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Interventional physical and occupational therapy services and motor coordination among low birth weight infants.

机译：低体重婴儿的介入物理和职业治疗服务以及运动协调。

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摘要

Introduction: Children born very low birth weight (VLBW) have an increased risk of impaired preschool motor coordination, which may have negative effects on the child's mental and physical health. Physical and occupational therapy services are suggested to attenuate the negative effects of poor preschool coordination. We estimated the effect of physical and occupational therapy services delivered in early childhood on preschool motor coordination among VLBW children. To control for confounding, we implemented propensity score (PS) methods estimated using traditional logistic regression (LR) and tree based methods. Methods: Using the Early Childhood Longitudinal Study Birth Cohort (ECLS-B) we estimated the effect of therapy on: skipping eight consecutive steps, hopping five times, standing on one leg for ten seconds, walking backwards six steps on a line, jumping distance, and change in jumping distance from preschool to kindergarten. We estimated the PS using random forest classification, bagging, and a single tree using the R statistical program and with LR in SAS 9.2. Using linear regression, we modeled the estimated effect of therapy on the distance that the child jumped. We weighted the adjusted models using inverse probability of treatment weights estimated from all four methods. We modeled all other end points as stated using LR. Results: Approximately 500 children were VLBW. RF and Bagging produced the best covariate balance between treatment groups (MSD 0.07, 0.03). The single classification tree produced the worst covariate balance (MDS 0.18). When estimating the PS with RF, treated VLBW children were 2.39 times as likely to successfully skipping eight steps (OR: 2.39, 95% CI: 0.75, 7.51) compared to the untreated group. Treated children jumped an additional 1.79 inches (95% CI: -2.21-5.79) further and were also 52% (OR: 1.52, 95% CI: 0.51, 4.54) more likely to successfully complete the backwards walking task. There was little effect of therapy on other endpoints. Effect estimates were similar among models weighted with RF, bagging, and LR. Conclusion: Providing therapy to VLBW children, may improve the child's school age motor coordination. RF is a useful method to improve covariate balance when estimating the PS and to potentially reduce bias in observational studies.
机译：简介：出生时体重很低的儿童患学龄前运动协调受损的风险增加，这可能对儿童的身心健康产生负面影响。建议进行物理和职业治疗服务以减轻不良的学前协调的负面影响。我们估计了幼儿期提供的物理和职业治疗服务对极低体重儿童的学前运动协调的影响。为了控制混淆，我们实施了使用传统逻辑回归（LR）和基于树的方法估算的倾向得分（PS）方法。方法：使用儿童早期纵向研究队列（ECLS-B），我们评估了以下治疗的效果：跳过连续八步，跳五遍，一条腿站立十秒钟，向后走六步，一条线，跳跃距离，以及从学龄前儿童到幼儿园的跳跃距离的变化。我们使用R统计程序和SAS 9.2中的LR使用随机森林分类，装袋和单棵树估计了PS。使用线性回归，我们对孩子跳跃距离上的估计治疗效果进行了建模。我们使用从所有四种方法估计的治疗权重的逆概率对调整后的模型进行加权。我们使用LR对所有其他端点建模。结果：大约500名儿童是VLBW。 RF和Bagging在治疗组之间产生了最佳的协变量平衡（MSD 0.07，0.03）。单一分类树产生最差的协变量平衡（MDS 0.18）。当用RF估计PS时，与未治疗组相比，接受治疗的VLBW儿童成功跳过八步的可能性为2.39倍（或：2.39，95％CI：0.75，7.51）。接受治疗的孩子再跳了1.79英寸（95％CI：-2.21-5.79），也更有52％（OR：1.52，95％CI：0.51、4.54）成功完成了向后行走的任务。治疗对其他终点影响不大。在以RF，装袋和LR加权的模型之间，效果估计相似。结论：为VLBW儿童提供治疗，可以改善儿童的学龄期运动协调能力。 RF是一种有用的方法，可以在估计PS时改善协变量平衡，并有可能减少观察性研究中的偏差。

著录项

  • 作者

    Watkins, Stephanie Elaine.;

  • 作者单位

    The University of North Carolina at Chapel Hill.;

  • 授予单位 The University of North Carolina at Chapel Hill.;
  • 学科 Health Sciences Epidemiology.;Health Sciences Rehabilitation and Therapy.
  • 学位 Ph.D.
  • 年度 2012
  • 页码 193 p.
  • 总页数 193
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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