data on food-group intake from Danish (n = 55), Dutch (n = 65), Swiss (n = 79), and Spanish (n = 46) female participants in the Survey in Europe on Nutrition and the Elderly a Concerted Action (SENECA) were compared. Participants were born between 1913 and 1918. Information on food intake was obtained with use of the same diet-history method at all sites and in both 1988-1989 and 1993. Actual food intake was coded according to the Eurocode system, the applicability of which for European multicenter studies was evaluated in this study. All participants, regardless of site, reported consumption of milk, grain products, and vegetables, and almost all ate meat, fats, and fruit. Fewer women ate eggs, fish, and sugar. The variations between the sites were in the food groups consumed and the types of foods within the groups. Spanish women appeared to have the most healthy food-intake pattern. They also had more changes in their dietary pattern than did women in the other countries. The Eurocode was adequate for describing the actual food intake of elderly women in four European towns. The coding for meat, however, was ambiguous and should be revised.

Aged↗

Hand function in low-risk preterm infants: its relation to muscle power regulation.

Some preterm infants show a discrepancy in muscle power often recognisable as hyperextension of trunk and shoulders. Even if there is no evident pathology involved, the hyperextension influences later hand function. In this study we assessed a group of healthy infants (N=51) at the age of 39 weeks: 32 were born preterm (and corrected for gestational age) and 19 were born at term. Both quantitative and qualitative measures of hand function were obtained. It was found that the preterm infants scored significantly lower scores in both assessments for hand function. Moreover, a significant correlation was found between the quality of hand function at the age of 39 weeks and hyperextension of the trunk at 18 weeks. Hyperextension of the trunk at 18 weeks had a high predictive value for poor hand function at 39 weeks and thus should hold implications for clinical and therapeutic management.

Hand↗

An instrument to measure independent walking: are there differences between preterm and fullterm infants?

In clinical practice walking independently has always been considered a major milestone in development. Nevertheless, little attention has been paid to the quality of movement expressed in the first attempts at walking free. Even when children achieve walking within a normal time range, some of them show features that are deviant. Early walking is difficult to judge, but at the same time may provide a sensitive means for detecting possible developmental impairments. The main aim of this paper is to provide a standardized clinical instrument for the qualitative assessment of early walking in a structured free field situation and to compare preterm and fullterm infants. All subjects were assessed 14 days after being able to walk 5 meters independently. The study group consisted of 52 children, of whom 33 were born prematurely (further distinguished in terms of being small- or appropriate-for-gestational age), and 19 were born fullterm. Judgments of walking performance were made in terms of optimal, near-optimal, near-poor, or poor. After correction for age, the preterm group was still later in the onset of walking, but more importantly, showed a qualitatively different pattern of locomotion. Those who were the youngest and small-for-gestational age were overrepresented in the near-poor and poor categories of walking.

Analysis of Variance↗

Muscle power, sitting unsupported and trunk rotation in pre-term infants.

Discrepancies between active and passive muscle power are often seen in pre-term infants over the first year. Generally of a transient nature, they are most obvious in the extensor muscles of the trunk where there is a high active muscle power relative to the passive component. While high active muscle power may not be a sign of cerebral palsy, it is our contention that it will impair functions such as unsupported sitting and the ability to rotate in this position. In this study, 20 full-term and 37 healthy pre-term infants were assessed at the (corrected) ages of 39 and 52 weeks for muscle power in the trunk, sitting unsupported and rotation around the body axis while seated. At the age of 39 weeks, all full-term infants could sit without support. In contrast half of the pre-term infants could not sit without support and the majority of them could not rotate the trunk in this position. At 52 weeks the majority of pre-term infants could sit without support, despite having higher active muscle power in the trunk. However this deviant muscle power prevented rotatory movements of the trunk during sitting. The origin of this deviance may reside in the positioning to which pre-term infants are subjected after birth and thus postural management should be directed towards avoidance of extensor positions.

Adolescent↗

Development of muscle power in preterm infants: individual trajectories after term age.

In a longitudinal study individual trajectories were traced for the developing relationship between active and passive muscle power in preterm (n = 37) and fullterm (n = 20) infants from term to 24 weeks (corrected) age. Such trajectories should enable the identification of those infants at highest risk for later neurological dysfunctions. This contention is supported by the findings of this study: those preterm infants who showed marked discrepancies between the two sorts of muscle power or rigidity in both beyond 12 weeks corrected age were most likely to manifest neurological problems at 52 weeks of age.

Female↗

A method to assess the development of muscle power in preterms after term age.

The purpose of this paper is to report a detailed description of an instrument for evaluating the development of active and passive muscle power in preterms beyond term age. The instrument is constructed on a basis of age-specific items that assess these two components of muscle power and on the assumption that a persistent discrepancy between them serves to detect those preterms at most risk for disturbances in motor development. The application of the instrument is illustrated by reporting the individual trajectories of five case studies without any serious medical complications. It is concluded that if a marked discrepancy between active and passive power persists beyond the corrected age of 3 months, then this may be a sign of underlying pathology which will eventuate in abnormal postural outcomes and thereby disturbances in the control and coordination of movement. Having now provided a detailed description of how this instrument should be applied in postterm follow-up of preterm infants, we are currently examining its sensitivity and specificity on a much larger sample of similar subjects.

Age Factors↗

Development of the relationship between active and passive muscle power in preterms after term age.

Fifty-eight infants were assessed with an instrument which is designed to evaluate the development of the relationship between active and passive muscle power. The purpose of this longitudinal assessment was to investigate whether preterms show a different development course than fullterms in the relationship between these two components of muscle power. Thirty-seven low-risk preterms and twenty-one healthy fullterms were followed from term until 24 weeks corrected age. It is concluded that preterms differ markedly from fullterms in the developing interrelationship between active and passive muscle power. The value of the instrument for detecting signs of early pathology is discussed.

Age Factors↗

Acuity assessment of non-verbal infants and children: clinical experience with the acuity card procedure.

The acuity card procedure was used to assess the visual acuity of 510 neurologically normal and abnormal infants and children. Acuity estimates were obtained for 93 per cent of 842 binocular and 279 monocular tests. The observed development of binocular acuity of normal fullterm and preterm infants agreed well with previous reports using the traditional forced-choice preferential looking technique. Monocular tests seemed to support earlier suggestions that grating acuity may be relatively insensitive to strabismic amblyopia. Infants at risk of later neurological deficits but developing normally had only a slight delay in development of acuity, but there was a high incidence of acuity deficits (54 per cent) among those with severe neurological defects. The great majority of a group of multiply handicapped children had low acuity for age. Repeat tests showed a high degree of test-retest consistency. The acuity card procedure was a successful and useful method for assessing the acuity of infants and children who cannot be tested with standard ophthalmological methods.

Adolescent↗

Pliable but not receptive: concerning the marginal influence of a medical psychology course on the socialization process of doctors.

Growth into a professional role requires absorption of knowledge, the learning of skills and the adoption of behavioural patterns and values which are part of a particular profession. In sociological literature this is described as the socialization/professionalization process. In this article the research literature which describes the process is reviewed. However, apart from the many positive aspects of adjusting and conforming, there are also more negative developments in the learning behaviour and attitudes of the future doctor. The Department of Medical Psychology in Amsterdam has structured its teaching programme--in part--to overcome or to decrease such tendencies. This article deals with those parts of the course which attempt to influence medical students' interviewing and interpersonal skills. Research into the effects of this teaching points to a marginal influence in both areas. The author looks for explanations for this, in the light of the research literature. In conclusion, the direction is indicated which could further increase the influence of the medical psychology course on future doctors.

Humans↗