婴儿运动表现测试在高危儿早期管理中的应用价值

Clinical value of the Test of Infant Motor Performance in the early management of high-risk infants

摘要

高危儿的早期识别与干预对改善其神经发育结局具有重要意义。婴儿运动表现测试(TIMP)是适用于矫正34周龄~矫正4月龄婴儿的运动功能评估方法,能为高危儿早期管理构建“评估-指导-教育”三位一体的整合支持模式。TIMP虽具有较高的临床价值,但仍然存在适用边界、文化适应、人员培训等局限性问题。本文将系统梳理TIMP在高危儿早期管理中的应用价值,并分析TIMP的局限性,以期为高危儿的早期管理提供更多支持。

Abstract

Early identification and intervention are essential for improving neurodevelopmental outcomes in high-risk infants. The Test of Infant Motor Performance (TIMP) is a motor assessment tool for infants from 34 weeks′ postmenstrual age to 4 months′ corrected age. In the early management of high-risk infants, it can support an integrated three-component model of assessment, guidance, and education.Although TIMP has considerable clinical value, it still has limitations regarding its scope of application, cultural adaptation, and personnel training.This review discusses the clinical value and limitations of TIMP in the early management of high-risk infants,aiming to provide more support for early management strategies for high-risk infants.

关键词

婴儿运动表现测试 / 高危儿随访 / 个性化干预 / 家长教育

Key words

Test of Infant Motor Performance / follow-up of high-risk infants / individualized intervention / parent education

[1] Erdei C, Gallo V, Maitre NL, et al. The science of neurohabilitation and neurodevelopmental care for infants with high-risk neonatal illnesses[J].J Pediatr,2025,282:114582.
[2] 农绍汉,余卫红,李翠红,等.高危儿神经发育障碍预防性早期干预研究进展[J].中国当代儿科杂志, 2024,26(3):297-301.
Nong SH, Yu WH, Li CH, et al. Preventive early intervention strategies for neurodevelopmental disorders of high-risk infants[J].Chin J Contemp Pediatr,2024, 26(3):297-301.(in Chinese)
[3] Campbell SK. Functional movement assessment with the test of infant motor performance[J]. J Perinatol, 2021, 41(10): 2385-2394.
[4] Ustad T, Helbostad JL, Campbell SK, et al. Test-retest reliability of the Test of Infant Motor Performance Screening Items in infants at risk for impaired functional motor performance[J]. Early Hum Dev, 2016, 93: 43-46.
[5] Brown S, Mechling K. Commentary on “test of infant motor performance for infants in Brazil: Unidimensional model, item difficulty, and motor function”[J].Pediatr Phys Ther,2020, 32(4):398.
[6] Rodrigues D, Joshi K, Rajadhyaksha S, et al. Motor performance of Indian preterm infants as compared to the US population on the Test of Infant Motor Performance (TIMP)[J].Early Hum Dev,2024,195:106056.
[7] Kvestad I, Silpakar JS, Hysing M, et al. The reliability and predictive ability of the Test of Infant Motor Performance (TIMP) in a community-based study in Bhaktapur, Nepal[J].Infant Behav Dev, 2023,70:101809.
[8] Ravarian A, Rahmani N, Soleimani F, et al. Test of infant motor performance: Cross-cultural adaptation, validity and reliability in Persian infants[J].Early Hum Dev,2023,184:105831.
[9] Peyton C, Schreiber MD, Msall ME. The test of infant motor performance at 3 months predicts language, cognitive, and motor outcomes in infants born preterm at 2 years of age[J].Dev Med Child Neurol,2018,60(12):1239-1243.
[10] Williamson AE, Boyd RN, Ware RS, et al. Predicting neurodevelopment in very preterm infants using the Test of Infant Motor Performance[J]. Early Hum Dev, 2025, 206: 106271.
[11] das Neves Cardoso AC, de Campos AC, dos Santos MM, et al. Motor performance of children with down syndrome and typical development at 2 to 4 and 26 months[J]. Pediatr Phys Ther, 2015, 27(2): 135-141.
[12] Kloze A, Brzuszkiewicz-Kuzmicka G, Czyzewski P. Use of the TIMP in assessment of motor development of infants with down syndrome[J]. Pediatr Phys Ther, 2016, 28(1): 40-45.
[13] Krosschell KJ, Bosch M, Nelson L, et al. Motor function test reliability during the NeuroNEXT spinal muscular atrophy infant biomarker study[J].J Neuromuscul Dis,2018,5(4):509-521.
[14] Kolb SJ, Coffey CS, Yankey JW, et al. Natural history of infantile-onset spinal muscular atrophy[J]. Ann Neurol,2017,82(6):883-891.
[15] Boynewicz K, Campbell SK, Chroust A. Early identification of atypical motor performance of infants with prenatal opioid exposure[J].Pediatr Phys Ther,2023,35(3):359-365.
[16] Huang T, Li W, Wang C, et al. Research into the correlation between positional skull deformation and motor performance of infants aged under 4 months[J].BMC Pediatr,2023,23(1):212.
[17] 屈福祥,胡斌,王成举,等.中美婴儿运动表现测试常模差异分析[J].中国儿童保健杂志,2022,30(2): 148-152.
Qu FX, Hu B, Wang CJ, et al. Differences of the test of infant motor performance between Chinese and American norms[J].Chin J Child Health Care,2022,30(2):148-152.(in Chinese)
[18] 李海薇,赵琳,卢爱洁,等.婴儿运动表现测试在昆明地区小婴儿中的应用研究[J].中国儿童保健杂志,2021,29(12):1363-1367.
Li HW, Zhao L, Lu AJ, et al. Application of the test of infant motor performance for infants in Kunming area[J].Chin J Child Health Care,2021,29(12):1363-1367.(in Chinese)
[19] 王成举,胡斌,屈福祥,等.婴儿运动表现测试在早产儿运动评估中的应用[J].中国儿童保健杂志, 2020,28(7):744-747.
Wang CJ, Hu B, Qu FX, et al. Application of test of infant motor performance in motor assessment of preterm infants[J].Chin J Child Health Care,2020,28(7):744-747.(in Chinese)
[20] 曹慧,唐甜.婴儿运动表现测试(TIMP)在马鞍山地区高危儿评估中的运用[J].公共卫生与预防医学,2025,36(2):82-85.
Cao H, Tang T. Application of Test of Infant Motor Performance in the assessment of high-risk infants in Ma′anshan Area[J].J Public Health Prev Med,2025,36(2):82-85.(in Chinese)
[21] Wang TT, Zheng B, Yang H, et al. Predictive value and ranking of writhing and fidgety movements for cerebral palsy: A Meta-analysis based on the Superiority Index[J]. Medicine, 2025, 104(33): e43813.
[22] Maitre NL, Kjeldsen CP, Duncan AF, et al. Automated detection of abnormal general movements from pressure and positional information in hospitalized infants[J].Pediatr Res,2025,97:598-607.
[23] 宋文亚,倪育,罗翠仪,等.全身运动评估与婴儿运动表现测试的相关性研究[J].中国妇幼健康研究, 2022,33(2):1-4.
Song WY, Ni Y, Luo CY, et al. Relationship between the general movements and the test of infant motor performance[J].Chin J Woman Child Health Res,2022,33(2):1-4.(in Chinese)
[24] BurtonVJ, Kannan S, Jayakumar S, et al. Longitudinal Hammersmith Infant Neurological Examination (HINE) trajectories in children with cerebral palsy identified in high-risk follow-up[J]. J Clin Med, 2025, 14(5): 1572.
[25] 田巍巍,朱敏,张跃,等.Hammersmit婴儿神经学检查在高危儿粗大运动发育随访中的应用研究[J].中华物理医学与康复杂志,2022,44(9):795-799.
Tian WW, Zhu M, Zhang Y, et al. The Hammersmith Infant Neurological Examination for following-up the gross motor development of high-risk infants[J].Chin J Phys Med Rehabil,2022,44(9):795-799.(in Chinese)
[26] Kapil N, Majmudar-Sheth B, Johnson T. Hammersmith infant neurological examination subscores are predictive of cerebral palsy[J]. Pediatr Neurol, 2024, 151: 84-89.
[27] Pietruszewski L, Moore-Clingenpeel M, Moellering GCJ, et al. Predictive value of the test of infant motor performance and the Hammersmith Infant Neurological Examination for cerebral palsy in infants[J]. Early Hum Dev, 2022, 174: 105665.
[28] Davies S, Lucas BR, Dwyer GM. Reliability of the Alberta Infant Motor Scale (AIMS) when used via telehealth for neurodevelopmentally high-risk infants[J].Phys Occup Ther Pediatr,2025,45(4):558-571.
[29] 韩佳乐,曹建国,王景刚,等.婴儿运动表现测试和Alberta婴儿运动量表在0～4月龄高危儿中的应用[J].中国妇幼保健,2023,38(9):1635-1638.
[30] 韩佳乐,王景刚,曹建国.高危儿早期神经学评估方法[J].中国儿童保健杂志, 2021, 29(9): 981-985.
Han JL, Wang JG, Cao JG. Review on the early neurological assessment of high-risk infants[J]. Chin J Child Health Care,2021,29(9):981-985.(in Chinese)
[31] 贾品,陈天.我国儿童保健工作发展历程及相关问题[J].社会与公益,2025(4):427-429.
[32] Madayi A, Shi L, Zhu Y, et al. The Test of Infant Motor Performance (TIMP) in very low birth weight infants and outcome at two years of age[J]. J Perinatol, 2021, 41(10): 2432-2441.
[33] 中国医师协会儿科医师分会儿童保健学组.NICU出院高危儿0～3岁生长发育随访管理技术的专家共识[J].中国儿童保健杂志,2021,29(8):809-814.
Child Health Care Group, Pediatrician Branch, Chinese Medical Association. Expert consensus on growth and development follow-up management techniques for high-risk newborns discharged from NICU at 0 - 3 years old[J]. Chin J Child Health Care,2021,29(8):809-814.(in Chinese)
[34] 中国优生优育协会婴幼儿发育专业委员会.高危新生儿行为神经发育早期干预专家共识[J].中国儿童保健杂志,2022,30(3): 233-236.
Infant and Child Development, China Eugenics Association Professional Committee. Expert consensus on early intervention of neurobehavioral development in high-risk neonates[J].Chin J Child Health Care,2022,30(3):233-236.(in Chinese)
[35] 倪钰飞,顾秋燕,杨卫超,等.婴儿运动表现测试在早产儿运动发育促进性干预中的价值[J].中国妇幼健康研究,2020,31(8):1050-1053.
Ni YF, Gu QY, Yang WC, et al. Study on the value of the test of infant motor performance in motor development promoting intervention for preterm infants[J].Chin J Woman Child Health Res,2020,31(8):1050-1053.(in Chinese)
[36] Orton J, Doyle LW, Tripathi T, et al. Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants[J].Cochrane Database Syst Rev,2024,2:CD005495.
[37] Dusing SC, Tripathi T, Marcinowski EC, et al. Supporting play exploration and early developmental intervention versus usual care to enhance development outcomes during the transition from the neonatal intensive care unit to home: A pilot randomized controlled trial[J].BMC Pediatr,2018,18(1):46.
[38] Finlayson F, Olsen J, Dusing SC, et al. Supporting Play, Exploration, and Early Development Intervention (SPEEDI) for preterm infants: A feasibility randomised controlled trial in an Australian context[J].Early Hum Dev,2020,151:105172.
[39] 荣月芳,谢安慰,柏丹丹,等.高危儿早期干预中其家长疾病获益感的质性研究[J].全科护理,2023, 21(17):2399-2402.
[40] 秦月意,田甜,陆晓.家庭干预支持度对高危儿运动功能早期干预效果的影响[J].中国儿童保健杂志,2023,31(11):1168-1173.
Qin YY, Tian T, Lu X. Influence of family support on the effect of early intervention on motor function in high-risk children[J].Chin J Child Health Care,2023,31(11):1168-1173.(in Chinese)