Skip to main content
Top
Published in: European Journal of Pediatrics 12/2017

01-12-2017 | Original Article

The association between infantile postural asymmetry and unsettled behaviour in babies

Authors: Julie Ellwood, Michael Ford, Alf Nicholson

Published in: European Journal of Pediatrics | Issue 12/2017

Login to get access

Abstract

Unsettled infant behaviour is a common problem of infancy without known aetiology or clearly effective management. Some manual therapists propose that musculoskeletal dysfunction contributes to unsettled infant behaviour, yet reported improvement following treatment is anecdotal. The infantile postural asymmetry measurement scale is a tool which measures infantile asymmetry, a form of musculoskeletal dysfunction. The first part of the study aimed to investigate its reliability and validity for measuring infantile postural asymmetry. This study also aimed to investigate whether there was an association between infantile postural asymmetry and unsettled infant behaviour and whether an association was mediated by, or confounded with, the demographic variables of age, sex, parity, birth weight and weight gain in 12- to 16-week-old infants. Fifty-eight infants were recruited and a quantitative cross-sectional observational design was used. An association between unsettled behaviour and infantile postural asymmetry was not found. A significant difference between high and low cervical rotation deficit groups for surgency was detected in female babies and needs further examination.
Conclusion: Questions remain regarding the construct validity of the infantile postural asymmetry scale. No association between unsettled infant behaviour and infantile postural asymmetry was found in 12- to 16-week-old infants. The influence of sex on the interaction between infantile postural asymmetry and infant behaviour needs further examination. An association between unsettled infant behaviour and infantile postural asymmetry is still unproven.
What is known:
Unsettled infant behaviour has a considerable impact on many family situations.
Identifying a definitive cause has been a source of much examination and research. Many different hypotheses have been suggested yet much is still unknown.
What is new:
The association between unsettled infant behaviour and infantile postural asymmetry is still unproven.
The need to validate a reliable tool to measure infantile postural asymmetry, with particular focus on cervical spine rotation deficit, is indicated.
Literature
1.
go back to reference Douglas PS, Mares RE, Hill PS (2012) Interdisciplinary perspectives on the management of the unsettled baby: key strategies for improved outcomes. Aust J Prim Health 18(4):332–338PubMed Douglas PS, Mares RE, Hill PS (2012) Interdisciplinary perspectives on the management of the unsettled baby: key strategies for improved outcomes. Aust J Prim Health 18(4):332–338PubMed
2.
go back to reference McCallum SM, Rowe HJ, Gurrin L, Quinlivan J, Fisher JR (2011) Unsettled infant behaviour and health service use: a cross-sectional community survey in Melbourne, Australia. J Paediatr Child Health 47(11):818–823CrossRefPubMed McCallum SM, Rowe HJ, Gurrin L, Quinlivan J, Fisher JR (2011) Unsettled infant behaviour and health service use: a cross-sectional community survey in Melbourne, Australia. J Paediatr Child Health 47(11):818–823CrossRefPubMed
3.
go back to reference Morris S, St James-Roberts I, Sleep J, Gillham P (2001) Economic evaluation of strategies for managing crying and sleeping problems. Arch Dis Child 84(1):15–19CrossRefPubMedPubMedCentral Morris S, St James-Roberts I, Sleep J, Gillham P (2001) Economic evaluation of strategies for managing crying and sleeping problems. Arch Dis Child 84(1):15–19CrossRefPubMedPubMedCentral
4.
go back to reference Jung M, Landenberger M, Jung T, Lindenthal T, Philippi H (2017) Vojta therapy and neurodevelopmental treatment in children with infantile postural asymmetry: a randomised controlled trial. J Phys Ther Sci 29:301–306CrossRefPubMedPubMedCentral Jung M, Landenberger M, Jung T, Lindenthal T, Philippi H (2017) Vojta therapy and neurodevelopmental treatment in children with infantile postural asymmetry: a randomised controlled trial. J Phys Ther Sci 29:301–306CrossRefPubMedPubMedCentral
6.
go back to reference van Vlimmeren LA, Helders PJM, van Adrichem LNA, Engelbert RHH (2004) Diagnostic strategies for the evaluation of asymmetry in infancy: a review. Eur J Pediatr 163:185–191CrossRefPubMed van Vlimmeren LA, Helders PJM, van Adrichem LNA, Engelbert RHH (2004) Diagnostic strategies for the evaluation of asymmetry in infancy: a review. Eur J Pediatr 163:185–191CrossRefPubMed
7.
go back to reference Nuysink J, van Haastert IC, Takken T, Helders PJM (2008) Symptomatic asymmetry in the first six months of life: differential diagnosis. Eur J Pediatr 167:613–619CrossRefPubMedPubMedCentral Nuysink J, van Haastert IC, Takken T, Helders PJM (2008) Symptomatic asymmetry in the first six months of life: differential diagnosis. Eur J Pediatr 167:613–619CrossRefPubMedPubMedCentral
8.
go back to reference Stellwagen L, Hubbard E, Chambers C, Lyons Jones K (2008) Torticollis, facial asymmetry and plagiocephaly in normal newborns. Arch Dis Child 93:827–831CrossRefPubMed Stellwagen L, Hubbard E, Chambers C, Lyons Jones K (2008) Torticollis, facial asymmetry and plagiocephaly in normal newborns. Arch Dis Child 93:827–831CrossRefPubMed
9.
go back to reference Kaplan S, Coulter C, Fetters L (2013) Physical therapy management of congenital muscular torticollis: an evidence-based clinical practice guideline: from the section on pediatrics of the American Physical Therapy Association. Pediatr Phys Ther 25(4):348–394CrossRefPubMed Kaplan S, Coulter C, Fetters L (2013) Physical therapy management of congenital muscular torticollis: an evidence-based clinical practice guideline: from the section on pediatrics of the American Physical Therapy Association. Pediatr Phys Ther 25(4):348–394CrossRefPubMed
10.
go back to reference Philippi H, Faldum A, Bergmann H, Jung T, Pabst B, Scheulpen A (2004) Idiopathic infantile asymmetry, proposal of a measurement scale. Early Hum Dev 80:79–90CrossRefPubMed Philippi H, Faldum A, Bergmann H, Jung T, Pabst B, Scheulpen A (2004) Idiopathic infantile asymmetry, proposal of a measurement scale. Early Hum Dev 80:79–90CrossRefPubMed
11.
go back to reference Rubio A, Griffet J, Caci H, Amandine E, Bérard E, El Hayek T, Boutté P (2009) The moulded baby syndrome: incidence and risk factors regarding 1,001 neonates. Eur J Pediatr 168:605–611CrossRefPubMed Rubio A, Griffet J, Caci H, Amandine E, Bérard E, El Hayek T, Boutté P (2009) The moulded baby syndrome: incidence and risk factors regarding 1,001 neonates. Eur J Pediatr 168:605–611CrossRefPubMed
12.
go back to reference Philippi H, Faldum A, Jung T, Bergmann H, Bauer K, Gross D, Spranger J (2006) Patterns of postural asymmetry in infants: a standardised video-based analysis. Eur J Pediatr 165:158–164CrossRefPubMed Philippi H, Faldum A, Jung T, Bergmann H, Bauer K, Gross D, Spranger J (2006) Patterns of postural asymmetry in infants: a standardised video-based analysis. Eur J Pediatr 165:158–164CrossRefPubMed
13.
go back to reference Miller J, Fontana M, Jernlas K, Olofsson H (2013) Risks and rewards of early musculoskeletal assessment: an evidence-based case report. Br J Midwifery 21(10):736–743CrossRef Miller J, Fontana M, Jernlas K, Olofsson H (2013) Risks and rewards of early musculoskeletal assessment: an evidence-based case report. Br J Midwifery 21(10):736–743CrossRef
14.
go back to reference Philippi H, Faldum A, Scheulpen A, Pabst B, Jung T, Bergmann H, Bieber I, Kaemmerer C, Dijs P, Reitter B (2006) Infantile postural asymmetry and osteopathic treatment: a randomized therapeutic trial. Dev Med Child Neurol 48:5–9CrossRefPubMed Philippi H, Faldum A, Scheulpen A, Pabst B, Jung T, Bergmann H, Bieber I, Kaemmerer C, Dijs P, Reitter B (2006) Infantile postural asymmetry and osteopathic treatment: a randomized therapeutic trial. Dev Med Child Neurol 48:5–9CrossRefPubMed
15.
go back to reference Gartstein M, Rothbart MK (2003) Studying infant temperament via the revised infant behavior questionnaire. Infant Behav Dev 26:64–86CrossRef Gartstein M, Rothbart MK (2003) Studying infant temperament via the revised infant behavior questionnaire. Infant Behav Dev 26:64–86CrossRef
16.
go back to reference Putnam S, Helbig A, Gartstein M, Rothbart M, Leerkes E (2014) Development and assessment of short and very short forms of the infant behavior questionnaire—revised. J Pers Assess 96(4):445–458CrossRefPubMed Putnam S, Helbig A, Gartstein M, Rothbart M, Leerkes E (2014) Development and assessment of short and very short forms of the infant behavior questionnaire—revised. J Pers Assess 96(4):445–458CrossRefPubMed
17.
go back to reference Rothbart MK, Ahadi SA, Hershey L, Fisher P (2001) Investigations of temperament at 3–7 years: the Children’s Behavior Questionnaire. Infant Child Dev 72:1394–1408CrossRef Rothbart MK, Ahadi SA, Hershey L, Fisher P (2001) Investigations of temperament at 3–7 years: the Children’s Behavior Questionnaire. Infant Child Dev 72:1394–1408CrossRef
18.
go back to reference Lloyd-Roberts GC, Pilcher MF (1965) Structural idiopathic scoliosis in infancy. J Bone Joint Surg (Br) 47(B):520–523 Lloyd-Roberts GC, Pilcher MF (1965) Structural idiopathic scoliosis in infancy. J Bone Joint Surg (Br) 47(B):520–523
19.
go back to reference Cicchetti DV, Sparrow SA (1981) Developing criteria for establishing interrater reliability of specific items: applications to assessment of adaptive behavior. Am J Ment Defic 86(2):127–137PubMed Cicchetti DV, Sparrow SA (1981) Developing criteria for establishing interrater reliability of specific items: applications to assessment of adaptive behavior. Am J Ment Defic 86(2):127–137PubMed
20.
go back to reference Shamji MF, Fric-Shamji EC, Vassilyadi M (2012) Cosmetic and cognitive outcomes of positional plagiocephaly treatment. Clin Invest Med 35(5):E266–E270CrossRefPubMed Shamji MF, Fric-Shamji EC, Vassilyadi M (2012) Cosmetic and cognitive outcomes of positional plagiocephaly treatment. Clin Invest Med 35(5):E266–E270CrossRefPubMed
21.
go back to reference Putnam SP, Gartstein MA, Rothbart MK (2006) Measurement of fine-grained aspects of toddler temperament: the early childhood behavior questionnaire. Infant Behav Dev 29(3):386–401CrossRefPubMedPubMedCentral Putnam SP, Gartstein MA, Rothbart MK (2006) Measurement of fine-grained aspects of toddler temperament: the early childhood behavior questionnaire. Infant Behav Dev 29(3):386–401CrossRefPubMedPubMedCentral
22.
go back to reference Dixon MA, Cunningham GB (2006) Data aggregation in multilevel analysis: a review of conceptual and statistical issues. Meas Phys Educ Exerc Sci 10(2):85–107CrossRef Dixon MA, Cunningham GB (2006) Data aggregation in multilevel analysis: a review of conceptual and statistical issues. Meas Phys Educ Exerc Sci 10(2):85–107CrossRef
23.
go back to reference Rothwell PM (2005) RCT’s have this paper external validity of randomised controlled trials: “to whom do the results of this trial apply?”. Lancet 365:82–93CrossRefPubMed Rothwell PM (2005) RCT’s have this paper external validity of randomised controlled trials: “to whom do the results of this trial apply?”. Lancet 365:82–93CrossRefPubMed
25.
go back to reference Olafsdottir E, Forshei S, Fluge G, Markestad T (2001) Randomised controlled trial of infantile colic treated with chiropractic spinal manipulation. Arch Dis Child 84(2):138–141CrossRefPubMedPubMedCentral Olafsdottir E, Forshei S, Fluge G, Markestad T (2001) Randomised controlled trial of infantile colic treated with chiropractic spinal manipulation. Arch Dis Child 84(2):138–141CrossRefPubMedPubMedCentral
26.
go back to reference Wilberg JM, Nordsteen J, Nilsson N (1999) The short-term effect of spinal manipulation in the treatment of infantile colic: a randomized controlled clinical trial with a blinded observer. J Manipulative Physi 22(8):517–522CrossRef Wilberg JM, Nordsteen J, Nilsson N (1999) The short-term effect of spinal manipulation in the treatment of infantile colic: a randomized controlled clinical trial with a blinded observer. J Manipulative Physi 22(8):517–522CrossRef
27.
go back to reference McGrath JM, Records K, Rice M (2008) Maternal depression and infant temperament characteristics. Infant Behav Dev 31(1):71–80CrossRefPubMed McGrath JM, Records K, Rice M (2008) Maternal depression and infant temperament characteristics. Infant Behav Dev 31(1):71–80CrossRefPubMed
28.
go back to reference Mower WR (1999) Evaluating bias and variability in diagnostic test reports. Ann Emerg Med 33(1):85–91CrossRefPubMed Mower WR (1999) Evaluating bias and variability in diagnostic test reports. Ann Emerg Med 33(1):85–91CrossRefPubMed
29.
go back to reference Fitzgerald M, Walker S (2009) Infant pain management: a developmental neurobiological approach. Nat Rev Neurol 5:35–50CrossRef Fitzgerald M, Walker S (2009) Infant pain management: a developmental neurobiological approach. Nat Rev Neurol 5:35–50CrossRef
Metadata
Title
The association between infantile postural asymmetry and unsettled behaviour in babies
Authors
Julie Ellwood
Michael Ford
Alf Nicholson
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Pediatrics / Issue 12/2017
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-017-2993-x

Other articles of this Issue 12/2017

European Journal of Pediatrics 12/2017 Go to the issue