Spontaneous movements in the supine position of healthy term infants and preterm infants with or without periventricular leukomalacia

Can Clinical Assessment of Locomotive Body Function Explain Gross Motor Environmental Performance in Cerebral Palsy?

Gross Motor Function Classification System has discriminative purposes but does not assess short-term therapy goals. Locomotion Stages (LS) classify postural body functions and independent activity components. Assessing the relation between Gross Motor Function Classification System level and Locomotion Stages will make us understand if clinical assessment can explain and predict motor environmental performance in cerebral palsy. A total of 462 children were assessed with both scales. High reliability and strong negative correlation (-0.908) for Gross Motor Function Classification System and Locomotion Stages at any age was found. Sensitivity was 83%, and specificity and positive predictive value were 100% within the same age range. Regression analysis showed detailed probabilities for the realization of the Gross Motor Function Classification System depending on the Locomotion Stages and the age group. Postural body function measure with Locomotion Stages is reliable, sensitive, and specific for gross motor function and able to predict environmental performance.

Characterization and intervention for upper extremity exploration & reaching behaviors in infancy

This article aims to: 1) highlight general exploration, reaching, and object exploration behaviors as key activities of daily living in infancy, 2) describe how knowledge of early warning signs for these behaviors may improve early assessment, and 3) discuss interventions that may advance performance of these behaviors. Early intervention should focus on improving performance of these behaviors because: a) these early, interrelated upper extremity behaviors serve an integral role in global learning and development in infancy, b) among at-risk populations, differences have been observed in the quantity and quality of performance of these behaviors and, in many cases, these differences are associated with related perceptual-motor and cognitive delays. This article highlights how early assessment and intervention can target these key early behaviors in populations at risk for upper extremity disabilities, such as those born preterm, with Down syndrome, brachial plexus palsy, or arthrogryposis multiplex congentia.

Developmental Changes in Coordination of Infant Arm and Leg Movements and the Emergence of Function

We conducted a longitudinal kinematic study of spontaneous arm and leg motions in 4 supine infants at 3, 4½, and 6 months of age. The study addressed two questions: (a) whether there was a longitudinal change in the synchronization of joint rotations at the hips, knees, shoulders, and elbows, indicating that the arms and legs were moving more independently of each other; and (b) whether, during this period, the spatial location of the hands relative to the shoulders was different from that of the feet relative to the hips, indicating that the infants were beginning to use their upper limbs differently than their lower limbs. We found that, in general, the arms and legs were moving more independently of each other by 6 months of age. At the same time, the infants were more likely to hold their hands away from the body in preparation for making contact with an object in the midline, but they brought their feet close to the body to maximize propulsive kicks. Thus, a reorganization of the relative timing of joint rotations appears to be related to the emergence of different arm and leg functions.

Spontaneous movements in the supine position of preterm infants with intellectual disability

OBJECTIVE

Spontaneous movements at 2 months of corrected age in preterm infants with intellectual disability (ID) were investigated by assessing individual motor elements separated from movements involving the entire body.

METHODS

Video recordings of 20 preterm infants with ID (16 males, 4 females; median gestational age 26 weeks; median birth weight 810 g) were analyzed and were compared with those of 21 normal preterm infants (8 males, 13 females; median gestational age 30 weeks; median birth weight 1216 g).

RESULTS

In the preterm infants with ID at 2 months corrected age, startle response, lateral decumbent position, predominant shoulder rotation, and maintaining hip adduction were more frequently observed and hand sucking, maintaining shoulder abduction, to-and-fro shoulder abduction, to-and-fro elbow flexion, isolated hip adduction, to-and-fro hip abduction, and leg lift were less frequently seen than in the normal preterm infants (Fisher's exact test, p<0.05).

CONCLUSION

Abnormal spontaneous movements at 2 months of age in preterm infants with ID result from persistent immature movements and non-emergence of mature movements.