MOVEMENT quality may improve early detection of subtle motor difficulties in preterm infants.
Movement Quality Adds Detail Beyond Milestones
Movement quality assessment may strengthen developmental surveillance in preterm infants by identifying motor characteristics that milestone based tools do not fully capture, according to a longitudinal study following infants through 18 months corrected age.
Motor milestone attainment remains a key component of clinical follow up for preterm infants, but the study highlights an important limitation: milestones indicate whether a task has been achieved, while movement quality helps show how that task is performed. This distinction may be clinically relevant for infants who appear to meet gross motor expectations but show reduced adaptability, fluency, variation, or other qualitative signs of early motor vulnerability.
The prospective cohort included 90 preterm infants assessed at corrected ages of 8, 12, and 18 months. Movement quality was evaluated using the Infant Motor Profile (IMP), while motor milestone attainment was measured with the Alberta Infant Motor Scale (AIMS). Associations between IMP and AIMS scores were examined longitudinally, and outcomes were compared between moderate to late preterm infants and extremely to very preterm infants.
Movement Quality Differed by Gestational Age
At 8 and 18 months corrected age, IMP scores, except symmetry, were significantly positively correlated with AIMS scores, with correlation coefficients ranging from 0.23 to 0.90. These findings suggest that movement quality and motor milestone attainment often align, particularly at these assessment points.
However, the relationship was not consistent across development. At 12 months, adaptability and total IMP scores were significantly negatively correlated with AIMS scores, with correlation coefficients of minus 0.57 and minus 0.26, respectively. This age dependent pattern suggests that milestone attainment alone may not provide a complete picture of motor development in preterm infants.
Gestational age subgroup differences were also evident. Extremely to very preterm infants had lower total IMP and adaptability scores at 8 months, lower AIMS scores at 12 months, and lower total IMP, adaptability, fluency, and AIMS scores at 18 months compared with moderate to late preterm infants.
Implications for Early Motor Surveillance
The findings support a combined approach to early motor surveillance, particularly for clinicians monitoring preterm infants at risk of subtle motor dysfunction. Movement quality assessment appeared to differentiate preterm subgroups earlier than milestone attainment and captured characteristics not fully reflected by AIMS scores.
Incorporating movement quality into follow up programs may help clinicians identify infants who need closer monitoring or timely intervention, especially when conventional motor milestones appear reassuring. For pediatric, neonatal, and developmental care teams, the study reinforces the importance of evaluating both what infants can do and how they move.
Reference
Hsieh CH et al. Relationships between movement quality and motor milestones in preterm infants: A longitudinal study up to 18 months. Early Hum Dev. 2026;222:106612.
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