Efficient trunk control is crucial in infant motor development when infants first learn how to move against gravity. Traditional assessments of trunk control commonly treat the trunk as one unit but the Segmental Assessment of Trunk Control (SATCo) assesses trunk control segment by segment. Good reliability and validity of the SATCo have been proved in children with neuro-disability but not yet validated in young infants. The present study was to examine if the SATCo was reliable, valid and responsive for infants aged 4 to 9 months. Infants born at full-term and at less than 30 weeks of gestation were recruited and assessed using the SATCo monthly from 4 to 9 months of age (corrected for prematurity). Intra-class correlation coefficients (ICC) were used to examine intra- and inter-rater reliability between 2 raters. The ability of the SATCo to demonstrate differences between the full-term and preterm infants was examined using the Mann Whitney U test. The responsiveness of the SATCo on the full-term infants was tested using the Friedman test. Twenty full-term (mean gestation = 38.7 weeks; birthweight = 3019.9 g) and 20 preterm infants (mean gestation = 27.2 weeks; birthweight = 989.6 g) were recruited. The intra and inter-rater reliability of the SATCo levels on full-term infants was good (all ICC > 0.75), except inter-rater reliability at 6 months. The preterm infants scored significantly lower in reactive trunk control at 8 months (Mann Whitney U = 102.0, p = 0.016) but this was the only difference noted. A significant developmental trend was shown in the static, active and reactive trunk control of the full-term infants (Chi-square = 81.4, 75.6 and 79.5 respectively, all p < 0.001. The SATCo was reliable and responsive in assessing trunk control in young infants aged from 4 to 9 months. Care should be exercised when testing infants aged 5 to 6 months, who are more likely to use subtle hand support, and for those who have already achieved independent sitting. The SATCo could differentiate the reactive trunk control between the full-term and preterm infants at 8 months but not earlier. Psychometric properties of the SATCo in infants with motor disorders requires further investigation.

Full trunk control in sitting is demonstrated only when the head-trunk are aligned and upper limbs remain free of contact from mechanical support. These components represent a Controlled Kinetic Chain and can be evaluated in people with neuromotor disability using the Segmental Assessment of Trunk Control (SATCo) when a therapist provides manual trunk support at different segmental levels. However, the SATCo, as with other clinical assessments of control, is subjective. The SATCo was translated to objective rules relating the position of the hands and elbows to the head-trunk and then tested to determine the extent to which this automated objective method replicated the clinical judgement. Clinical evaluation used video to determine whether the upper limb was free of mechanical support while the objective evaluation used 3D motion capture of the trunk and upper limbs with a classification rule. The agreement between clinical and objective classification was calculated for three conditions of a distance-from-support-surface threshold parameter in five healthy adults and five children with cerebral palsy. The unfitted (zero-threshold values) method replicated the clinical judgement in part (68.26%±15.7, adults, 48.3%±33.9 children). The fitted (level-of-support determined) agreement showed that the process could be refined using trial specific parameters (88.32%±5.3 adults, 89.84%±10.2 children). The fixed-values agreement showed high values when using general group parameters (80.80%±3.1 adults, 74.31%±21.5 children). This objective classification of the upper limb component of trunk control largely captures the clinical evaluation. It provides the first stages in development of a clinically-friendly fully automated method.

Objective: To examine the feasibility and practicality of whole body vibration therapy for individua...

Aim: To test sensitivity of the Segmental Assessment of Trunk Control (SATCo) to changes in neutral vertical (NV) head and trunk control in children with neuromuscular disorders (NMD) and compared with typically developing (TD) children. Methods: In this observational cross-sectional study, SATCo was applied in 19 children with NMD (10y6m(3y7m), 2 female) and 19 TD children (7y10m(4y12m), 6 female). Statistical differences between condition (NMD and TD), segment (seven trunk segments), and control type (static, active, and reactive control), and relationship between age and SATCo outcomes were analysed with linear mixed-effects models (LME). Results: SATCo scores were measurably different between conditions (F _(1,39.6) =151.0,p<.001), segments (F _(6,138.3) =23.3,p<.001), control type (F _(2,33.0) =6.3,p=.005), and interactions condition segment (F _(6,138.3) =23.3,p<.001) and condition control type (F _(2,33.0) =6.3,p=.005). A significant relationship between decreasing active control and increasing age in 10 children with Duchenne muscular dystrophy confirmed measurable decline in trunk control following diagnosis. Interpretation: The results showed that SATCo is sensitive to differences in trunk control status in NMD. While still ambulatory, children with NMD presented already a measurable trunk control deficit at varying segments. SATCo has potential as an outcome measure for therapeutic interventions or effectiveness of treatments promoting NV trunk control in children with NMD and needs further study. What this paper adds: Neutral vertical head/trunk control was different between NMD and TD children SATCo is sensitive to head/trunk control differences between NMD and TD children Ambulant children with NMD showed measurable head/trunk control deficit at various segments SATCo detected subtle head/trunk control changes in early disease stages of NMD Active segmental trunk control declines with increasing age in Duchenne muscular dystrophy

Aim: To investigate whether children with various spinal muscular atrophy (SMA) subtypes treated with disease-modifying therapies (DMT) obtain neutral vertical (NV) head and trunk control, and how this relates to motor function. Method: In this observational cross-sectional study, a convenience sample of 21 children diagnosed with SMA (6y1m (4y), 10 female) was tested with Segmental Assessment of Trunk Control (SATCo) and functional assessments. A linear mixed-effects model (LME) was used for statistical analysis. Results: SATCo scores were measurably different between condition (types of SMA), F=4.96, p<.05, and control type (static, active, and reactive control), F=6.40, p<.05. The interaction condition*control type was also significant, F=3.14, p<.05. No child with SMA1 demonstrated NV head control and there was no relationship between SATCo scores and motor function. Four children with SMA2 and SMA3 demonstrated NV head static control, and one demonstrated NV mid-thoracic static control. Interpretation: The results indicate that children with SMA treated with DMTs acquire very little or no unsupported NV head/trunk control. SATCo was shown to be sensitive to differences in trunk control in different types of SMA revealing potential as an outcome measure for therapeutic interventions or treatment effectiveness. Further studies are needed to clarify this potential.