Analysis of Grip Strength in Preterm children and its Impact on Fine Motor Skills at 3-5 Years

Preterm infants are defined as those born before 37 weeks of completed pregnancy or less than 259 days; an estimated 15 million babies are born early every year.1 Approximately 1 million children die each year due to complications of preterm birth, other survivors face a lifetime of disability, including learning disabilities and visual and hearing problems.2.The extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (ELBW) (< 1000 grams) remain at high risk for death and disability with 30–50% mortality and, in survivors, at least 20–50% risk of morbidity with delayed motor development due to impaired brain growth particularly they have white matter injury causing subtle changes in oligodendrocytes which is carried over to later years.3,4When compared with full-term infants, preterm children have the prevalence of abnormal fine motor scores which are especially crucial in 3-5 years as it helps in handwriting for academic purposes and self-care in activities of daily life.5 Delay in fine motor skills causes increased dependency on parents and caregivers.6 While the primary development of muscle tissue occurs prior to birth, differentiation of muscle fibers is considered incomplete until 40 weeks post conception.7 Preterm children have incomplete development in muscular tissue and extremity flexor tone. These immature musculoskeletal developments produce maturation-related hypotonia which contributes to the vulnerability of postural and skeletal malalignment 8which leads to reduced force production by the muscles against gravity9. Fine Motor development, does not appear as gross motor activities, it is solely by the infant’s biological maturity. Infants born at very early gestational ages exhibit significant differences in their fine motor development compared with their normal counterparts. 10Adequate muscular strength of the hands and fingers is required for effective fine motor development11. Hand function develops mainly at 3-5 years where the demand is more12.So to quantify grip strength Martin Vigorimeter is used 13 and it is correlated with fine motor skills through Peabody developmental motor scale assessment.14