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Title	Evaluation of use of the Early Motor Pattern Profile (EMPP) in high-risk NICU follow-up clinic
Author	Hatcher, Charles Robert, III
Date	2011
Affiliation/College	College of Graduate Studies
Department	Developmental-Behavioral Pediatrics
Extent	v, 78 leaves : ill.; 29 cm
Subject.MeSH	Academic Dissertations Academic Dissertations--South Carolina Intensive Care, Neonatal Motor Skills.
Collection	MUSC Theses and Dissertations
Contributing Institution	Waring Historical Library (MUSC)
Rights	Copyright is held by the author.
Language	English
Type	Text
Format	application/pdf
Media Type	Manuscripts
Resource Identifier	mtd2011_hatcher_cr
Abstract	Evaluation of Use of the Early Motor Pattern Profile (EMPP) in High-Risk NICU Follow-up Clinic. (Under the direction of MICHELLE MACIAS, MD) Background Neuromotor function is a vital cOlnponent of the premature infant examination. Though some early abnormalities may resolve spontaneously, it is important to distinguish findings indicative of persistent motor problem.s. The Early Motor Patten1 Profile (EMPP) is a I5-item screening to01 that evaluates muscle tone, reflexes, and movement to determine a child's neurologic status. Objective To evaluate usefulness of the EMPP and association between the EMPP and the Modified Peabbdy Developmental Motor Scale (m-PDMS) compared \vith a standard neurological examination in detecting neurOlnotor abnonl1alities in premature, VLBW « 1500 grams) infants at 6 months corrected age. Design/Methods Chart review was completed of 52 infants evaluated in a high-risk NICU followup clinic over a 2 year period. The EMPP was divided into pass/fail categories by standard cutoff score at >9 and m-PDMS by a developmental quotient (DQ) of ~85. A ne\v EMPP PIF category \vas created using ROC curve analysis giving a cutoff at >3. Each category was assessed to detennine Sensitivity (Sn) and Specificity (Sp) values for predicting Inotor tone abnormality on physical exam and physical therapy CPT) referral. The influence of child factors (demographics, birth history, and physical exam findings) on EMPP score was assessed using chi square, Wilcoxon-Mann-Whitney, and Student's ttest. Results For general tone abnormality, the m-PDMS, standard-cutoff EMPP and new cutoff EMPP provided Sn values of 22.2%, 36.1 % and 78.5% respectively and Sp of 87.5%, 100% and 69.90/0 respectively. For referral to PT, Sn was 33.3%, 37.0%, and 80.7% respectively and Sp ,vas 95.5%, 86.4%, and 50.5% respectively. EMPP score was only significantly associated \vith related physical exam findings. Conclusions For premature, VLBW infants at 6 months adjusted age, EMPP is superior to mPDMS at predicting motor tone abnormality and referral to physical therapy. Reflex and posture abnonnalities indicative of neuromotor pathology may be present with or without major gross motor delay. Accurately identifying VLBW children at risk for motor problems using the EMPP with cutoff at >3 may result in earlier intervention and better gross motor outcome. Further research is planned to determine longitudinal validity of the EMPP for determining those at highest probability of continued neuromotor abnormalities.

Evaluation of use of the Early Motor Pattern Profile (EMPP) in high-risk NICU follow-up clinic

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