Background Preterm infants with periventricular brain injury (PBI) have a high incidence of atypical development and leg movements. Objective Determine whether kicking and treadmill stepping intervention beginning at 2 months corrected age (CA) in children with PBI improves motor function at 12 months CA when compared with control subjects. Method In a multi-center pilot study for a controlled clinical trial, sixteen infants with PBI were randomly assigned to home exercise consisting of kicking and treadmill stepping or a no-training control condition. Development was assessed at 2, 4, 6, 10, and 12 months CA with the Alberta Infant Motor Scale (AIMS). At 12 months children were classified as normal, delayed, or with cerebral palsy (CP). Results At 12 months CA 3 of 7 (43%) of the exercise group children walked alone or with one hand held versus 1 of 9 (11%) in the control group (p=.262), but no significant differences in AIMS scores were found at any age. Half of the subjects had CP or delay; the outcomes of these infants were not improved by exercise. Compliance with the home program was lower than requested and may have affected results. Conclusion Although not statistically significant with a small sample size, self-produced kicking and treadmill exercise may lower age at walking in infants with normal development following PBI, but improvements of the protocol to increase and document compliance are needed before a larger study is implemented.

Means ranged from 49 (standard deviation = 15) at 34-35 weeks' postconceptional age through 120 (standard deviation = 16) at 16-17 weeks after term. High-risk infants scored significantly lower than other infants (beta = -0.133, P < 0.0001). Latino infants scored lower than infants of all other ethnicities (beta = -0.052, p < 0.006). Performance did not differ by sex. CONCLUSIONS/CLINICAL IMPLICATIONS: These standards for performance on the TIMP can be used to identify infants with delayed motor development.

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Purpose Describe behavior of children with periventricular brain injury (PBI) in a tethered-kicking intervention. Methods Sixteen infants with PBI were randomly assigned to exercise or no-training in a longitudinal pilot study. Frequency of leg movements and inter-limb coordination were described from videos at 2 and 4 months corrected age (CA). Results Eight of 13 children (62%) with longitudinal data increased the frequency of leg movements while tethered to a mobile between 2 and 4 months CA. Movement frequency was correlated with scores on the Test of Infant Motor Performance, but there were no differences between experimental groups. Children with typical development at 12 months CA increased the proportion of leg movements that were synchronous between 2 and 4 months as did a child with cerebral palsy in the experimental group. Conclusion The tethered-kicking intervention facilitates movement in infants with PBI but effects on development remain to be demonstrated.