Article

AIM: To systematically review the predictive validity of spontaneous early infant
movements for later cerebral palsy (CP). METHOD: Cohort studies with published
data to calculate predictive validity of early spontaneous movements for later CP
were searched in four electronic databases: CINAHL, Embase, MEDLINE, and PsycINFO. RESULTS: Forty-seven studies met inclusion criteria. The Prechtl
General Movements Assessment (GMA) during the fidgety period (10-20wks corrected
age) had the strongest sensitivity: 97 per cent (95% confidence interval [CI]
93-99) and specificity: 89% (95% CI 83-93). The sensitivity and specificity of
the Prechtl GMA during the writhing period (birth-6wks) was 93% (95% CI 86-96)
and 59% (95% CI 45-71) respectively. Cramped-synchronized movements in the
writhing period according to Prechtl had the best specificity (sensitivity: 70%
[95% CI 54-82]; specificity: 97% [95% CI 74-100]). Hadders-Algra's method of
assessing general movements had a pooled sensitivity and specificity of 89% (95%
CI 66-97) and 81% (95% CI 64-91) respectively. Presence of asymmetric postures
and movement quality/quantity were reported under the Hammersmith Infant
Neurological Examination, Hammersmith Neonatal Neurological Examination, and
Movement Assessment of Infants but had weak associations with later CP.
INTERPRETATION: Fidgety movements assessed by the Prechtl GMA have the strongest
predictive validity for later CP, but cannot be considered in isolation because
of the presence of false positive results. WHAT THIS PAPER ADDS: Fidgety general
movements (Prechtl) are most predictive for later cerebral palsy compared with
other spontaneous movements. False positive results are high among all
spontaneous movement assessments.
CI - (c) 2018 Mac Keith Press.

Langue : ANGLAIS