Cerebral palsy in children: Movements and postures during early infancy, dependent on preterm vs. full term birth

Abstract

BackgroundA deviant motor behaviour at age 3 to 5 months is predictive of cerebral palsy (CP). Particular features of the early motor repertoire even proved predictive of the degree of functional limitations as classified on the Gross Motor Function Classification System (GMFCS) in children with CP, born preterm.AimsWe aimed to determine whether an association between the early motor repertoire and the GMFCS also holds true for children born at term.Study designLongitudinal study.Subjects79 infants (60 boys and 19 girls; 47 infants born at term; video recorded for the assessment of movements and posture at age 9 to 20 weeks postterm age) who developed CP.Outcome measuresThe GMFCS was applied at age 2 to 5 years.ResultsMotor optimality at age 3 to 5 months showed a significant correlation with functional mobility and activity limitation as classified on the GMFCS at age 2 to 5 years in both children born at term (Spearman rho = − 0.66, p < 0.001) and born preterm (rho = − 0.37, p < 0.05). Infants born preterm were more likely to show normal movement patterns than infants born at term. A normal posture and an abnormal, jerky (yet not monotonous) movement character resulted in better levels of function and mobility. With the exception of one, none of the infants showed fidgety movements. A cramped-synchronised movement character, repetitive opening and closing of the mouth, and abnormal finger postures characterised children who would show a poor self-mobility later.ConclusionsAssessing the quality of motor performance at 9 to 20 weeks postterm age (irrespective of the gestational age) improves our ability to predict later functional limitations in children with CP.

Fidgety movements – tiny in appearance, but huge in impact

“…37---39 A crampedsynchronized movement character, repetitive opening and closing of the mouth, repetitive kicking, and abnormal finger postures characterized children who would later demonstrate poor self-mobility. 30,34 Sporadic FMs (score: F+/−) FMs are confined to a few body parts and never last longer than 3 s (median: 1 s). There is no evidence that occasional isolated fidgety bursts (from 9 to 16 weeks post term age) indicate, for example, a milder type of CP.…”

Finger movement at birth in brachial plexus birth palsy

“…There are numerous reports in the literature relating finger movements to brain region and brain damage [18][19][20][21][22] , stroke [23][24][25] , cerebral palsy [26][27][28] , Parkinson's disease [29,30] , carpal tunnel syndrome [31,32] , traumatic injury [21,[33][34][35][36][37] . However, there are only few reports correlating finger movements and obstetric brachial plexus injury [2,38] and hand injuries, despite the hands are important in performing daily activities [36] .…”

Interacciones tempranas madre-niño y predicción de desarrollo motor mediante ecuaciones estructurales: Aplicación del modelo en niños con riesgo de daño neurológico perinatal

“…Existen investigaciones que han mostrado el valor predictivo del desarrollo motor en poblaciones con diversos riesgos biológicos (Chen, Lo & Heathcock, 2013;Evensen, Skranes, Brubakk & Vik, 2009;Jackson et al, 2012;Yuge et al, 2011;Zanudin et al, 2013). Asimismo, estudios que han evaluado la calidad de los movimientos observados durante los primeros meses de vida en niños prematuros han reportado que representan un factor predictivo de alteraciones en el de sarrollo en la edad escolar (Bruggink, Van Braeckel, & Bos, 2010;Butcher et al, 2009;Yang et al, 2012). Estas expresiones tempranas de organización motora han permitido probar el valor predictivo de diversas escalas que evalúan el desarrollo motor en po blaciones de riesgo (Flegel & Kolobe, 2002;Harris, Backman & Mayson, 2010;Spittle, Boyd, Inder & Doyle, 2009;Spittle, Doyle & Boyd, 2008).…”