310 Impact of specialist developmental physiotherapy input in gross motor skills of those babies born with congenital diaphragmatic hernia
Bibliographic record
Abstract
Objectives Surgery for major birth defects during the neonatal stage of life frequently leads to delay in attainment of early developmental skills. Survivors of congenital diaphragmatic hernia (CDH) have a high level of morbidity with neurodevelopmental disability being the most common. Critical illness such as CDH and long-term hospitalisation may affect later neurodevelopment. Many infants with CDH require long-term ventilation, sedation, and the use of muscle relaxants. At our neonatal unit, in addition to inpatient therapies to enhance flexed posture overcoming abdominal weakness, physiotherapy assessment and advice continues in a multidisciplinary (MDT) dedicated outpatient clinic consisting of neonatologists, paediatric surgeons, physiotherapists and speech and language therapists. Methods The Alberta Infant Motor Scale is an observational tool which assesses an infant’s gross motor skills in four different positions: supine, prone, sitting and standing. It was used in a 6-year cohort of 46 infants affected by CDH, followed up and supported in our MDT clinic, at various points between 4 to 24 months of age. The scores were then used to guide physiotherapy input including specific exercises, advice on positioning, play and assisting transitions. Results Progression in AIMS were plotted and subject to a logistic regression with P scores of 0.005 to 0.49 and R squared of 0.26 to 1.0 demonstrating that AIMS as a screening tool for gross motor delay and subsequent physiotherapy intervention improved attainment of gross motor skills. Figure 1 shows this progression was most marked in those affected by larger defects (type C & D). Conclusions Advice on early positioning, play and support with transitions are shown to improve gross motor delay in our patients as shown by sustained improvement in their observational scores.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".