Does a detailed assessment of poor repertoire general movements help to identify those infants who will develop normally?

• Published in: Early human development Vol. 82; no. 1; pp. 53 - 59
• Main Authors: Nakajima, Yayohi, Einspieler, Christa, Marschik, Peter B., Bos, Arend F., Prechtl, Heinz F.R.
• Format: Journal Article
• Language: English
• Published: Lausanne Elsevier Ireland Ltd 2006; New York,NY Elsevier; Amsterdam The Lancet Publishing Group, a division of Elsevier Science Ltd
• Subjects: Biological and medical sciences; Brain diseases; Cerebral Palsy - diagnosis; Cerebral Palsy - physiopathology; Child; Child Development - classification; Child Development - physiology; Embryology: invertebrates and vertebrates. Teratology; Female; Fidgety movements; Fundamental and applied biological sciences. Psychology; Health aspects; Humans; Infant; Infant, Newborn; Infant, Premature - physiology; Infants; Male; Motor Activity - physiology; Movement - physiology; Neurologic Examination; Neurological outcome; Prediction; Predictive Value of Tests; Preterm infant; Qualitative assessment; Risk factors; Videotape Recording; United States; Qualitative assessment; Preterm infant; Fidgety movements; PVL; Prediction; IVH; GMs; Neurological outcome; Human; Prematurity; Infant
• DOI: 10.1016/j.earlhumdev.2005.07.010
• ISSN: 0378-3782

The assessment of the quality of general movements (GMs) in young infants is a reliable and valid diagnostic tool for detecting brain dysfunction early in life. Poor repertoire GMs are the most frequently observed abnormal GMs during the preterm, term and early postterm period. However, their predictive value for the neurological outcome is low. To find out whether a detailed scoring of poor repertoire GMs might lead to a better prediction of the neurological outcome. We studied 18 preterm infants who were repeatedly videoed from birth to 22 weeks postterm age, including several recordings assessed as poor repertoire GMs. At 8 to 10 years, six children were neurologically normal, six had mild neurological abnormalities, and the remaining six were classified as cerebral palsy. Each GM globally assessed as poor repertoire was scored in details according to several aspects of neck and trunk, arm and leg movements applying Prechtl's optimality concept. By and large, the detailed score of poor repertoire GMs was not related to the neurological outcome. For the clinical application of the GM assessment, it remains important to assess the fidgety movements of those infants with poor repertoire GM trajectories in order to predict their outcome.