Effects of Early Physiotherapy on Motor Optimality Score in At-Risk of Infants

All babies will have their Motor Optimality Scores (MOS-R) calculated at the end of the 4th and 5th months, adjusted for fidgety General Movements of the videos. The MOS-R assesses movement repertoire and scores in the following four areas.The total of these scores varies between 5 and 28. Higher scores shows better developmental status.

General movements (GMs) are the spontaneous repertoire of movements present from early fetal life until the 20th week postpartum. They are writhing until the 8th week postpartum and then fidgety until approximately the 20th week.Video recordings will begin in the NICU three days after birth in the preterm period. All infants will be examined for writhing and fidgety movements (FM) via video recordings.Movements during the preterm and writhing periods will be classified as PR, CS, and Ch GMs or normal. Movements during the fidgety period will be recorded as F+ or F++ when normal, AF when abnormal, or F- when not observed.

This measurement has been developed by Dubowitz, the examination standardized optimality scores by evaluating low-risk term and high-risk preterm infants at term age. The scale consists of a 34-item proforma. This proforma includes tone (10), tone patterns (5), reflexes (6), movements (3), abnormal signs (3), and behavior (7). All items are scored from 1 to 3 (half points are also possible). Higher scores indicate better neurological status.

The Hammersmith Infant Neurological Examination (HINE) is a simple, standardized, and scoreable test for the clinical neurological assessment of infants aged 2-24 months. HINE consists of a total of 37 items, divided into three sections: neurological examination, developmental motor milestones, and behavioral status.It consists of three sections: (1) a neurological examination that assesses cranial nerve function, posture, movements, tone, reflexes, and reactions; (2) motor milestones; and (3) behavior. Each of the 26 items on the test is initially scored individually (0, 1, 2, 3, or half points). A total score is then calculated, with miimum score of 37 and a maximum score of 78 points.A higher score indicates better neurological status.

The BAYLEY-III Infant and Child Development Assessment Scale (BAYLEY-III ) is a neurocognitive assessment used to monitor the development of infants aged 0-42 months. It comprises five domains: cognitive, language, motor, social-emotional, and adaptive functions. This study will assess only the cognitive, language, and motor domains.To ensure comparability of results from the 5 domains, a composite score is calculated for each domain (mean 100±15). A composite score below 2 standard deviations (SD) (<70) is considered a severe delay across all domains.Higher scores give better developmental stages.

Sociodemographic information and prenatal/perinatal risks (MRI, cUS results, diagnosis, neurological evaluation) of all infants and their parents will be obtained from hospital records after treatment.