Early motor repertoire is related to level of self‐mobility in children with cerebral palsy at school age

Bruggink, Janneke L M; Cioni, Giovanni; Einspieler, Christa; Maathuis, Carel G. B.; Pascale, Rosa M.; Bos, Arend F.

doi:10.1111/j.1469-8749.2009.03294.x

Cited by 65 publications

(84 citation statements)

References 34 publications

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“…Values of all variables were lower in children with non-ambulatory CP than in children with ambulatory CP, reflecting the variation in the centroid of motion (centroid of motion standard deviation, acceleration standard deviation, and velocity standard deviation). Recent findings of an association between a cramped movement character in combination with non-flat posture and later low self-mobility 23 would be in accordance with low quantity of motion and velocity standard deviation values in children who later develop non-ambulatory CP. This might be a result of a less variable movement pattern in infants with a cramped movement pattern.…”

Section: Discussionsupporting

confidence: 58%

Early prediction of cerebral palsy by computer‐based video analysis of general movements: a feasibility study

Adde

Helbostad

Jensenius

et al. 2010

Develop Med Child Neuro

111

162

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AIM The aim of this study was to investigate the predictive value of a computer-based video analysis of the development of cerebral palsy (CP) in young infants.METHOD A prospective study of general movements used recordings from 30 high-risk infants (13 males, 17 females; mean gestational age 31wks, SD 6wks; range 23-42wks) between 10 and 15 weeks post term when fidgety movements should be present. Recordings were analysed using computer vision software. Movement variables, derived from differences between subsequent video frames, were used for quantitative analyses. CP status was reported at 5 years.RESULTS Thirteen infants developed CP (eight hemiparetic, four quadriparetic, one dyskinetic; seven ambulatory, three non-ambulatory, and three unknown function), of whom one had fidgety movements. Variability of the centroid of motion had a sensitivity of 85% and a specificity of 71% in identifying CP. By combining this with variables reflecting the amount of motion, specificity increased to 88%. Nine out of 10 children with CP, and for whom information about functional level was available, were correctly predicted with regard to ambulatory and non-ambulatory function.INTERPRETATION Prediction of CP can be provided by computer-based video analysis in young infants. The method may serve as an objective and feasible tool for early prediction of CP in highrisk infants.Cerebral palsy (CP) is a permanent disorder in the development of movement and posture in the developing fetal or infant brain 1 and is one of the major disabilities that result from extremely preterm birth. [2][3][4] The utility of predictive assessment tools in young infants is limited by the need for expensive equipment and highly experienced personnel, as well as low accuracy. Although the primary insult(s) cannot be repaired, early identification of CP enables intervention to be instituted while the plasticity of the nervous system is high. [5][6][7][8] Early identification may also lead to more focused follow-up and reassure the parents of those children who are unlikely to develop CP.In young infants, neurological damage is typically expressed by means of generalized and non-specific dysfunction. 9 The General Movement Assessment (GMA), based on systematic observation of infants' spontaneous movements from video recordings, has been shown to predict CP with high accuracy. 10,11 The absence of fidgety movements at 2 to 4 months corrected age may identify infants who will develop CP with more than 90% sensitivity. 10,[12][13][14] Although the GMA has been demonstrated to predict CP with high accuracy, it depends on highly experienced observers, and its use in clinical practice is limited. 12,15,16 A software program developed within the Max/MSP/Jitter environment for analysing music-related movements in musicians and dancers 17 has recently been customized for the purpose of studying fidgety movements. Using the customized software, movement variables have been demonstrated to identify infants with fidgety movements with high accuracy. 18 The aim of...

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Section: Discussionsupporting

confidence: 58%

Early prediction of cerebral palsy by computer‐based video analysis of general movements: a feasibility study

Adde

Helbostad

Jensenius

et al. 2010

Develop Med Child Neuro

111

162

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“…Fifty percent of the infants scored between 10 and 13, which is significantly lower than infants with a normal neurological outcome and higher than infants who were later diagnosed with cerebral palsy. So far, two studies carried out in children with cerebral palsy in China, Italy, and the Netherlands demonstrated the lower the MOS at 3–5 months, the more severely limited their gross motor function (Bruggink et al, 2009, Yang et al, 2012). As we intend to monitor our sample of children with Down syndrome for at least 2 more years, we shall also assess the relation between the MOS and the motor, cognitive and language outcomes.…”

Section: Discussionmentioning

confidence: 99%

The motor repertoire in 3- to 5-month old infants with Down syndrome

Herrero

Einspieler

Aizawa

et al. 2017

Research in Developmental Disabilities

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BackgroundEven though Down syndrome is the most common chromosomal cause of intellectual disability, studies on early development are scarce.AimTo describe movements and postures in 3- to 5-month-old infants with Down syndrome and assess the relation between pre- and perinatal risk factors and the eventual motor performance.Methods and proceduresExploratory study; 47 infants with Down syndrome (26 males, 27 infants born preterm, 22 infants with congenital heart disease) were videoed at 10–19 weeks post-term (median = 14 weeks). We assessed their Motor Optimality Score (MOS) based on postures and movements (including fidgety movements) and compared it to that of 47 infants later diagnosed with cerebral palsy and 47 infants with a normal neurological outcome, matched for gestational and recording ages.Outcomes and resultsThe MOS (median = 13, range 10–28) was significantly lower than in infants with a normal neurological outcome (median = 26), but higher than in infants later diagnosed with cerebral palsy (median = 6). Fourteen infants with Down syndrome showed normal fidgety movements, 13 no fidgety movements, and 20 exaggerated, too fast or too slow fidgety movements. A lack of movements to the midline and several atypical postures were observed. Neither preterm birth nor congenital heart disease was related to aberrant fidgety movements or reduced MOS.Conclusions and implicationsThe heterogeneity in fidgety movements and MOS add to an understanding of the large variability of the early phenotype of Down syndrome. Studies on the predictive values of the early spontaneous motor repertoire, especially for the cognitive outcome, are warranted.What this paper addsThe significance of this exploratory study lies in its minute description of the motor repertoire of infants with Down syndrome aged 3–5 months. Thirty percent of infants with Down syndrome showed age-specific normal fidgety movements. The rate of abnormal fidgety movements (large amplitude, high/slow speed) or a lack of fidgety movements was exceedingly high. The motor optimality score of infants with Down syndrome was lower than in infants with normal neurological outcome but higher than in infants who were later diagnosed with cerebral palsy. Neither preterm birth nor congenital heart disease were related to the motor performance at 3–5 months.

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“…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.…”

Section: Normal Fmsmentioning

confidence: 99%

Fidgety movements – tiny in appearance, but huge in impact

Einspieler

Peharz

Marschik

2016

Jornal de Pediatria

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131

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Abnormal, absent, or sporadic FMs indicate an increased risk for later neurological dysfunction, whereas normal FMs are highly predictive of normal development, especially if they co-occur with other smooth and fluent movements. Early recognition of neurological signs facilitates early intervention. It is important to re-assure parents of infants with clinical risk factors that the neurological outcome will be adequate if FMs develop normally.

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Early motor repertoire is related to level of self‐mobility in children with cerebral palsy at school age

Cited by 65 publications

References 34 publications

Early prediction of cerebral palsy by computer‐based video analysis of general movements: a feasibility study

Early prediction of cerebral palsy by computer‐based video analysis of general movements: a feasibility study

The motor repertoire in 3- to 5-month old infants with Down syndrome

Fidgety movements – tiny in appearance, but huge in impact

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