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Examining Early Childhood Gross Motor Skill Proficiency in Children Born Preterm

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Examining Early Childhood Gross Motor Skill Proficiency in Children Born Preterm EXAMINING EARLY CHILDHOOD GROSS MOTOR SKILL PROFICIENCY IN CHILDREN BORN PRETERM by BETH MARINA MAXINE RIZZARDO B.Kin., The University of British Columbia, 2016 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Kinesiology) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) July 2018 © Beth Marina Maxine Rizzardo, 2018 The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, a thesis/dissertation entitled: Examining Early Childhood Gross Motor Skill Proficiency in Children Born Preterm submitted by Beth Marine Maxine Rizzardo in partial fulfillment of the requirements for the degree of Master of Science in Kinesiology Examining Committee: Dr. Shannon Bredin, Kinesiology Supervisor Dr. Darren Warburton, Kinesiology Supervisory Committee Member Dr. Carolyn McEwen, Kinesiology Supervisory Committee Member ii Abstract Preterm birth (<37 weeks) is a public health concern in Canada. Long-term developmental concerns have been documented, however less is known about the relationship between preterm birth and gross motor development. Understanding the acquisition of fundamental motor skills in early childhood is important as it lays the foundation for movement experiences across the lifespan. Although children born early preterm (<32 weeks) show marked gross motor delays, children born preterm at later gestational ages receive little follow-up and are often excluded from research, limiting our knowledge. The purpose of this research was to examine the relationship between gestational age and gross motor skill performance of children (4-6 years of age) born preterm. Eighteen children (n = 11 f, 7 m; mean age = 5.2 ± 0.7 y) born preterm (mean gestational age = 31.6 ± 3.3 wks) were recruited and assessed in one session on gross motor skill proficiency (Test of Gross Motor Development–Second Edition; TGMD-2), balance (single-leg static balance), and muscular strength (grip strength, standing long jump). Anthropometric measurements were also collected. Pearson product correlations, as well as regression analyses, were conducted to examine relationships of predictors and performance variables. Findings showed that gestational age was not significantly correlated to the TGMD-2 overall Gross Motor Quotient score (r = 0.409, n = 18, p > .05). Irrespective of gestational age, gross motor proficiency was low. Holding age constant, gestational age was found to be a significant predictor of both balance time and standing long jump distance. Children born at later gestational ages balanced longer and jumped further; however balance was still poorly performed by the participants. The findings of this investigation indicate the need for further research into the gross motor skill development of children born preterm throughout the early childhood years. These findings suggest that difficulties in fundamental gross motor skills are exhibited across gestational age and difficulties are not constrained to the first years of life, but also exhibited at preschool and kindergarten-age. This work has implications for the design and implementation of developmentally appropriate programming for the preterm population in the early childhood years. iii Lay Summary It is important to develop critical motor skills and patterns in early childhood that use large muscle groups to move. Unfortunately, children born early (preterm) are at risk for delayed development of gross motor skills. To date, most of the research has focused on children born very early, and there is little information about children who are born preterm but closer to full term. This investigation assessed the gross motor skills of children born preterm at age 4-6 years. Eighteen children with an average age of 5.2 years who were born at an average gestational age of 31.6 weeks participated. The children exhibited poor movement skills, as well as balance skills. These results suggest that children who are born preterm should be followed-up for motor development delay throughout childhood, regardless of how early they are born. In addition, balance may be an important part of movement development in these children. iv Preface Beth M.M. Rizzardo was the primary author of this thesis under the supervision of Dr. Shannon Bredin, who helped develop the thesis structure and offered substantial input and edits. As supervisory committee members, Dr. Darren Warburton and Dr. Carolyn McEwen provided assistance in the direction of this thesis, in addition to providing editorial feedback. All research was conducted in the Cognitive and Motor Learning Laboratory, Physical Activity Promotion and Chronic Disease Prevention Unit in the School of Kinesiology at the University of British Columbia. A version of section 2.8 and the age adjustment infographic has been published as: Rizzardo, B.M.M., & Bredin, S.S.D. (2018). Premature birth and motor milestones: The importance and use of adjusted age. Health & Fitness Journal of Canada, 11(1): 3-6. Beth M.M. Rizzardo was responsible for the creation of the infographic and writing of the accompanying summary. Dr. Shannon Bredin contributed to the direction of the infographic topic and provided edits. A version of Chapter 3 has been published as: Rizzardo, B.M.M., & Bredin, S.S.D. (2018). Preterm birth and childhood gross motor competence. Health & Fitness Journal of Canada, 11(1): 7-15. Beth M.M. Rizzardo is the primary author of the manuscript. Dr. Shannon Bredin was involved with the concept formation and provided edits to the manuscript. The data of 10 participants were presented on June 6th, 2018 at the 2018 International Society of Behavioral Nutrition and Physical Activity Annual Meeting in Hong Kong, China: v Rizzardo, B.M.M., McEwen, C.E.., Warburton, D.E.R., Kaufman, K.L., Grishin, N.K., & Bredin, S.S.D. (2018). Examining the gross motor skill proficiency of children born preterm at age 4-6 years. In: 2018 ISBNPA Abstract Book, 446. Hong Kong, China: International Society of Behavioral Nutrition and Physical Activity. ISBN: 978-1- 7324011-0-5 A version of Chapter 5 is in editing for submission at the time of thesis acceptance. Beth M.M. Rizzardo initiated the concept of this study and was responsible for participant recruitment, data collection, statistical analysis, and was primary author of the manuscript. Dr. Shannon Bredin was responsible for overseeing and supervising the study and was involved throughout, including concept formation, manuscript edits, and providing significant input. Dr. Darren Warburton and Dr. Carolyn McEwen both contributed to formation of the study protocol, offered guidance, and provided feedback and manuscript edits. Dr. Carolyn McEwen also provided statistical guidance in the analysis and discussion of the data. Kai Kaufman and Nikol Grishin assisted with data collection, and Nikol Grishin performed the interrater reliability TGMD–2 scoring. Ethical approval for this investigation was received from the University of British Columbia Behavioural Research Ethics Board, under the title Gross Motor Skill Proficiency in Children Born Young-for-Date, UBC Ethics Certificate H17-01599. vi Table of Contents Abstract .................................................................................................................................... iii Lay Summary ............................................................................................................................ iv Preface ........................................................................................................................................ v Table of Contents ...................................................................................................................... vii List of Tables .............................................................................................................................. x List of Figures ............................................................................................................................ xi Glossary.................................................................................................................................... xii List of Abbreviations ............................................................................................................... xiv Acknowledgements ................................................................................................................... xv Dedication ............................................................................................................................... xvi CHAPTER 1: Introduction ...................................................................................................... 1 1.1 Preterm Birth Rate............................................................................................................. 1 1.2 Outcomes of Preterm Birth ................................................................................................ 1 1.4 The Issue ........................................................................................................................... 4 1.5 Purpose and Overview of Research Investigation .............................................................. 4 1.6 Overview of the Document ................................................................................................ 5 CHAPTER 2: Foundational Concepts of Motor Development ..............................................
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