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Cole et al. showed that walking is adversely affected by the wearing of disposable diapers. They reported that infants wearing diapers displayed less mature gait patterns and made more missteps and falls.
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Read More »The present study is the first to demonstrate that we can allow infants to move their lower limbs more freely by making both the waist and crotch belts of diapers narrower than those presently used but not by just making the waist belt narrower. The data indicate that wearing a diaper with a normal shape may restrict the lower-limb movements of young infants. Figure 1b,c demonstrate that the values of velocity of lower limb movements and the trajectory area of knee movement in sagittal plane of infants wearing Normal diapers were significantly lower than for infants in Naked condition, suggesting that infants in Naked condition moved their legs more freely compared to when wearing Normal diapers. Furthermore, the value of the trajectory area of knee movement in sagittal plane in Type A condition was significantly lower than that in Naked condition, suggesting that the crotch width of the diaper affects the range of the infant’s lower limb movements. The present results also suggest that the diaper waistband width interacted with the diaper crotch width to affect the spontaneous movements of the lower limbs of young infants. Figure 1c demonstrates that the trajectory area of knee movement in sagittal plane of infants wearing Type B diapers was significantly greater than that of infants wearing Normal diapers. Normal diapers and Type B diapers differ in waistband width (Normal = 100 mm, Type B = 50 mm) and crotch width (Normal = 200 mm, Type B = 120 mm). In contrast, despite there being a difference in waistband width between Normal and Type A diapers, no significant difference in any of the parameters (the velocity of lower limb movements, the trajectory area of knee movement in the sagittal plane and the frontal plane, the distance between both knees and between side of abdomen and knee, and correlation of velocities between side of abdomen and knee and between left and right ankles) was detected between infants in Normal and Type A diapers (Fig. 1b–g), suggesting that waistband width alone does not affect the movement of the lower limbs of infants. Consistent with the present study, previous studies have reported that the shape of diapers plays an important role in the development of spontaneous movements of the lower limbs (antigravity limb movements) of young infants. Cole et al.13 showed that walking is adversely affected by the wearing of disposable diapers. They reported that infants wearing diapers displayed less mature gait patterns and made more missteps and falls. Groenen et al.35 reported that not only diapers but also clothing can affect the frequency and quality of young infants’ movement. In these studies, the influence of diaper wearing and shape on the movement characteristics of infants was evaluated using data on walking and steps. It is difficult to directly compare the results of these studies with our research. However, previous studies showed that the quantity of kicking movements in infancy was related to the age at which infants began to walk3,6, and indicated that there was less exploratory behavior of legs in infants at risk of developmental delay compared to infants with typical development8. The difference between diaper type in the amount (the velocity) and range (the trajectory area of knee movements in sagittal plane) of lower limb movements in the supine position in early infancy shown in this study may possibly affect walking characteristics. The present study supports a possibility that more advanced design of infant clothing, including diapers, may contribute to more proper development of body movements of young infants. It is important to note that the findings of the present study are limited. We have demonstrated a difference in one of the parameters of lower limb spontaneous movements between the Type B and Normal diaper condition, but we did not detect any difference in the other parameters of lower limb movements among the Type A, Type B, and Normal diaper conditions (Fig. 1b–g).
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Read More »Our findings may be insufficient to conclude that the results of the present study will lead us to be able to determine better clothing designs for infants that do not hinder their spontaneous and natural body movements. However, even with its limited results, the present study indicates that diaper design has a significant effect at least on the trajectory area of knee movement in the sagittal plane - a probable indicator of the range of lower leg lifting movements and proximity of these movements to the trunk. The extent to which such movement reflects the amount of kicking in the lower limbs needs further study, but it has also been reported that the development of antigravity movements are critical for infants as they promote exploration activities of the form of their body, and increase sensory-motor experiences such as hand-foot contact (double touch), which are important as a basis for later motor development9,28,30. As diaper design can influence such movements, it seems possible that careful design of infant clothing, including diapers, may contribute to more proper development of the body movements of young infants. Adjustment of diaper shape could potentially be utilized for not only preterm infants, but also for term infants who happen to have insufficient antigravity limb movements in early infancy. Miyagishima et al.28 reported that antigravity limb movements in preterm infants within the first 3 months of corrected age were insufficient compared with those in term infants, and no improvement in development was observed in preterm infants within those first 3 months. They also showed that gross motor development at 6 and/or 12 months corrected age was delayed in infants who had insufficient antigravity limb movements in early infancy30. We also acknowledge that this study may not include all possible parameters which might significantly reflect lower limb movements in infants. However, this study has demonstrated that the combined effects of narrower waist and crotch belts can affect infants’ lower limb movements in terms of trajectory area. In future research, it will be beneficial to identify other parameters such as other movements related to hip joint movements which may affect infants’ lower limb movements by utilizing more sophisticated three-dimensional data. In addition, this study does not evaluate how strongly the shape of diapers affects the postnatal development of the lower limb movement of older infants since we only assessed the movement at the one developmental stage of approximately 3 months of age and not later developmental stages. Also, because of the relatively small sample size (n = 27), this study did not fully perform analysis on sex difference in the parameters. Although the study population is also well-balanced between boys (n = 14) and girls (n = 13), a study population with a larger sample size will be required to make a satisfactory statistical analysis of the effect of sex difference on the parameters in a future study.
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