Article

Abnormal general movements at around 3 months corrected age indicate a high
risk of cerebral palsy (CP). We aimed to determine whether specific movement
characteristics can improve the predictive power of definitely abnormal general
movements. METHOD: Video recordings of 46 infants with definitely abnormal
general movements at 9 to 13 weeks corrected age (20 males; 26 females; median
gestational age 30wks; median birthweight 1200g) were analysed for the following
characteristics: presence of fidgety, cramped synchronized, stiff, or jerky
movements and asymmetrical tonic neck reflex pattern. Neurological condition
(presence or absence of CP), gross motor development (Alberta Infant Motor
Scales), quality of motor behaviour (Infant Motor Profile), functional mobility
(Pediatric Evaluation of Disability Inventory), and Mental Developmental Index
(Bayley Scales) were assessed at 18 months corrected age. Infants were excluded
from participating in the study if they had severe congenital anomalies or if
their caregivers had an insufficient knowledge of the Dutch language. RESULTS: Of
the 46 assessed infants, 10 developed spastic CP (Gross Motor Function
Classification System levels I to V; eight bilateral spastic CP, two unilateral
spastic CP). The absence of fidgety movements and the presence of predominantly
stiff movements were associated with CP (Fisher's exact test, p=0.018 and p=0.007
respectively) and lower Infant Motor Profile scores (Mann-Whitney U test, p=0.015
and p=0.022 respectively); stiff and predominantly stiff movements were
associated with lower Alberta Infant Motor Scales scores (Mann-Whitney U test,
p=0.01 and p=0.004 respectively). Cramped synchronized movements and the
asymmetrical tonic neck reflex pattern were not related to outcome. None of the
movement characteristics were associated with Pediatric Evaluation of Disability
Inventory scores or the Mental Developmental Index. INTERPRETATION: The
assessment of fidgety movements and movement stiffness may improve the predictive
power of definitely abnormal general movements for developmental outcome.
However, the presence of fidgety movements does not preclude the development of
CP.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2011 Mac Keith
Press.

Langue : ANGLAIS