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Christovão IS, de Almeida Rodrigues L, de Paula Machado ACC, de Souza Pascoal AF, Fontes DE, Mendonça KTD, de Castro Magalhães L, Camargos ACR. Hybrid developmental follow-up for preterm infants in Brazil: A feasibility study. Early Hum Dev 2024; 195:106069. [PMID: 38924944 DOI: 10.1016/j.earlhumdev.2024.106069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION The low attendance of families in child developmental follow-up programs for at-risk preterm children is a challenge in Brazil. OBJECTIVE This study evaluates the feasibility of implementing a developmental follow-up program for Brazilian preterm infants in a hybrid format. METHODS This is an observational, prospective cohort study, involving preterm infants. Longitudinal developmental test results, the participation frequency in the program, and the number of referrals to early intervention programs were used to assess feasibility. The General Movements (GMs) assessment, Alberta Infant Motor Scale (AIMS) and, Survey of Wellbeing of Young Children (SWYC) Milestones were administered via telehealth. The Bayley-III was administered in-person. RESULTS Thirty-four preterm infants attended the follow-up until 12 months of corrected age and 18 (52.9 %) concluded all follow-up assessments. Twenty-six (76.5 %) attended all assessments via telehealth, and 26 (76.5 %) attended the in-person assessment. Eighteen (52.9 %) infants showed at least one altered result in development tests. Infants exhibiting abnormal results in the GMs assessment, motor developmental delay according to the AIMS, or developmental delay based on Balley-III were promptly referred to early intervention services. CONCLUSION This study demonstrated high participation rate and low dropout in a developmental follow-up program employing a hybrid format. The substantial number of identified infants with developmental delay emphasizes the importance of timely detection of motor delays to referral to early intervention services.
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Affiliation(s)
- Isabella Saraiva Christovão
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lara de Almeida Rodrigues
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Ana Flávia de Souza Pascoal
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Déborah Ebert Fontes
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Karoline Tury de Mendonça
- Hospital das Clínicas, Universidade Federal de Minas Gerais/EBSERH, Belo Horizonte, Minas Gerais, Brazil
| | - Lívia de Castro Magalhães
- Graduate Program in Occupation Studies, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Cristina Resende Camargos
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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de Mendonça KT, de Souza Pascoal AF, Lanza FDC, Viñolas Prat B, de Souza Morais RL, Resende Camargos AC. Clinical Factors Related to Abnormal General Movements Trajectories: Development of a Multicriteria Index. Pediatr Phys Ther 2024:00001577-990000000-00101. [PMID: 39073072 DOI: 10.1097/pep.0000000000001129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
PURPOSE To create a multicriteria index with clinical factors associated with abnormal general movements (GMs) trajectories during a stay in the neonatal intensive care unit. METHODS A longitudinal study assessed abnormal GMs trajectories in preterm infants in the neonatal intensive care unit. The multicriteria index included clinical factors such as intraventricular hemorrhage, respiratory support, gestational age, patent ductus arteriosus, and infection based on multi-attribute utility theory. RESULTS A total of 52 preterm newborns, 57.7% male, were evaluated. The multicriteria index correlated with abnormal GMs trajectories and explained 26.5% of the variance in these trajectories. CONCLUSION The developed multicriteria index, with the inclusion of combined clinical factors, allowed the identification of part of the abnormal trajectories of GMs in preterm infants. The multicriteria analysis can help clinicians to identify infants who have a greater chance of poor developmental trajectories before hospital discharge.
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Affiliation(s)
- Karoline Tury de Mendonça
- Hospital das Clínicas/EBSERH, Belo Horizonte, Minas Gerais, Brazil (Ms Mendonça); Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil (Mss Mendonça and Pascoal and Drs Lanza and Camargos); Graduate Program in Health, Society and Environment, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil (Drs Viñolas Prat and Morais)
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Park MW, Shin HI, Bang MS, Kim DK, Shin SH, Kim EK, Lee ES, Shin HI, Lee WH. Reduction in limb-movement complexity at term-equivalent age is associated with motor developmental delay in very-preterm or very-low-birth-weight infants. Sci Rep 2024; 14:8432. [PMID: 38600352 PMCID: PMC11006919 DOI: 10.1038/s41598-024-59125-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 04/08/2024] [Indexed: 04/12/2024] Open
Abstract
Reduced complexity during the writhing period can be crucial in the spontaneous movements of high-risk infants for neurologic impairment. This study aimed to verify the association between quantified complexity of upper and lower-limb movements at term-equivalent age and motor development in very-preterm or very-low-birth-weight infants. Video images of spontaneous movements at term-equivalent age were collected from very-preterm or very-low-birth-weight infants. A pretrained pose-estimation model and sample entropy (SE) quantified the complexity of the upper- and lower-limb movements. Motor development was evaluated at 9 months of corrected age using Bayley Scales of Infant and Toddler Development, Third Edition. The SE measures were compared between infants with and without motor developmental delay (MDD). Among 90 infants, 11 exhibited MDD. SE measures at most of the upper and lower limbs were significantly reduced in infants with MDD compared to those without MDD (p < 0.05). Composite scores in the motor domain showed significant positive correlations with SE measures at most upper and lower limbs (p < 0.05). The results show that limb-movement complexity at term-equivalent age is reduced in infants with MDD at 9 months of corrected age. SE of limb movements can be a potentially useful kinematic parameter to detect high-risk infants for MDD.
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Affiliation(s)
- Myung Woo Park
- Department of Rehabilitation Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Moon Suk Bang
- Department of Rehabilitation Medicine, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- National Traffic Injury Rehabilitation Hospital, Yangpyeong, Republic of Korea
| | - Don-Kyu Kim
- Department of Rehabilitation Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Seung Han Shin
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ee-Kyung Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Sun Lee
- Department of Pediatrics, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Hyun Iee Shin
- Department of Rehabilitation Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
- Biomedical Research Institute, Chung-Ang University Hospital, Seoul, Republic of Korea.
| | - Woo Hyung Lee
- Department of Rehabilitation Medicine, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Zhussupova Z, Ayaganov D, Tekebayeva L, Jaxybayeva A, Mamedbayli A, Tamadon A, Zharmakhanova G. General movements assessment: A bibliometric analysis. Early Hum Dev 2024; 188:105924. [PMID: 38142466 DOI: 10.1016/j.earlhumdev.2023.105924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/17/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
This bibliometric analysis provides an in-depth exploration of the scholarly landscape in the field of Prechtl General Movement Assessment (GMA) research, spanning the period from 1961 to 2023. It offers valuable insights into the evolutionary trajectory and global impact of GMA. The study employs a longitudinal approach, meticulously tracking trends in scholarly output, international collaborations, and authorship patterns. Notably, our findings reveal a significant increase in GMA-related publications, highlighting the growing prominence of this field. The dominance of Australia and Austria in scholarly contributions underscores their pivotal roles. International collaborations are prominent, with active participation from European nations and the Americas. However, it is essential to acknowledge certain limitations, including potential data source biases and a reliance on English-language publications. This analysis serves as a valuable resource for stakeholders in the field, emphasizing the need for ongoing evaluation and collaborative efforts to enhance GMA applications and further our understanding of its clinical implications.
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Affiliation(s)
- Zhanna Zhussupova
- Department of Neurology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.
| | - Dinmukhamed Ayaganov
- Department of Neurology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.
| | - Latina Tekebayeva
- Department of Neurology, Kazakhstan's Medical University "KSPH", Almaty, Kazakhstan.
| | | | - Ayten Mamedbayli
- Department of Neurology, Azerbaijan Medical University, Baku, Azerbaijan.
| | - Amin Tamadon
- Department for Scientific Work, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.
| | - Gulmira Zharmakhanova
- Department of Natural Sciences, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.
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Huisenga DC, la Bastide-van Gemert S, Van Bergen AH, Sweeney JK, Hadders-Algra M. Predictive value of General Movements Assessment for developmental delay at 18 months in children with complex congenital heart disease. Early Hum Dev 2024; 188:105916. [PMID: 38091843 DOI: 10.1016/j.earlhumdev.2023.105916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Infants with complex congenital heart disease are at increased risk of impaired fetal brain growth, brain injury, and developmental impairments. The General Movement Assessment (GMA) is a valid and reliable tool to predict cerebral palsy (CP), especially in preterm infants. Predictive properties of the GMA in infants with complex congenital heart disease (CCHD) are unknown. AIM To evaluate predictive properties of the GMA to predict developmental outcomes, including cerebral palsy (CP), at 18-months corrected age (CA) in children with CCHD undergoing heart surgery in the first month of life. METHODS A prospective cohort of 56 infants with CCHD (35 males, 21 females) was assessed with GMA at writhing age (0-6 weeks CA) and fidgety age (7-17 weeks CA) and the Bayley Scales of Infant Development at 18 months. GMA focused on markedly reduced GM-variation and complexity (definitely abnormal (DA) GM-complexity) and fidgety movements. Predictive values of GMA for specific cognitive, language and motor delay (composite scores <85th percentile) and general developmental delay (delay in all domains) were calculated at 18 months. RESULTS At fidgety age, all infants had fidgety movements and no child was diagnosed with CP. DA GM-complexity at fidgety age predicted general developmental delay at 18 months (71 % sensitivity, 90 % specificity), but predicted specific developmental delay less robustly. DA GM-complexity at writhing age did not predict developmental delay, nor did it improve prediction based on DA GM-complexity at fidgety age. CONCLUSIONS In infants with CCHD and fidgety movements, DA GM-complexity at fidgety age predicted general developmental delay.
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Affiliation(s)
- Darlene C Huisenga
- Advocate Children's Hospital, Department of Pediatric Rehabilitation and Development, Oak Lawn, IL, USA; University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands
| | - Sacha la Bastide-van Gemert
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
| | - Andrew H Van Bergen
- Advocate Children's Hospital, Advocate Children's Heart Institute, Division of Pediatric Cardiac Critical Care, Oak Lawn, IL, USA
| | - Jane K Sweeney
- Rocky Mountain University of Health Professions, Provo, UT, USA
| | - Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands.
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Shin HI, Park MW, Lee WH. Spontaneous movements as prognostic tool of neurodevelopmental outcomes in preterm infants: a narrative review. Clin Exp Pediatr 2023; 66:458-464. [PMID: 37202346 PMCID: PMC10626027 DOI: 10.3345/cep.2022.01235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 04/24/2023] [Accepted: 05/05/2023] [Indexed: 05/20/2023] Open
Abstract
An estimated 15 million infants are born prematurely each year. Although the survival rate of preterm infants has increased with advances in perinatal and neonatal care, many still experience various complications. Since improving the neurodevelopmental outcomes of preterm births is a crucial topic, accurate evaluations should be performed to detect infants at high risk of cerebral palsy. General movements are spontaneous movements involving the whole body as the expression of neural activity and can be an excellent biomarker of neural dysfunction caused by brain impairment in preterm infants. The predictive value of general movements with respect to cerebral palsy increases with continuous observation. Automated approaches to examining general movements based on machine learning can help overcome the limited utilization of assessment tools owing to their qualitative or semiquantitative nature and high dependence on assessor skills and experience. This review covers each of these topics by summarizing normal and abnormal general movements as well as recent advances in automatic approaches based on infantile spontaneous movements.
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Affiliation(s)
- Hyun Iee Shin
- Department of Rehabilitation Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Myung Woo Park
- Department of Rehabilitation Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Woo Hyung Lee
- Department of Rehabilitation Medicine, Seoul National University Children’s Hospital, Seoul National University College of Medicine, Seoul, Korea
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Alberge C, Ehlinger V, Noack N, Bolzoni C, Colombié B, Breinig S, Dicky O, Delobel M, Arnaud C. Early psychomotor therapy in very preterm infants does not improve Bayley-III scales at 2 years. Acta Paediatr 2023; 112:1916-1925. [PMID: 37191836 DOI: 10.1111/apa.16848] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/17/2023]
Abstract
AIM To assess the efficacy of post-hospital psychomotor therapy in the development of very preterm infants at nine and 24 months. METHODS We conducted a randomised controlled study at Toulouse Children's Hospital between 2008 and 2014 among preterm infants aged under 30 weeks. All infants in both groups could benefitt from physiotherapy to prevent motor disorders. The intervention group received 20 early post-hospital psychomotor therapy sessions. The development was assessed by the Bayley Scale Infant Development at nine and 24 months. RESULTS The intervention and control group contained 77 and 84 infants, respectively, with 57 infants in each group undergoing assessment at 24 months. Boys accounted for 56% of the population. Median gestational age was 28 weeks, range 25-29. The development scores at 24 months did not significantly differ between the randomisation groups. At 9 months, we observed improvements in global motricity (mean difference 0.9 point, p = 0.04) and fine motricity for the subgroup containing educationally underserved mothers (mean difference 1.6 point, p = 0.008). There was no significant difference in neuromotor functioning between the two groups. CONCLUSION The benefits of psychomotor therapy were short-lived and did not persist post-intervention. Our results and this organisational model encouraged us to persevere towards similar multi-professional care.
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Affiliation(s)
- Corine Alberge
- Paediatric Intensive Care Unit, Toulouse University Children's Hospital, Toulouse, France
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
| | | | - Nathalie Noack
- Regional Vulnerable Newborns Follow-up Network, Occitanie, France
| | | | - Bruno Colombié
- Regional Vulnerable Newborns Follow-up Network, Occitanie, France
| | - Sophie Breinig
- Paediatric Intensive Care Unit, Toulouse University Children's Hospital, Toulouse, France
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
| | - Odile Dicky
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
- Neonatology Department, Toulouse University Children's Hospital, Toulouse, France
| | - Malika Delobel
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
| | - Catherine Arnaud
- CERPOP, UMR1295, University of Toulouse, Inserm, Toulouse, France
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Doi H, Furui A, Ueda R, Shimatani K, Yamamoto M, Sakurai K, Mori C, Tsuji T. Spatiotemporal patterns of spontaneous movement in neonates are significantly linked to risk of autism spectrum disorders at 18 months old. Sci Rep 2023; 13:13869. [PMID: 37620366 PMCID: PMC10449803 DOI: 10.1038/s41598-023-40368-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Infants make spontaneous movements from the prenatal period. Several studies indicate that an atypical pattern of body motion during infancy could be utilized as an early biomarker of autism spectrum disorders (ASD). However, to date, little is known about whether the body motion pattern in neonates is associated with ASD risk. The present study sought to clarify this point by examining, in a longitudinal design, the link between features of spontaneous movement at about two days after birth and ASD risk evaluated using the Modified Checklist for Autism in Toddlers by their caregivers at 18 months old. The body movement features were quantified by a recently developed markerless system of infant body motion analysis. Logistic regression analysis revealed that ASD risk at 18 months old is associated with the pattern of spontaneous movement at the neonatal stage. Further, logistic regression based on body movement features during sleep shows better performance in classifying high- and low-risk infants than during the awake state. These findings raise the possibility that early signs of ASD risk may emerge at a developmental stage far earlier than previously thought.
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Affiliation(s)
- Hirokazu Doi
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan.
- School of Science and Engineering, Kokushikan University, 4-28-1 Setagaya, Setagaya-ku, Tokyo, 154-8515, Japan.
- Department of Information and Management Systems Engineering, Nagaoka University of Technology, 1603-1 Kamitomioka, Nagaoka, Niigata, 940-2188, Japan.
| | - Akira Furui
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-hiroshima, Hiroshima, 739-8527, Japan.
| | - Rena Ueda
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-hiroshima, Hiroshima, 739-8527, Japan
| | - Koji Shimatani
- Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1, Gakuen-machi, Mihara, Hiroshima, 734-8558, Japan
| | - Midori Yamamoto
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba, 263-8522, Japan
| | - Kenichi Sakurai
- Department of Nutrition and Metabolic Medicine, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba, 263-8522, Japan
| | - Chisato Mori
- Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba, 263-8522, Japan
- Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Toshio Tsuji
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-hiroshima, Hiroshima, 739-8527, Japan.
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Gajewska E, Moczko J, Naczk M, Naczk A, Sobieska M. Impact of selected risk factors on motor performance in the third month of life and motor development in the ninth month. PeerJ 2023; 11:e15460. [PMID: 37334124 PMCID: PMC10274587 DOI: 10.7717/peerj.15460] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 05/03/2023] [Indexed: 06/20/2023] Open
Abstract
Background Proper motor development can be influenced by a range of risk factors. The resulting motor performance can be assessed through quantitative and qualitative analysis of posture and movement patterns. Methods This study was designed as the cohort follow-up of the motor assessment and aimed to demonstrate, in a mathematical way, the impact of particular risk factors on elements of motor performance in the 3rd month and the final motor performance in the 9th month of life. Four hundred nineteen children were assessed (236 male and 183 female), including 129 born preterm. Each child aged 3 month underwent a physiotherapeutic assessment of the quantitative and qualitative development, in the prone and supine positions. The neurologist examined each child aged 9 month, referring to the Denver Development Screening Test II and assessing reflexes, muscle tone and symmetry. The following risk factors were analyzed after the neurological consultation: condition at birth (5th min Apgar score), week of gestation at birth, intraventricular hemorrhage, respiratory distress syndrome, and the incidence of intrauterine hypotrophy and hyperbilirubinemia determined based on medical records. Results A combination of several risk factors affected motor development stronger than any one of them solely, with Apgar score, hyperbilirubinemia, and intraventricular hemorrhage exhibiting the most significant impact. Conclusions Premature birth on its own did not cause a substantial delay in motor development. Nonetheless, its co-occurrence with other risk factors, namely intraventricular hemorrhage, respiratory distress syndrome, and hyperbilirubinemia, notably worsened motor development prognosis. Moreover, improper position of the vertebral column, scapulae, shoulders, and pelvis in the third month of life may predict disturbances in further motor development.
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Affiliation(s)
- Ewa Gajewska
- Chair and Clinic of the Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jerzy Moczko
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Mariusz Naczk
- Institute of Health Sciences, Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
| | - Alicja Naczk
- Department of Physical Education and Sport, Faculty of Physical Culture in Gorzow Wielkopolski, University School of Physical Education in Poznan, Gorzow Wielkopolski, Poland
| | - Magdalena Sobieska
- Department of Rehabilitation and Physiotherapy, Poznan University of Medical Sciences, Poznan, Poland
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Cappellini G, Sylos-Labini F, Avaltroni P, Dewolf AH, Assenza C, Morelli D, Lacquaniti F, Ivanenko Y. Comparison of the forward and sideways locomotor patterns in children with Cerebral Palsy. Sci Rep 2023; 13:7286. [PMID: 37142631 PMCID: PMC10160037 DOI: 10.1038/s41598-023-34369-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 04/28/2023] [Indexed: 05/06/2023] Open
Abstract
Switching locomotion direction is a common task in daily life, and it has been studied extensively in healthy people. Little is known, however, about the locomotor adjustments involved in changing locomotion direction from forward (FW) to sideways (SW) in children with cerebral palsy (CP). The importance of testing the ability of children with CP in this task lies in the assessment of flexible, adaptable adjustments of locomotion as a function of the environmental context. On the one hand, the ability of a child to cope with novel task requirements may provide prognostic cues as to the chances of modifying the gait adaptively. On the other hand, challenging the child with the novel task may represent a useful rehabilitation tool to improve the locomotor performance. SW is an asymmetrical locomotor task and requires a differential control of right and left limb muscles. Here, we report the results of a cross-sectional study comparing FW and SW in 27 children with CP (17 diplegic, 10 hemiplegic, 2-10 years) and 18 age-matched typically developing (TD) children. We analyzed gait kinematics, joint moments, EMG activity of 12 pairs of bilateral muscles, and muscle modules evaluated by factorization of EMG signals. Task performance in several children with CP differed drastically from that of TD children. Only 2/3 of children with CP met the primary outcome, i.e. they succeeded to step sideways, and they often demonstrated attempts to step forward. They tended to rotate their trunk FW, cross one leg over the other, flex the knee and hip. Moreover, in contrast to TD children, children with CP often exhibited similar motor modules for FW and SW. Overall, the results reflect developmental deficits in the control of gait, bilateral coordination and adjustment of basic motor modules in children with CP. We suggest that the sideways (along with the backward) style of locomotion represents a novel rehabilitation protocol that challenges the child to cope with novel contextual requirements.
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Affiliation(s)
- Germana Cappellini
- Laboratory of Neuromotor Physiology, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, 306 Via Ardeatina, 00179, Rome, Italy
- Department of Systems Medicine and Center of Space Biomedicine, University of Rome Tor Vergata, 00133, Rome, Italy
| | - Francesca Sylos-Labini
- Laboratory of Neuromotor Physiology, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, 306 Via Ardeatina, 00179, Rome, Italy
- Department of Systems Medicine and Center of Space Biomedicine, University of Rome Tor Vergata, 00133, Rome, Italy
| | - Priscilla Avaltroni
- Laboratory of Neuromotor Physiology, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, 306 Via Ardeatina, 00179, Rome, Italy
| | - Arthur H Dewolf
- Department of Systems Medicine and Center of Space Biomedicine, University of Rome Tor Vergata, 00133, Rome, Italy
| | - Carla Assenza
- Department of Pediatric Neurorehabilitation, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, 00179, Rome, Italy
| | - Daniela Morelli
- Department of Pediatric Neurorehabilitation, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, 00179, Rome, Italy
| | - Francesco Lacquaniti
- Laboratory of Neuromotor Physiology, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, 306 Via Ardeatina, 00179, Rome, Italy
- Department of Systems Medicine and Center of Space Biomedicine, University of Rome Tor Vergata, 00133, Rome, Italy
| | - Yury Ivanenko
- Laboratory of Neuromotor Physiology, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, 306 Via Ardeatina, 00179, Rome, Italy.
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Lewis SP, Sweeney JK. Comorbidities in Infants and Children with Neonatal Brachial Plexus Palsy: A Scoping Review to Inform Multisystem Screening. Phys Occup Ther Pediatr 2023; 43:503-527. [PMID: 36659827 DOI: 10.1080/01942638.2023.2169091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 10/31/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023]
Abstract
AIMS The scoping review was undertaken to explore comorbidities in infants and children with neonatal brachial plexus palsy (NBPP). The purpose of the review was to inform physical and occupational therapy screening of multiple body systems during the examination of children with NBPP. METHODS EBSCO Discovery and EMBASE electronic databases were searched for reports published between January 1996 and September 2021 describing comorbidities in children with NBPP between birth and 18 years. Key data pertaining to comorbidity prevalence, risk factors, clinical features, and associated outcomes were extracted and charted by one researcher and confirmed by a second researcher. RESULTS Thirty-six articles were included in the scoping review. Fourteen comorbidities were identified across the musculoskeletal, neurological, cardiopulmonary, and integumentary systems and the communication domain. The most prevalent comorbidities were clavicle fractures, plagiocephaly, torticollis, high body mass index, and language delays. The least prevalent comorbidity was facial nerve palsy. CONCLUSIONS Physical and occupational therapists can use knowledge of comorbidities in infants and children with NBPP for multisystem screening during the examination. A thorough history can identify risk factors for comorbidities. Detection of comorbidities during screening allows for timely specialty referrals to optimize care.
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Affiliation(s)
- Sarah P Lewis
- Rocky Mountain University of Health Professions, Provo, UT, USA
- Rehabilitation Department, Seattle Children's Hospital, Seattle, WA, USA
| | - Jane K Sweeney
- Rocky Mountain University of Health Professions, Provo, UT, USA
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Delsing CPA, Adriaansens C, van Hulst K, Erasmus CE, van den Hoogen FJA. Long-term effects of submandibular gland excision on drooling in children with neurodevelopmental disorders: A cross-sectional study. Int J Pediatr Otorhinolaryngol 2023; 164:111377. [PMID: 36403383 DOI: 10.1016/j.ijporl.2022.111377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/31/2022] [Accepted: 11/04/2022] [Indexed: 11/13/2022]
Abstract
AIM Submandibular gland excision (SMGE) is suitable for the management of drooling in patients with non-progressive neurodisabilities. We aimed to investigate the long-term effects of SMGE. METHOD Patients who had SMGE between 2007 and 2018 were included. Main outcomes were a Visual Analogue Scale (VAS), Drooling Severity (DS), and Drooling Frequency (DF) collected at baseline, 8 weeks, 32 weeks and with a median of 313 weeks after SMGE (long-term). Secondary outcomes were satisfaction with the procedure, Drooling Quotient (DQ) and adverse events (AEs). RESULTS We included thirty-five patients in the long-term analysis with a mean age of 14.5 years. A baseline VAS score of 80.4 was found, which improved on the long-term (mean difference -21.8, t(26) = 4.636, p < 0.0005)). DS and DF decreased significantly at the long-term compared to baseline (Z = -4.361, p < 0.0001 for DS, Z = -3.065, p = 0.002 for DF). Twenty-three out of 35 (66%) patients would recommend the procedure to peers. INTERPRETATION This study indicates a long-term stable effect on drooling after SMGE in patients with anterior drooling. Recurrence of drooling occurs due to unknown reasons, nevertheless most caregivers and/or patients are still satisfied and would recommend the procedure to others.
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Affiliation(s)
- Corinne P A Delsing
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Centre, Philips Van Leijdenlaan 15 (route 377), Postbus 9101, Nijmegen, 6500 HB, the Netherlands.
| | - Carleen Adriaansens
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Centre, Philips Van Leijdenlaan 15 (route 377), Postbus 9101, Nijmegen, 6500 HB, the Netherlands
| | - Karen van Hulst
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Corrie E Erasmus
- Department of Pediatric Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, the Netherlands
| | - Frank J A van den Hoogen
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Centre, Philips Van Leijdenlaan 15 (route 377), Postbus 9101, Nijmegen, 6500 HB, the Netherlands
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Coxon ML, Hoyt CR, Smith AE, Hadders-Algra M. Going Beyond Conventional Assessment of Developmental Motor Disorders: Exploring Video Methods for Early Identification Among Children 0 to 3 Years. ADVANCES IN REHABILITATION SCIENCE AND PRACTICE 2023; 12:27536351231207740. [PMID: 37928362 PMCID: PMC10621290 DOI: 10.1177/27536351231207740] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/21/2023] [Indexed: 11/07/2023]
Abstract
Motor skills and movement-related functioning significantly shape how children experience and interact with the world around them. Among infants and young children, developmental motor disorders contribute to delays with motor, cognitive, and psychosocial development. Early and accurate identification of these disorders is necessary to facilitate timely access to therapeutic interventions that minimize the long-term effects of disability on everyday activities and participation. In the United States, motor assessments commonly used among children 0 to 3 years focus on completion of specific motor skills at a single point in time, which provides only a part of the greater picture that is a child's motor and movement-related functioning. Video-capture methods, like the General Movements Assessment (GMA) and the Infant Motor Profile (IMP), offer greater accuracy and predictive power to (1) identify motor deficits in young children and (2) facilitate early access to supportive, therapeutic intervention.
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Affiliation(s)
- Maria Lopez Coxon
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Catherine R Hoyt
- Departments of Neurology and Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Alyssa E Smith
- Division of Pediatric Neurology, Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Mijna Hadders-Algra
- University of Groningen, University Medical Centre Groningen, Department of Pediatrics, Division of Developmental Neurology, Groningen, the Netherlands
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Kadam AS, Nayyar SA, Kadam SS, Patni BC, Khole MC, Pandit AN, Kabra NS. General Movement Assessment in preterm babies; Motor Optimality Scores (MOS-R), trajectory, and neurodevelopmental outcomes at one year. THE JOURNAL OF PEDIATRICS: X 2022. [DOI: 10.1016/j.ympdx.2022.100084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Domagalska-Szopa M, Szopa A, Serrano-Gómez ME, Hagner-Derengowska M, Behrendt J. Identification of risk factors in pre-term infants with abnormal general movements. Front Neurol 2022; 13:850877. [PMID: 36452169 PMCID: PMC9701825 DOI: 10.3389/fneur.2022.850877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 09/21/2022] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION This study aimed to investigate the relationship between prenatal, perinatal, and postnatal risk factors for neurodevelopmental impairment (NDI) with the outcomes of General Movement (GM) Assessment (GMA) in pre-term infants at 3-5 months of age. We sought to identify the risk factors associated with the predictors of psychomotor development in pre-term newborns, such as normal fidgety movements (FMs), absent FMs, or abnormal FMs, assessed during the fidgety period of motor development. METHODS The SYNAGIS program (prophylactic of Respiratory Syncytial Virus Infection) was used to identify risk factors for the development of neuromotor deficits in 164 pre-term infants who were at high risk of developing these deficits. Based on the GMA, all participants were divided into three groups of infants who presented: (1) normal FMs; (2) absent FMs; and (3) abnormal FMs. RESULTS The results of the current study suggest that abnormal GMs not only indicate commonly known factors like birth asphyxia (BA), respiratory distress syndrome (RDS), periventricular leukomalacia (PVL), intraventricular hemorrhage (IVH) grades 3-4, but also predict the development of motor impairments. In the present study, several specific risk factors including bronchopulmonary dysplasia (BPD), infertility treatments, maternal acute viral/bacterial infections during pregnancy, and elevated bilirubin levels were identified as attributes of an atypical fidgety movement pattern. CONCLUSIONS Additional clinical data, such as risk factors for NDI associated with early predictors of psychomotor development in pre-term newborns, i.e., absent or abnormal FMs, may be helpful in predicting neurological outcomes in pre-term infants with developmental concerns in the 1st month of life.
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Affiliation(s)
| | - Andrzej Szopa
- Department of Physiotherapy, Medical University of Silesia, Katowice, Poland
- Rehabilitation and Medical Center Neuromed SC, Katowice, Poland
| | - María Eugenia Serrano-Gómez
- Facultad de Enfermería y Rehabilitación, Universidad de La Sabana, Chía, Colombia
- Facultad de Psicología Ciencias de la Educación y del Deporte Blanquerna, Universidad Ramon Llull, Barcelona, Spain
| | | | - Jakub Behrendt
- Department of Neonatal Intensive Care, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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de Mendonça KT, Lanza FC, de Sousa Morais RL, Camargos ACR. Clinical factors associated with abnormal general movements of preterm newborns during hospitalization in a neonatal intensive care unit. Early Hum Dev 2022; 174:105682. [PMID: 36206619 DOI: 10.1016/j.earlhumdev.2022.105682] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/22/2022] [Accepted: 09/27/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION There is no clarity about which clinical variables during hospitalization in the Neonatal Intensive Care Unit (NICU) are associated with abnormal General Movements (GMs). OBJECTIVE To describe the trajectory of GMs of preterm newborns and explore the association between clinical variables and the presence of abnormal GMs during the NICU stay. METHODS Fifty-eight preterm newborns (33 males), with a mean gestational age at birth of 31,93 week's postmenstrual age, were evaluated using the GMs assessment by Hadders-Algra method. Clinical variables recorded weekly throughout the hospitalization period. The weekly association between clinical variables and the presence of abnormal GMs was tested using the Generalized Estimating Equations (GEE) model. RESULTS Preterm infants were recorded for up to sixteen weeks and more than half of the infants (56.9 %) had abnormal movements in at least one week during hospitalization. The absence of peri-intraventricular hemorrhage (PIVH) grades I-II and non-invasive ventilatory support and/or oxygen therapy on the day of the evaluation reduced, respectively, by 77.3 % (OR = 0.23; p > 0.0001) and 64.3 % (OR = 0.36; p > 0.0001) the chance of having an abnormal classification. In addition, each day of increased invasive mechanical ventilation increased the chance of having an abnormal classification by 1.11 times (OR = 0.025; p > 0.0001). CONCLUSION PIVH grades I-II, longer durations of mechanical ventilation and the presence of non-invasive ventilatory support and/or oxygen therapy are associated with abnormal movements during stay in the neonatal period. The data suggest that development outcome of infants having these conditions should be closely monitored.
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Affiliation(s)
- Karoline Tury de Mendonça
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda Córdoba Lanza
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rosane Luzia de Sousa Morais
- Graduate Program in Health, Society and Environment and Department of Physiotherapy, Universidade Federal do Vale do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Ana Cristina Resende Camargos
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Alonzo CJ, Letzkus LC, Connaughton EA, Kelly NL, Michel JA, Zanelli SA. High Prevalence of Abnormal General Movements in Hospitalized Very Low Birth Weight Infants. Am J Perinatol 2022; 29:1541-1547. [PMID: 33535241 DOI: 10.1055/s-0041-1722943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Abnormal general movements (GMs) are predictive of later risk of motor impairments in preterm infants. The goals of this study are to (1) describe the implementation of the GM assessment (GMA) in a neonatal intensive care unit (NICU) and (2) investigate the prevalence and evolution of abnormal GMs in very low birth weight (VLBW) infants. STUDY DESIGN Observational study of GMs in VLBW infants (gestational age [GA] <32 weeks and/or birth weight [BW] <1,500 g) following GMA implementation in a level-IV NICU. All VLBW infants admitted between November 2017 and April 2019 were eligible for the GMA. Infants were excluded if they required high-frequency ventilation or if they could not be unbundled for video acquisition. GMAs were scored weekly by at least 2 GMA-certified providers. RESULTS The GMA was performed in 121 VLBW infants with a mean (standard deviation [SD]) GA of 28.3 (2.6) and BW of 1,113 (400 g). Only 28% of infants had normal GMs on initial assessment (32.9 ± 2.7 weeks' GA), while 61 and 11% had poor repertoire and cramped-synchronized GMs, respectively. At NICU discharge (37.6 ± 3.4 weeks corrected GA), 45 and 21% of infants were classified as having poor repertoire and cramped-synchronized GMs, respectively. Most infants with cramped-synchronized GMs on initial assessment had persistent abnormal GMs at discharge. In contrast, only one infant with normal GMs on first assessment developed cramped-synchronized GMs. CONCLUSION Abnormal GMs are common in VLBW infants, including a high prevalence of the more concerning cramped-synchronized movement pattern. The GMA can be successfully performed in VLBW infants. The GMA may be helpful in identifying infants at increased risk of later motor impairments, as well as assisting clinicians, in the stratification of infants who may benefit from additional brain imaging and/or an intensive hospital-based interventions. KEY POINTS · Abnormal GMs are common in VLBW infants.. · Poor repertoire in the most prevalent pattern observed.. · Infants at risk for abnormal motor outcomes can be identified in the NICU..
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Affiliation(s)
- Corrie J Alonzo
- Department of Pediatrics, Division of Neonatology, University of Virginia, Charlottesville, Virginia
| | - Lisa C Letzkus
- Department of Pediatrics, Division of Developmental Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Elizabeth A Connaughton
- Department of Rehabilitation services, Department of Physical Therapy, University of Virginia, Charlottesville, Virginia
| | - Nancy L Kelly
- Department of Rehabilitation services, Department of Physical Therapy, University of Virginia, Charlottesville, Virginia
| | - Joseph A Michel
- Department of Pediatrics, Division of Neonatology, University of Virginia, Charlottesville, Virginia
| | - Santina A Zanelli
- Department of Pediatrics, Division of Neonatology, University of Virginia, Charlottesville, Virginia
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Automated Movement Analysis to Predict Cerebral Palsy in Very Preterm Infants: An Ambispective Cohort Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9060843. [PMID: 35740780 PMCID: PMC9222200 DOI: 10.3390/children9060843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/30/2022] [Accepted: 06/02/2022] [Indexed: 11/20/2022]
Abstract
The General Movements Assessment requires extensive training. As an alternative, a novel automated movement analysis was developed and validated in preterm infants. Infants < 31 weeks’ gestational age or birthweight ≤ 1500 g evaluated at 3−5 months using the general movements assessment were included in this ambispective cohort study. The C-statistic, sensitivity, specificity, positive predictive value, and negative predictive value were calculated for a predictive model. A total of 252 participants were included. The median gestational age and birthweight were 274/7 weeks (range 256/7−292/7 weeks) and 960 g (range 769−1215 g), respectively. There were 29 cases of cerebral palsy (11.5%) at 18−24 months, the majority of which (n = 22) were from the retrospective cohort. Mean velocity in the vertical direction, median, standard deviation, and minimum quantity of motion constituted the multivariable model used to predict cerebral palsy. Sensitivity, specificity, positive, and negative predictive values were 55%, 80%, 26%, and 93%, respectively. C-statistic indicated good fit (C = 0.74). A cluster of four variables describing quantity of motion and variability of motion was able to predict cerebral palsy with high specificity and negative predictive value. This technology may be useful for screening purposes in very preterm infants; although, the technology likely requires further validation in preterm and high-risk term populations.
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Cott R, Hagmann C, Etter R, Latal B. [Differences in the Distribution of the General Movements Classification Between Neonatal Risk Groups in the Children's Hospital Zurich: An Observational Study]. Z Geburtshilfe Neonatol 2022; 226:265-273. [PMID: 35672004 DOI: 10.1055/a-1808-2843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Neonatal infants are at increased risk for motor development disorders. OBJECTIVE To compare General Movements (GMs) classification between three neonatal risk groups, correlate the GMs Assessment (GMA) with a standardized developmental neurological examination (SDNE) and determine risk factors for abnormal GMs. METHODS Monocentric observational study with three risk groups (children with operated congenital heart disease (CHD) n=26, with operated congenital gastrointestinal malformations (CGM) n=17 and with fetal operated myelomeningocele (MMC) n=12 who underwent inpatient video-based examination. GMA was evaluated according to Hadders-Algra classification and divided into 4 categories: normal optimal (NO), normal suboptimal (NS), mildly abnormal (MA), definitely abnormal (DA). RESULTS The distribution was as follows: CHD 80.8% NS, 19.2% MA, CGM 5.9% NO, 64.7% NS, 29.4% MA, MMC upper extremities 100% NS, lower extremities 33.3% NS, 33.3% MA and 33.3% DA (group comparison Kruskal-Wallis 10.729, p=0.003). GMA correlated significantly with SDNE (Spearman r s=0.869, p<0.001). Binary logistic regression analysis showed that only gestational age (Chi2=11.93, p<0.001) correlated with abnormal GMs. CONCLUSION The majority of children showed normal GMs. Children with MMC and those with lower gestational age showed an increased risk of abnormal GMs. The GMA and SDNE represent complementary "bedside tools" to detect early motor abnormalities.
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Affiliation(s)
- Rachel Cott
- Abteilung Entwicklungspädiatrie, Universitäts-Kinderspital Zürich, Zürich, Schweiz
| | - Cornelia Hagmann
- Abteilung Intensivmedizin und Neonatologie, Universitäts-Kinderspital Zürich, Zürich, Schweiz
| | - Ruth Etter
- Abteilung Entwicklungspädiatrie, Universitäts-Kinderspital Zürich, Zürich, Schweiz
| | - Bea Latal
- Abteilung Entwicklungspädiatrie, Universitäts-Kinderspital Zürich, Zürich, Schweiz
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Leyener U, Kraushaar C, Dathe AK, Felderhoff-Müser U, Marschik PB, Zhang D, Hüning BM. [Physiotherapy in German Neonatal Intensive Care Units - Indication and Clinical Application of the General Movements Assessments]. Z Geburtshilfe Neonatol 2022; 226:256-264. [PMID: 35595512 DOI: 10.1055/a-1791-5778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Standardized recommendations for inpatient and outpatient physiotherapy for preterm infants are lacking in Germany. The aim of this study was to investigate the prescription practice in German neonatal intensive care units. Are standardized assessments used to determine indications? How important is the General Movements Assessment in postnatal diagnostics? METHODS We conducted an online survey in German neonatal intensive care units asking 21 questions on indication and prescription practices for inpatient and outpatient physiotherapy in preterm infants' care as well as on General Movements Assessment and its clinical application via Lime Survey. RESULTS 81% of the participating sites "always" or "often" recommend indication-based inpatient physiotherapy for preterm infants and 53% "always"/"often" recommend outpatient therapy. Indications are mainly based on these symptoms (N=344) or diagnoses (N=273) (multiple answers): hypotonia (94%), abnormal and imbalanced muscle tone (92%), neurological abnormalities (97%) and brain damage (94%). Standardized testing is used by 41% of the participants. The General Movements Assessment is known to 87% of the neonatal intensive care units, 11% use it several times a week, 17% several times a month for indication of physiotherapy. CONCLUSION Physiotherapy is frequently prescribed for preterm infants. The majority of indications are based on symptoms or clinical pictures rather than on standardized tests. The General Movements Assessment is a widely known method but not systematically applied at the moment.
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Affiliation(s)
- Uta Leyener
- Klinik für Kinderheilkunde I, Neonatologie, Pädiatrische Intensivmedizin, Pädiatrische Neurologie, Universitätsmedizin Essen, Essen, Deutschland
| | - Carolin Kraushaar
- Klinik für Kinderheilkunde, Institut für Physiotherapie, Universitätsmedizin Essen, Essen, Deutschland
| | - Anne-Kathrin Dathe
- Klinik für Kinderheilkunde I, Neonatologie, Pädiatrische Intensivmedizin, Pädiatrische Neurologie, Universitätsmedizin Essen, Essen, Deutschland
| | | | - Peter B Marschik
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Schweden.,Systemische Ethologie und Entwicklungswissenschaft Klinik für Kinder und Jugendpsychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Göttingen, Deutschland.,iDN - Interdisziplinäre Entwicklungsforschung, Klinische Abteilung für Phoniatrie, Medizinische Universität Graz, Graz, Österreich
| | - Dajie Zhang
- Systemische Ethologie und Entwicklungswissenschaft Klinik für Kinder und Jugendpsychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Göttingen, Deutschland.,iDN - Interdisziplinäre Entwicklungsforschung, Klinische Abteilung für Phoniatrie, Medizinische Universität Graz, Graz, Österreich
| | - Britta Maria Hüning
- Klinik für Kinderheilkunde I, Neonatologie, Pädiatrische Intensivmedizin, Pädiatrische Neurologie, Universitätsmedizin Essen, Essen, Deutschland
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Örtqvist M, Einspieler C, Ådén U. Early prediction of neurodevelopmental outcomes at 12 years in children born extremely preterm. Pediatr Res 2022; 91:1522-1529. [PMID: 33972686 DOI: 10.1038/s41390-021-01564-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Extremely preterm (EPT) birth is a major risk factor for neurodevelopmental impairments. The aim was to evaluate the predictive value of Prechtl General Movement Assessment (GMA), including the Motor Optimality Score-Revised (MOS-R), at 3 months corrected age (CA) for adverse neurodevelopmental outcome at the age of 12 years. METHODS The GMA, including the MOS-R, was applied at 3 months CA and outcomes were assessed at 12 years by Touwen's neurological examination, the Movement Assessment Battery for Children-2, and chart reviews. RESULTS Fifty-three infants born EPT (33 boys, mean GA 25 weeks, mean body weight 805 ± 156 g) were included. Forty-two (79%) children participated in the follow-up (mean age 12.3 ± 0.4) and 62% of these had adverse outcomes. The MOS-R differed between groups (p = 0.007). The respective predictive values of GMA, aberrant FMs, and the MOS-R cut-off of 21 for adverse outcomes were positive predictive values (PPVs) of 1.00 and 0.77, negative predictive value of 0.47 and 0.63, sensitivity of 0.31 and 0.77, and specificity of 1.00 and 0.77. CONCLUSIONS Using the Prechtl GMA, including the MOS-R, at 3 months CA predicted an overall adverse neurodevelopment at 12 years, with a high PPV, specificity, and sensitivity in children born EPT. IMPACT The Prechtl GMA, including the MOS-R, can improve early identification of long-term adverse neurodevelopmental outcomes. This is the first study to investigate the predictive value of the MOS-R for neurodevelopmental outcome at mid-school age in children born EPT. Using the GMA, including the MOS-R, is suggested as one important part of the neurological assessment at 3 months CA in children born EPT. Aberrant FMs in combination with a MOS of <21 is an indicator of an increased risk of future adverse neurodevelopment in children born EPT.
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Affiliation(s)
- Maria Örtqvist
- Neonatal Research Unit, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
| | - Christa Einspieler
- Research Unit Interdisciplinary Developmental Neuroscience, Dept. Phoniatrics, Medical University of Graz, Graz, Austria
| | - Ulrika Ådén
- Neonatal Research Unit, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
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Shin HI, Shin HI, Bang MS, Kim DK, Shin SH, Kim EK, Kim YJ, Lee ES, Park SG, Ji HM, Lee WH. Deep learning-based quantitative analyses of spontaneous movements and their association with early neurological development in preterm infants. Sci Rep 2022; 12:3138. [PMID: 35210507 PMCID: PMC8873498 DOI: 10.1038/s41598-022-07139-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/11/2022] [Indexed: 12/23/2022] Open
Abstract
This study aimed to develop quantitative assessments of spontaneous movements in high-risk preterm infants based on a deep learning algorithm. Video images of spontaneous movements were recorded in very preterm infants at the term-equivalent age. The Hammersmith Infant Neurological Examination (HINE) was performed in infants at 4 months of corrected age. Joint positional data were extracted using a pretrained pose-estimation model. Complexity and similarity indices of joint angle and angular velocity in terms of sample entropy and Pearson correlation coefficient were compared between the infants with HINE < 60 and ≥ 60. Video images of spontaneous movements were recorded in 65 preterm infants at term-equivalent age. Complexity indices of joint angles and angular velocities differed between the infants with HINE < 60 and ≥ 60 and correlated positively with HINE scores in most of the joints at the upper and lower extremities (p < 0.05). Similarity indices between each joint angle or joint angular velocity did not differ between the two groups in most of the joints at the upper and lower extremities. Quantitative assessments of spontaneous movements in preterm infants are feasible using a deep learning algorithm and sample entropy. The results indicated that complexity indices of joint movements at both the upper and lower extremities can be potential candidates for detecting developmental outcomes in preterm infants.
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Affiliation(s)
- Hyun Iee Shin
- Department of Rehabilitation Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Moon Suk Bang
- Department of Rehabilitation Medicine, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Don-Kyu Kim
- Department of Rehabilitation Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Seung Han Shin
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ee-Kyung Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yoo-Jin Kim
- Department of Pediatrics, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Eun Sun Lee
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Pediatrics, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Seul Gi Park
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hye Min Ji
- Department of Rehabilitation Medicine, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Woo Hyung Lee
- Department of Rehabilitation Medicine, Seoul National University Children's Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Dall'Orso S, Arichi T, Fitzgibbon SP, Edwards AD, Burdet E, Muceli S. Development of functional organization within the sensorimotor network across the perinatal period. Hum Brain Mapp 2022; 43:2249-2261. [PMID: 35088920 PMCID: PMC8996360 DOI: 10.1002/hbm.25785] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/30/2021] [Accepted: 01/10/2022] [Indexed: 11/18/2022] Open
Abstract
In the mature human brain, the neural processing related to different body parts is reflected in patterns of functional connectivity, which is strongest between functional homologs in opposite cortical hemispheres. To understand how this organization is first established, we investigated functional connectivity between limb regions in the sensorimotor cortex in 400 preterm and term infants aged across the equivalent period to the third trimester of gestation (32–45 weeks postmenstrual age). Masks were obtained from empirically derived functional responses in neonates from an independent data set. We demonstrate the early presence of a crude but spatially organized functional connectivity, that rapidly matures across the preterm period to achieve an adult‐like configuration by the normal time of birth. Specifically, connectivity was strongest between homolog regions, followed by connectivity between adjacent regions (different limbs but same hemisphere) already in the preterm brain, and increased with age. These changes were specific to the sensorimotor network. Crucially, these trajectories were strongly dependent on age more than age of birth. This demonstrates that during the perinatal period the sensorimotor cortex undergoes preprogrammed changes determining the functional movement organization that are not altered by preterm birth in absence of brain injury.
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Affiliation(s)
- Sofia Dall'Orso
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg.,Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London.,Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, UK.,Paediatric Neurosciences, Evelina London Children's Hospital, St. Thomas' Hospital, London, UK.,Medical Research Council Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Sean P Fitzgibbon
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - A David Edwards
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London.,Medical Research Council Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Etienne Burdet
- Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, UK
| | - Silvia Muceli
- Department of Electrical Engineering, Chalmers University of Technology, Gothenburg.,Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London
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Kiebzak W, Żurawski A, Głuszek S, Kosztołowicz M, Białek WA. Cortisol Levels in Infants with Central Coordination Disorders during Vojta Therapy. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8121113. [PMID: 34943309 PMCID: PMC8700341 DOI: 10.3390/children8121113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/08/2021] [Accepted: 11/25/2021] [Indexed: 12/16/2022]
Abstract
Background: Due to the decrease in the percentage of perinatal mortality, which is one of the Millennium Development Goals, the number of children with a central coordination disorder (CCD) has increased, present in up to 40% of premature babies. Neurodevelopmental disorders detected in the diagnostic process require early interventions that will eliminate or overcome existing dysfunctions. These treatments often cause discomfort in the infant, which induces insecurity and activation of basic defense mechanisms. The aim of the work is to assess changes in cortisol concentration in infants treated with the Vojta method. Methods and findings: The study included 35 children with CCD aged between three and nine months. The participants had no comorbidities that could have affected the obtained results. The activities were planned to occur in three stages: 1. Collection of a saliva sample directly before the physiotherapy appointment. 2. Collection of saliva immediately after rehabilitation. 3. Collection of saliva 20 min after the end of rehabilitation. The physiotherapeutic intervention included the assessment of seven reactions of the body position in space according to Vojta and the conduct of a therapeutic session consisting of the first phase of rotation and creeping reflex according to Vojta. The concentration of free cortisol in saliva was assessed with LC-MS/MS. In the first measurement, none of the children presented an excess of the normative concentration of cortisol. The cortisol measurement performed directly after rehabilitation showed above-normative values in three children. In the third measurement, all of the children presented a decreased concentration of free cortisol. The analysis (paired two-tailed t-test, p < 0.05) showed statistically significant differences between particular stages of the measurements. The analysis of the scores obtained in the second measurement showed the concentration of scores in the area of “normal” at a level of 0.83 (normal concentration) and the area “above normal” at the level of 0.005 (very weak concentration). Based on the analysis of significance of the obtained scores, it was found that the result was not accidental, and the Vojta method used in the treatment of children with CCD was suitable. Conclusions: Here, for the first time, we presented how Vojta therapy was correlated with cortisol levels among children with a central coordination disorder.
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Affiliation(s)
- Wojciech Kiebzak
- Institute of Health Science, Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland;
| | - Arkadiusz Żurawski
- Institute of Health Science, Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland;
- Correspondence: ; Tel.: +48-787-339222
| | - Stanisław Głuszek
- Laboratory of Medical Genetics, Department of Surgical Medicine, Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (S.G.); (W.A.B.)
| | - Michał Kosztołowicz
- Sandomierskie Towarzystwo Naukowe, 27-600 Sandomierz, Poland;
- Kieleckie Towarzystwo Naukowe, 25-303 Kielce, Poland
| | - Wioletta Adamus Białek
- Laboratory of Medical Genetics, Department of Surgical Medicine, Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland; (S.G.); (W.A.B.)
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What Do We Know About Motor Development of Preterm Children Without Major Neurological Damage and Disorder? A Narrative Review. JOURNAL OF MOTOR LEARNING AND DEVELOPMENT 2021. [DOI: 10.1123/jmld.2020-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This review addresses the question of a possible specificity of motor development of preterm children with no diagnosis of neurological impairment or major cerebral lesion. With that goal, we proceed with a narrative review on the basis of nine studies. All the studies used standardized assessments of motor abilities with a comparison methodology of preterm and full-term groups aged between 3 and 8 years. The review stresses three major findings in the preterm groups as compared with the full-term groups: (a) inferior fine motor abilities; (b) heterogeneity in motor skills; and (c) differences in efficiency of cognitive, perceptual, and mobilization of perceptual motor processes, which do not necessarily result in lower scores in global performances. These findings suggest the need of long-term medical follow-up for all preterm children whether or not they are at risk for neurodevelopmental disorder. Focusing attention on the use of sensory information for motor control in preterm children could also lead to more precise evaluations of motor abilities, which will then provide more detailed parameters for improved learning and rehabilitation programs.
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26
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A soft-electronic sensor network tracks neuromotor development in infants. Proc Natl Acad Sci U S A 2021; 118:2116943118. [PMID: 34772819 DOI: 10.1073/pnas.2116943118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2021] [Indexed: 11/18/2022] Open
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Redd CB, Karunanithi M, Boyd RN, Barber LA. Technology-assisted quantification of movement to predict infants at high risk of motor disability: A systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 118:104071. [PMID: 34507051 DOI: 10.1016/j.ridd.2021.104071] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 07/08/2021] [Accepted: 08/20/2021] [Indexed: 05/23/2023]
Abstract
AIM To systematically review the scientific literature to determine the predictive validity of technology-assisted measures of observable infant movement in infants less than six months of corrected age (CA) to identify high-risk of motor disability. METHOD A comprehensive search for randomised and non-randomised controlled trials, cohort studies and cross-comparison trials was performed on five electronic databases up to Feb 2021. Studies were included if they quantified infant movement before 6 months CA using some method of technology-assistance and compared the instrumented measure to a diagnostic clinical measure of neurodevelopment. Studies were excluded if they did not report a technology-assisted measure of infant movement. Methodological quality of the included studies was assessed using the Downs and Black scale. RESULTS 23 studies met the full inclusion and exclusion criteria. Methodological quality of the included papers ranged from 9 to 24 (out of 26) on the Downs and Black scale. Infant movement assessments included the General Movements Assessment (GMA) and domains of the Hammersmith Infant Neurological Assessment (HINE). Studies used 2D video recordings, RGB-Depth recordings, accelerometry, and electromagnetic motion tracking technologies to quantify movement. Analytical approaches and movement features of interest were individual and varied. Technology assisted quantitative assessments identified cases of later diagnosed CP with sensitivity 44-100 %, specificity 59-95 %, Area under the ROC Curve 82-93 %; and typical development with sensitivity range 30-46 %, specificity 88-95 %, Area under the ROC Curve 68 %. INTERPRETATION Technology-assisted assessments of movement in infants less than 6 months CA using current technologies are feasible. Validation of measurement tools are limited. Although methods and results appear promising clinical uptake of technology-assisted assessments remains limited.
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Affiliation(s)
- Christian B Redd
- CSIRO, The Australian e-Health Research Centre, Brisbane, Australia; The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, Brisbane, Australia.
| | | | - Roslyn N Boyd
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, Brisbane, Australia
| | - Lee A Barber
- The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, Brisbane, Australia; Griffith University, School of Health Sciences and Social Work, Nathan, Australia
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Seesahai J, Luther M, Church PT, Maddalena P, Asztalos E, Rotter T, Banihani R. The assessment of general movements in term and late-preterm infants diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by 2 years of age-a scoping review. Syst Rev 2021; 10:226. [PMID: 34384482 PMCID: PMC8359053 DOI: 10.1186/s13643-021-01765-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 07/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The General Movements Assessment is a non-invasive and cost-effective tool with demonstrated reliability for identifying infants at risk for cerebral palsy. Early detection of cerebral palsy allows for the implementation of early intervention and is associated with better functional outcomes. No review to date has summarized the utility of the General Movements Assessment to predict cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy. METHODS We conducted a scoping review involving infants born greater than or equal to 34 weeks gestational age to identify all available evidence and delineate research gaps. We extracted data on sensitivity, specificity, and positive and negative predictive values and described the strengths and limitations of the results. We searched five databases (MEDLINE, Embase, PsychINFO, Scopus, and CINAHL) and the General Movements Trust website. Two reviewers conducted all screening and data extraction independently. The articles were categorized according to key findings, and a critical appraisal was performed. RESULTS Only three studies, a cohort and two case series, met all of the inclusion criteria. The total number of participants was 118. None of the final eligible studies included late-preterm neonates. All three studies reported on sensitivity, specificity, and positive predictive and negative predictive values. An abnormal General Movement Assessment at 3-5 months has a high specificity (84.6-98%) for cerebral palsy with a similarly high negative predictive value (84.6-98%) when it was normal. Absent fidgety movements, in particular, are highly specific (96%) for moderate to severe cerebral palsy and carry a high negative predictive value (98%) when normal. In the time period between term and 4-5 months post-term, any cramped synchronized movements had results of 100% sensitivity and variable results for specificity, positive predictive value, and negative predictive value. CONCLUSIONS A normal General Movements Assessment at 3 months in a term high-risk infant is likely associated with a low risk for moderate/severe cerebral palsy. The finding of cramped synchronized General Movements is a strong predictor for the diagnosis of cerebral palsy by 2 years of age in the term population with neonatal encephalopathy. The deficit of high-quality research limits the applicability, and so the General Movements Assessment should not be used in isolation when assessing this population. SYSTEMATIC REVIEW REGISTRATION Title registration with Joanna Briggs Institute. URL: http://joannabriggswebdev.org/research/registered_titles.aspx .
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Affiliation(s)
- Judy Seesahai
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Maureen Luther
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Paige Terrien Church
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Toronto, Toronto, Canada
| | - Patricia Maddalena
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Asztalos
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Toronto, Toronto, Canada
| | | | - Rudaina Banihani
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Toronto, Toronto, Canada.
- Newborn & Developmental Paediatrics, Sunnybrook Health Science Centre, 2075, Bayview Ave., Toronto, ON, M4N 3M5, Canada.
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Pouppirt NR, Martin V, Pagnotto-Hammitt L, Spittle AJ, Flibotte J, DeMauro SB. The General Movements Assessment in Neonates With Hypoxic Ischemic Encephalopathy. J Child Neurol 2021; 36:601-609. [PMID: 33439066 DOI: 10.1177/0883073820981515] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Clinical measures after birth and studies such as electroencephalogram (EEG) and brain imaging do not fully predict neurodevelopmental outcomes of infants with hypoxic-ischemic encephalopathy. Early detection of adverse neurologic outcomes, and cerebral palsy in particular, in high-risk infants is essential for ensuring timely management. The General Movements Assessment is a tool that can be used in the early detection of cerebral palsy in infants with brain injury. The majority of studies on the General Movements Assessment in the late preterm and term population were performed prior to the introduction of therapeutic hypothermia. AIMS To apply the General Movements Assessment in late preterm and term infants with hypoxic-ischemic encephalopathy (including those who received therapeutic hypothermia), to determine if clinical markers of hypoxic-ischemic encephalopathy predict abnormal General Movements Assessment findings, and to evaluate interrater reliability of the General Movements Assessment in this population. Study design: Pilot prospective cohort study Subjects: We assessed 29 late preterm and full-term infants with mild, moderate, and severe hypoxic-ischemic encephalopathy in Philadelphia, PA. RESULTS Most infants' general movements normalized by the fidgety age. Only infants with moderate or severe hypoxic-ischemic encephalopathy had abnormal general movements in both the writhing and the fidgety ages (n = 6). Seizure at any point during the initial hospitalization was the clinical sign most predictive of abnormal general movements in the fidgety age (sensitivity 100%, specificity 55%, positive predictive value 40%, negative predictive value 100%). Interrater reliability was greatest during the fidgety age (κ = 0.67). CONCLUSIONS Seizures were the clinical predictor most closely associated with abnormal findings on the General Movements Assessment. However, clinical markers of hypoxic-ischemic encephalopathy are not fully predictive of abnormal General Movements Assessment findings. Larger future studies are needed to evaluate the associations between the General Movements Assessment and childhood neurologic outcomes in patients with hypoxic-ischemic encephalopathy who received therapeutic hypothermia.
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Affiliation(s)
- Nicole R Pouppirt
- Division of Neonatology, Feinberg School of Medicine, Northwestern University, 2429Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Valerie Martin
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Linda Pagnotto-Hammitt
- Department of Physical Therapy, 6567Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Alicia J Spittle
- 34361Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - John Flibotte
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Sara B DeMauro
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Misko A, Wood L, Kiselyov K, Slaugenhaupt S, Grishchuk Y. Progress in elucidating pathophysiology of mucolipidosis IV. Neurosci Lett 2021; 755:135944. [PMID: 33965501 PMCID: PMC8253105 DOI: 10.1016/j.neulet.2021.135944] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 11/19/2022]
Abstract
Mucolipidosis IV (MLIV) is an autosomal-recessive disease caused by loss-of-function mutations in the MCOLN1 gene encoding the non-selective cationic lysosomal channel transient receptor potential mucolipin-1 (TRPML1). Patients with MLIV suffer from severe motor and cognitive deficits that manifest in early infancy and progressive loss of vision leading to blindness in the second decade of life. There are no therapies available for MLIV and the unmet medical need is extremely high. Here we review the spectrum of clinical presentations and the latest research in the MLIV pre-clinical model, with the aim of highlighting the progress in understanding the pathophysiology of the disease. These highlights include elucidation of the neurodevelopmental versus neurodegenerative features over the course of disease, hypomyelination as one of the major brain pathological disease hallmarks, and dysregulation of cytokines, with emerging evidence of IFN-gamma pathway upregulation in response to TRPML1 loss and pro-inflammatory activation of astrocytes and microglia. These scientific advances in the MLIV field provide a basis for future translational research, including biomarker and therapy development, that are desperately needed for this patient population.
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Affiliation(s)
- Albert Misko
- Center for Genomic Medicine and Department of Neurology, Massachusetts General Hospital Research Institute and Harvard Medical School, Boston, MA, 02114, United States
| | - Levi Wood
- Georgia W. Woodruff School of Mechanical Engineering, Wallace H. Coulter Department of Biomedical Engineering, and Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, 30332, United States
| | - Kirill Kiselyov
- Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA, 15260, United States
| | - Susan Slaugenhaupt
- Center for Genomic Medicine and Department of Neurology, Massachusetts General Hospital Research Institute and Harvard Medical School, Boston, MA, 02114, United States
| | - Yulia Grishchuk
- Center for Genomic Medicine and Department of Neurology, Massachusetts General Hospital Research Institute and Harvard Medical School, Boston, MA, 02114, United States.
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Raghuram K, Orlandi S, Church P, Chau T, Uleryk E, Pechlivanoglou P, Shah V. Automated movement recognition to predict motor impairment in high-risk infants: a systematic review of diagnostic test accuracy and meta-analysis. Dev Med Child Neurol 2021; 63:637-648. [PMID: 33421120 DOI: 10.1111/dmcn.14800] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2020] [Indexed: 12/21/2022]
Abstract
AIM To assess the sensitivity and specificity of automated movement recognition in predicting motor impairment in high-risk infants. METHOD We searched MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, and Scopus databases and identified additional studies from the references of relevant studies. We included studies that evaluated automated movement recognition in high-risk infants to predict motor impairment, including cerebral palsy (CP) and non-CP motor impairments. Two authors independently assessed studies for inclusion, extracted data, and assessed methodological quality using the Quality Assessment of Diagnostic Accuracy Studies-2. Meta-analyses were performed using hierarchical summary receiver operating characteristic models. RESULTS Of 6536 articles, 13 articles assessing 59 movement variables in 1248 infants under 5 months corrected age were included. Of these, 143 infants had CP. The overall sensitivity and specificity for motor impairment were 0.73 (95% confidence interval [CI] 0.68-0.77) and 0.70 (95% CI 0.65-0.75) respectively. Comparatively, clinical General Movements Assessment (GMA) was found to have sensitivity and specificity of 98% (95% CI 74-100) and 91% (95% CI 83-93) respectively. Sensor-based technologies had higher specificity (0.88, 95% CI 0.80-0.93). INTERPRETATION Automated movement recognition technology remains inferior to clinical GMA. The strength of this study is its meta-analysis to summarize performance, although generalizability of these results is limited by study heterogeneity.
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Affiliation(s)
- Kamini Raghuram
- Department of Neonatal-Perinatal Medicine, University of Toronto, Toronto, ON, Canada
| | - Silvia Orlandi
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Paige Church
- Department of Newborn and Developmental Paediatrics, Women and Babies' Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Tom Chau
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Elizabeth Uleryk
- The Hospital for Sick Children, University of Toronto Libraries, Toronto, ON, Canada
| | - Petros Pechlivanoglou
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Vibhuti Shah
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada
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Dolinskaya IY, Solopova IA, Zhvansky DS, Keshishian ES, Ivanenko Y. Increasing muscle activity correlations during spontaneous movements in the first six months of life. Neurosci Lett 2021; 756:135957. [PMID: 33989731 DOI: 10.1016/j.neulet.2021.135957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/07/2021] [Accepted: 05/09/2021] [Indexed: 11/24/2022]
Abstract
Spontaneous muscle activity in the first months of life is an important prerequisite to developing voluntary motor skills and to adapting sensorimotor circuits and muscle tone to body and environmental changes. Even though high variability is a characteristic of early development, several studies have reported significant correlations of limb movements. These assessments were typically made based on kinematics, while the analysis of lower and upper limb muscle activity may provide additional information about maturation of the neuromuscular control. To this end, we examined the electromyographic activity of 12 muscles of the upper and lower limbs in full-term healthy infants (n = 40) aged from 1 week to six months. An increase of ipsilateral and contralateral limb muscle activity correlations with age was found in both flexors and extensors and may reflect a progressive emergence of elements of coordinative neuromuscular behaviour. Correlations between arm and leg muscle responses also increased during passive leg movements. Overall, the findings are consistent with maturation of physiologically relevant neuromuscular network connections during the course of transition from spontaneous-like to voluntary goal-directed movements during early development.
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Affiliation(s)
- I Y Dolinskaya
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia.
| | - I A Solopova
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia
| | - D S Zhvansky
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia
| | - E S Keshishian
- Moscow Research Institute of Clinical Pediatrics of Russian Federation, Moscow, Russia
| | - Y Ivanenko
- Laboratory of Neuromotor Physiology, Fondazione Santa Lucia, Rome, Italy
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Neuromuscular Control before and after Independent Walking Onset in Children with Cerebral Palsy. SENSORS 2021; 21:s21082714. [PMID: 33921544 PMCID: PMC8069021 DOI: 10.3390/s21082714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/06/2021] [Accepted: 04/09/2021] [Indexed: 11/25/2022]
Abstract
Early brain lesions which produce cerebral palsy (CP) may affect the development of walking. It is unclear whether or how neuromuscular control, as evaluated by muscle synergy analysis, differs in young children with CP compared to typically developing (TD) children with the same walking ability, before and after the onset of independent walking. Here we grouped twenty children with (high risk of) CP and twenty TD children (age 6.5–52.4 months) based on their walking ability, supported or independent walking. Muscle synergies were extracted from electromyography data of bilateral leg muscles using non-negative matrix factorization. Number, synergies’ structure and variability accounted for when extracting one (VAF1) or two (VAF2) synergies were compared between CP and TD. Children in the CP group recruited fewer synergies with higher VAF1 and VAF2 compared to TD children in the supported and independent walking group. The most affected side in children with asymmetric CP walking independently recruited fewer synergies with higher VAF1 compared to the least affected side. Our findings suggest that early brain lesions result in early alterations of neuromuscular control, specific for the most affected side in asymmetric CP.
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Movements and posture in infants born extremely preterm in comparison to term-born controls. Early Hum Dev 2021; 154:105304. [PMID: 33556691 DOI: 10.1016/j.earlhumdev.2020.105304] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/11/2020] [Accepted: 12/15/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Identifying altered motor development at an early stage is crucial for infants born extremely preterm (EPT), as they face a high risk of long-term neurodevelopmental impairment. The Prechtl General Movement Assessment (GMA), including the Motor Optimality Score Revised (MOS-R), can provide important insights into these infants' later neurodevelopmental function. AIMS To compare age-specific movements and postures in infants born EPT compared to term-born controls at three months corrected age. STUDY DESIGN A retrospective observational study design. SUBJECTS 53 infants born EPT (mean gestational age 25 weeks; 23-26) were included and matched for gender and recording age with 53 term-born controls (mean gestational age 40 weeks, 37-41). OUTCOME MEASURES GMA including the MOS-R at three months corrected age (re-analysis of video-recordings). RESULTS Of the infants born EPT, 19% showed aberrant fidgety movements (FMs); all term-born infants had normal FMs. There was a significant difference in MOS-R (p≤0.001) between controls (median = 26, IQR 26-28) and EPT infants (median = 18, IQR 17-21), as well as in all subcategories of the MOS-R. The EPT group had a significantly higher number of infants showing atypical movement and postural patterns as well as a reduced repertoire for the age compared to the controls. All infants born EPT moved monotonously and jerky. P-values were all <0.001. CONCLUSION Infants born EPT have an altered early motor development. The MOS-R may contribute to further understanding of motor performance in this group of children since it can detect neurological- and motor alterations at a very early age.
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Garofoli F, Longo S, Pisoni C, Accorsi P, Angelini M, Aversa S, Caporali C, Cociglio S, De Silvestri A, Fazzi E, Rizzo V, Tzialla C, Zecca M, Orcesi S. Oral melatonin as a new tool for neuroprotection in preterm newborns: study protocol for a randomized controlled trial. Trials 2021; 22:82. [PMID: 33482894 PMCID: PMC7820522 DOI: 10.1186/s13063-021-05034-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 01/08/2021] [Indexed: 11/12/2022] Open
Abstract
Background Prevention of neurodevelopmental impairment due to preterm birth is a major health challenge. Despite advanced obstetric and neonatal care, to date there are few neuroprotective molecules available. Melatonin has been shown to have anti-oxidant/anti-inflammatory effects and to reduce brain damage, mainly after hypoxic ischemic encephalopathy. The planned study will be the first aiming to evaluate the capacity of melatonin to mitigate brain impairment due to premature birth. Method In our planned prospective, multicenter, double-blind, randomized vs placebo study, we will recruit, within 96 h of birth, 60 preterm newborns with a gestational age ≤ 29 weeks + 6 days; these infants will be randomly allocated to oral melatonin, 3 mg/kg/day, or placebo for 15 days. After the administration period, we will measure plasma levels of malondialdehyde, a lipid peroxidation product considered an early biological marker of melatonin treatment efficacy (primary outcome). At term-equivalent age, we will evaluate neurological status (through cerebral ultrasound, cerebral magnetic resonance imaging, vision and hearing evaluations, clinical neurological assessment, and screening for retinopathy of prematurity) as well as the incidence of bronchodysplasia and sepsis. We will also monitor neurodevelopmental outcome during the first 24 months of corrected age (using the modified Fagan Test of Infant Intelligence at 4–6 months and standardized neurological and developmental assessments at 24 months). Discussion Preterm birth survivors often present long-term neurodevelopmental sequelae, such as motor, learning, social-behavioral, and communication problems. We aim to assess the role of melatonin as a neuroprotectant during the first weeks of extrauterine life, when preterm infants are unable to produce it spontaneously. This approach is based on the supposition that its anti-oxidant mechanism could be useful in preventing neurodevelopmental impairment. Considering the short- and long-term morbidities related to preterm birth, and the financial and social costs of the care of preterm infants, both at birth and over time, we suggest that melatonin administration could lead to considerable saving of resources. This would be the first study addressing the role of melatonin in very low birth weight preterm newborns, and it could provide a basis for further studies on melatonin as a neuroprotection strategy in this vulnerable population. Trial registration ClinicalTrials.gov NCT04235673. Prospectively registered on 22 January 2020.
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Affiliation(s)
- Francesca Garofoli
- Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi 1, 27100, Pavia, Italy
| | - Stefania Longo
- Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi 1, 27100, Pavia, Italy
| | - Camilla Pisoni
- Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi 1, 27100, Pavia, Italy.
| | - Patrizia Accorsi
- Child and Adolescence Neuropsychiatry Unit, Children's Hospital, ASST Spedali Civili of Brescia, 25123, Brescia, Italy
| | - Micol Angelini
- Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi 1, 27100, Pavia, Italy
| | - Salvatore Aversa
- Neonatal Unit and Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili of Brescia, 25123, Brescia, Italy
| | - Camilla Caporali
- Child Neurology and Psychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, 27100, Pavia, Italy.,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100, Pavia, Italy
| | - Sara Cociglio
- Child Neurology and Psychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, 27100, Pavia, Italy
| | - Annalisa De Silvestri
- Unit of Clinical Epidemiology & Biometry, Fondazione IRCCS Policlinico San Matteo, 27100, Pavia, Italy
| | - Elisa Fazzi
- Child and Adolescence Neuropsychiatry Unit, Children's Hospital, ASST Spedali Civili of Brescia, 25123, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, 25123, Brescia, Italy
| | - Vittoria Rizzo
- Clinical Chemistry Laboratory and Department of Molecular Medicine, Fondazione IRCCS Policlinico San Matteo, 27100, Pavia, Italy
| | - Chryssoula Tzialla
- Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi 1, 27100, Pavia, Italy
| | - Marco Zecca
- Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi 1, 27100, Pavia, Italy
| | - Simona Orcesi
- Child Neurology and Psychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, 27100, Pavia, Italy.,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, 27100, Pavia, Italy
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Dewolf AH, Sylos Labini F, Ivanenko Y, Lacquaniti F. Development of Locomotor-Related Movements in Early Infancy. Front Cell Neurosci 2021; 14:623759. [PMID: 33551751 PMCID: PMC7858268 DOI: 10.3389/fncel.2020.623759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/21/2020] [Indexed: 12/04/2022] Open
Abstract
This mini-review focuses on the emergence of locomotor-related movements in early infancy. In particular, we consider multiples precursor behaviors of locomotion as a manifestation of the development of the neuronal networks and their link in the establishment of precocious locomotor skills. Despite the large variability of motor behavior observed in human babies, as in animals, afferent information is already processed to shape the behavior to specific situations and environments. Specifically, we argue that the closed-loop interaction between the neural output and the physical dynamics of the mechanical system should be considered to explore the complexity and flexibility of pattern generation in human and animal neonates.
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Affiliation(s)
- Arthur H Dewolf
- Department of Systems Medicine, Center of Space Biomedicine, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | | | - Yury Ivanenko
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Francesco Lacquaniti
- Department of Systems Medicine, Center of Space Biomedicine, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.,Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
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Using Wearable Sensor Technology to Measure Motion Complexity in Infants at High Familial Risk for Autism Spectrum Disorder. SENSORS 2021; 21:s21020616. [PMID: 33477359 PMCID: PMC7830886 DOI: 10.3390/s21020616] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/13/2021] [Accepted: 01/13/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Motor dysfunction has been reported as one of the first signs of atypical development in infants at high familial risk for autism spectrum disorder (ASD) (HR infants). However, studies have shown inconsistent results regarding the nature of motor dysfunction and whether it can be predictive of later ASD diagnosis. This is likely because current standardized motor assessments may not identify subtle and specific motor impairments that precede clinically observable motor dysfunction. Quantitative measures of motor development may address these limitations by providing objective evaluation of subtle motor differences in infancy. METHODS We used Opal wearable sensors to longitudinally evaluate full day motor activity in HR infants, and develop a measure of motion complexity. We focus on complexity of motion because optimal motion complexity is crucial to normal motor development and less complex behaviors might represent repetitive motor behaviors, a core diagnostic symptom of ASD. As proof of concept, the relationship of the motion complexity measure to developmental outcomes was examined in a small set of HR infants. RESULTS HR infants with a later diagnosis of ASD show lower motion complexity compared to those that do not. There is a stronger correlation between motion complexity and ASD outcome compared to outcomes of cognitive ability and adaptive skills. CONCLUSIONS Objective measures of motor development are needed to identify characteristics of atypical infant motor function that are sensitive and specific markers of later ASD risk. Motion complexity could be used to track early infant motor development and to discriminate HR infants that go on to develop ASD.
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Jonathan EB, Suryawan A, Irmawati M. The Effect of Massage Stimulation on the General Movements Quality in Breastfed Preterm Infant. FOLIA MEDICA INDONESIANA 2021. [DOI: 10.20473/fmi.v56i4.24644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
General Movements (GMs) assessment is one of the modalities to detect abnormal infant development early, the examination of preterm infant development is very important. Preterm infant has a long-term health impact and the risk of neonatal morbidity and mortality, need breast milk as the best nutritionand also need stimulation, one of which is massage. This study aimto analyze massage stimulation effect on the general movements in breastfed preterm infant in Dr. Soetomo Hospital Surabaya.A randomize control group pre test post test design was conducted on preterm infant, 39 babies were enrolled. Massage stimulation was done for 10 consecutive days 3 times in the neonatal ward while observing the condition.The quality assessment of GMs is according to the standardization of the Prechtl method, through two stages, taking video recording and editing GMs, and analysis the video recordings of GMs.Statistical by comparison test.The quality of preterm GMs in massage group (85.7%) and control group(69.6%) with p=0.287. The quality of GMs writhing in the massage group was dominated by abnormal GMs (65%), in control group were dominated by normal (63.2%) with p=0,150. In the fidgety GMs, the massage group (75%) and not massage (78.9%) were dominated by normal GMs, with p=1,000.There were no differences in the quality of preterm GMs, writhingGMs and fidgetyGMs for preterm infants in both group.
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Abbruzzese LD, Yamane N, Fein D, Naigles L, Goldman S. Assessing Child Postural Variability: Development, Feasibility, and Reliability of a Video Coding System. Phys Occup Ther Pediatr 2021; 41:314-325. [PMID: 33063576 DOI: 10.1080/01942638.2020.1833272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIMS Postural variability is central to children's locomotion, motor control, and environmental exploration, and lacks standardized methods for systematic assessment. The purpose of this study was to develop and evaluate the feasibility and interrater reliability of Child Posture Variability Coding (CPVC), a method of quantifying postural variability in young children. METHOD Videos of parent-child play interactions obtained from a longitudinal study investigating language acquisition in typically developing (TD) children and children with autism spectrum disorder (ASD) were used to develop 33 codes for children's voluntary changes in static and dynamic postures. Interrater reliability was calculated for three raters who independently coded 10 randomly selected videos of children aged 23 to 48 months (TD: n = 5, median = 35, IQR = 12.5; ASD: n = 5, median = 35, IQR = 6.75). RESULTS Overall, CPVC demonstrated excellent interrater reliability (Krippendorff's α > 0.90). Among all codes developed, five codes (i.e., sit-half, sit-other, crawl, cruise, and supported walk) were not observed by any coders in the sample, but were kept in the coding scheme to reflect normal developmental milestones. CONCLUSIONS CPVC is a reliable, feasible method of quantifying postural variability in young children with and without neurodevelopmental disorders in naturalistic contexts.
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Affiliation(s)
- Laurel Daniels Abbruzzese
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Natasha Yamane
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Deborah Fein
- Department of Psychology, University of Connecticut, Storrs, Connecticut, USA
| | - Letitia Naigles
- Department of Psychology, University of Connecticut, Storrs, Connecticut, USA
| | - Sylvie Goldman
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
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Wu Y, Rijssen IM, Buurman MT, Dijkstra L, Hamer EG, Hadders‐Algra M. Temporal and spatial localisation of general movement complexity and variation-Why Gestalt assessment requires experience. Acta Paediatr 2021; 110:290-300. [PMID: 32274828 PMCID: PMC7818473 DOI: 10.1111/apa.15300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 03/30/2020] [Accepted: 04/01/2020] [Indexed: 11/23/2022]
Abstract
Aim General movements’ assessment (GMA), based on Gestalt perception, identifies infants at risk of cerebral palsy. However, the requirement of ample experience to construct the assessor's inner criteria for abnormal movement hampers its widespread clinical use. This study aims to describe details of general movements (GMs) in various body parts and to investigate their association with GMA‐Gestalt. Methods Participants were 24 typically developing infants and 22 very‐high‐risk infants. GMs were assessed during the writhing (0‐8 weeks) and/or fidgety GM phase (2‐5 months) by GMA‐Gestalt and a semi‐quantification of the duration of simple movements and complex movements in various body parts. Results During both GM phases, the quality of movement often varied within a single assessment, but the degree of complexity and variation of movements in trunk, arms and legs were interrelated (ρ = 0.32‐0.84). Longer durations of complex movements in arms and legs (P < .042) were further associated with a better quality in GMA‐Gestalt. Head movement was associated with movements in other body parts only in the writhing phase and not associated with GMA‐Gestalt during both GM phases. Conclusion Infants did not show consistently over time and across body parts simple or complex movements. Detailed description of movement characteristics may facilitate the development of computer‐based GMA.
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Affiliation(s)
- Ying‐Chin Wu
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology Groningen The Netherlands
| | - Ilse M. Rijssen
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology Groningen The Netherlands
| | - Maria T. Buurman
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology Groningen The Netherlands
| | - Linze‐Jaap Dijkstra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology Groningen The Netherlands
| | - Elisa G. Hamer
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology Groningen The Netherlands
- Department of Neurology Radboud University Medical Center Nijmegen The Netherlands
| | - Mijna Hadders‐Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology Groningen The Netherlands
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The quality of general movements in infants with complex congenital heart disease undergoing surgery in the neonatal period. Early Hum Dev 2020; 151:105167. [PMID: 32916592 DOI: 10.1016/j.earlhumdev.2020.105167] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/22/2020] [Accepted: 08/25/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Advances in diagnostic technologies, surgical management, and perioperative care have increased survival for neonates with complex congenital heart disease (CCHD). The success of these advances exposed a heightened risk of brain injury and developmental disabilities. The General Movements Assessment, a non-invasive method, may detect early neurodevelopmental impairments in high-risk infants. AIMS To examine whether infants with CCHD undergoing neonatal surgery have higher prevalence of atypical general movements (GMs) than a reference group, and whether single ventricle physiology with systemic oxygen saturations <90% increases risk for atypical GMs. METHODS Serial General Movements Assessment (GMA) in a cohort of infants with CCHD (n = 74) at writhing (term-6 weeks) and fidgety (7-17 weeks) GM-age. GMA focused on the presence of definitely abnormal GM-complexity and absent fidgety movements. Single GMAs at 3 months were available from a reference sample of Dutch infants (n = 300). Regression analyses examined relationships between cardiac characteristics and definitely abnormal GM-complexity. RESULTS Higher prevalence of definitely abnormal GM-complexity in infants with CCHD compared to reference infants (adjusted OR 5.938, 95% CI 2.423-14.355), single ventricle CCHD increased the risk. Occurrence of absent fidgety movements was similar in infants with CCHD and reference infants (adjusted OR 0.475, 95% CI 0.058-3.876). Systemic postoperative oxygen saturations <90% was associated with higher risk of definitely abnormal GM-complexity at fidgety (adjusted OR 16.445 95% CI 1.149-235.281), not at writhing age. CONCLUSIONS Infants with CCHD, especially those with single ventricle CCHD, are at increased risk of definitely abnormal GM-complexity. GMA at fidgety age is recommended.
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Hesse N, Pujades S, Black MJ, Arens M, Hofmann UG, Schroeder AS. Learning and Tracking the 3D Body Shape of Freely Moving Infants from RGB-D sequences. IEEE TRANSACTIONS ON PATTERN ANALYSIS AND MACHINE INTELLIGENCE 2020; 42:2540-2551. [PMID: 31180836 DOI: 10.1109/tpami.2019.2917908] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Statistical models of the human body surface are generally learned from thousands of high-quality 3D scans in predefined poses to cover the wide variety of human body shapes and articulations. Acquisition of such data requires expensive equipment, calibration procedures, and is limited to cooperative subjects who can understand and follow instructions, such as adults. We present a method for learning a statistical 3D Skinned Multi-Infant Linear body model (SMIL) from incomplete, low-quality RGB-D sequences of freely moving infants. Quantitative experiments show that SMIL faithfully represents the RGB-D data and properly factorizes the shape and pose of the infants. To demonstrate the applicability of SMIL, we fit the model to RGB-D sequences of freely moving infants and show, with a case study, that our method captures enough motion detail for General Movements Assessment (GMA), a method used in clinical practice for early detection of neurodevelopmental disorders in infants. SMIL provides a new tool for analyzing infant shape and movement and is a step towards an automated system for GMA.
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Wu YC, Straathof EJM, Heineman KR, Hadders-Algra M. Typical general movements at 2 to 4 months: Movement complexity, fidgety movements, and their associations with risk factors and SINDA scores. Early Hum Dev 2020; 149:105135. [PMID: 32795785 DOI: 10.1016/j.earlhumdev.2020.105135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/02/2020] [Accepted: 07/07/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Movement complexity and the presence of fidgety movements (FMs) during general movements (GMs) both reflect aspects of neurological integrity in early infancy. AIM To assess interrelations between the degree of movement complexity and characteristics of FMs during typical GMs and to investigate associations between mildly impaired GMs and risk factors and neurodevelopmental condition. STUDY DESIGN Observational cohort study. SUBJECTS 283 infants (25 born preterm) at 2-4 months corrected age, representative of the general Dutch population. OUTCOME MEASURES GMs were classified in terms of GM-complexity (normal or mildly abnormal (MA)) and FMs (clearly present, sporadic, or exaggerated). Concurrent neurological, developmental and socio-emotional status were measured with the Standardized Infant NeuroDevelopmental Assessment (SINDA). RESULTS Infants with MA GM-complexity had a higher risk of having sporadic FMs and exaggerated FMs. Perinatal complications were not associated with mildly impaired GMs. MA GM-complexity was associated with advanced maternal age (adjusted OR = 2.29 [1.11, 4.76]) and having a non-native Dutch mother (adjusted OR = 2.93 [1.29, 6.64]). It was also associated with atypical neurological (OR = 7.62 [3.51, 16.54]) and developmental scores (OR = 2.38 [1.16, 4.88]). Sporadic and exaggerated FMs were associated with low-to-middle maternal education (adjusted OR = 2.88, [1.45, 5.72]) and having a non-native Dutch father (adjusted OR = 7.16 [1.41, 36.32]), respectively. However, neither sporadic nor exaggerated FMs were associated with the SINDA outcomes. CONCLUSIONS GM-complexity and FMs are two interrelated but different aspects of GMs. Mild impairments in GM-complexity and FMs share a non-optimal socio-economic background as risk factor, but only MA GM-complexity is associated with a concurrent non-optimal neurodevelopmental condition.
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Affiliation(s)
- Ying-Chin Wu
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands; Department of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan
| | - Elisabeth J M Straathof
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands
| | - Kirsten R Heineman
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands; SEIN, Stichting Epilepsie Instellingen Nederland, Zwolle, the Netherlands
| | - Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics, Division of Developmental Neurology, Groningen, the Netherlands.
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Irshad MT, Nisar MA, Gouverneur P, Rapp M, Grzegorzek M. AI Approaches Towards Prechtl's Assessment of General Movements: A Systematic Literature Review. SENSORS (BASEL, SWITZERLAND) 2020; 20:E5321. [PMID: 32957598 PMCID: PMC7570604 DOI: 10.3390/s20185321] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 01/10/2023]
Abstract
General movements (GMs) are spontaneous movements of infants up to five months post-term involving the whole body varying in sequence, speed, and amplitude. The assessment of GMs has shown its importance for identifying infants at risk for neuromotor deficits, especially for the detection of cerebral palsy. As the assessment is based on videos of the infant that are rated by trained professionals, the method is time-consuming and expensive. Therefore, approaches based on Artificial Intelligence have gained significantly increased attention in the last years. In this article, we systematically analyze and discuss the main design features of all existing technological approaches seeking to transfer the Prechtl's assessment of general movements from an individual visual perception to computer-based analysis. After identifying their shared shortcomings, we explain the methodological reasons for their limited practical performance and classification rates. As a conclusion of our literature study, we conceptually propose a methodological solution to the defined problem based on the groundbreaking innovation in the area of Deep Learning.
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Affiliation(s)
- Muhammad Tausif Irshad
- Institute of Medical Informatics, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany; (M.A.N.); (P.G.); (M.G.)
- Punjab University College of Information Technology, University of the Punjab, Lahore 54000, Pakistan
| | - Muhammad Adeel Nisar
- Institute of Medical Informatics, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany; (M.A.N.); (P.G.); (M.G.)
- Punjab University College of Information Technology, University of the Punjab, Lahore 54000, Pakistan
| | - Philip Gouverneur
- Institute of Medical Informatics, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany; (M.A.N.); (P.G.); (M.G.)
| | - Marion Rapp
- Clinic for Pediatric and Adolescent Medicine, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany;
| | - Marcin Grzegorzek
- Institute of Medical Informatics, University of Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany; (M.A.N.); (P.G.); (M.G.)
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Skworc A, Marciniak S, Sławska H. Influence of infections on the quality of general movements in premature infants. Early Hum Dev 2020; 148:105118. [PMID: 32673903 DOI: 10.1016/j.earlhumdev.2020.105118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The task of contemporary neonatology is not only to save the lives of children born prematurely, but also to provide them with the highest possible quality of life. The Prechtl method, one of several methods of assessing the quality of general movement patterns, enables early identification of immaturity or damage to the central nervous system. AIM Dynamic assessment of the type and quality of general movement (GMs) in preterm infants to determine indications for early neurodevelopmental support and to identify the relationship between the occurrence of maternal and neonatal perinatal risk factors and the type and quality of general movements. MATERIAL AND METHOD 90 infants were assessed between 28 0/7 and 36 6/7 weeks gestational age. Dominant cases (57 cases) were infants born between 32 and 36 weeks GE. Most cases (48) received low Apgar score at 1 min (≤7), including two born in very severe condition. Neonatal infections were diagnosed in 26 infants. The study included three GM assessments: I - up to 14th day post-partum, II at term and III between 12 and 15 weeks corrected age. The analysis included gestational age, general condition of the newborn as per Apgar score as well as early and late infections. RESULTS Neonatal infections were found to show a close correlation with the occurrence of abnormal general movements. It was confirmed that gestational age and congenital infections are important variables affecting the occurrence of abnormal general movements.
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Affiliation(s)
- Aneta Skworc
- Department of Neonatology, Specialist Hospital No. 2, Bytom, Poland
| | - Sylwia Marciniak
- Department of Neonatology, Specialist Hospital No. 2, Bytom, Poland; Medical University of Silesia, Katowice, Poland.
| | - Helena Sławska
- Department of Neonatology, Specialist Hospital No. 2, Bytom, Poland; Medical University of Silesia, Katowice, Poland
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Cappellini G, Sylos-Labini F, Dewolf AH, Solopova IA, Morelli D, Lacquaniti F, Ivanenko Y. Maturation of the Locomotor Circuitry in Children With Cerebral Palsy. Front Bioeng Biotechnol 2020; 8:998. [PMID: 32974319 PMCID: PMC7462003 DOI: 10.3389/fbioe.2020.00998] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/30/2020] [Indexed: 12/26/2022] Open
Abstract
The first years of life represent an important phase of maturation of the central nervous system, processing of sensory information, posture control and acquisition of the locomotor function. Cerebral palsy (CP) is the most common group of motor disorders in childhood attributed to disturbances in the fetal or infant brain, frequently resulting in impaired gait. Here we will consider various findings about functional maturation of the locomotor output in early infancy, and how much the dysfunction of gait in children with CP can be related to spinal neuronal networks vs. supraspinal dysfunction. A better knowledge about pattern generation circuitries in infancy may improve our understanding of developmental motor disorders, highlighting the necessity for regulating the functional properties of abnormally developed neuronal locomotor networks as a target for early sensorimotor rehabilitation. Various clinical approaches and advances in biotechnology are also considered that might promote acquisition of the locomotor function in infants at risk for locomotor delays.
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Affiliation(s)
- Germana Cappellini
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy.,Department of Pediatric Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | | | - Arthur H Dewolf
- Centre of Space Bio-medicine and Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Irina A Solopova
- Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Moscow, Russia
| | - Daniela Morelli
- Department of Pediatric Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Francesco Lacquaniti
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy.,Centre of Space Bio-medicine and Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Yury Ivanenko
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
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47
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Parisi C, Hesse N, Tacke U, Pujades Rocamora S, Blaschek A, Hadders-Algra M, Black MJ, Heinen F, Müller-Felber W, Schroeder AS. Analyse der Spontanmotorik im 1. Lebensjahr: Markerlose 3-D-Bewegungserfassung zur Früherkennung von Entwicklungsstörungen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:881-890. [DOI: 10.1007/s00103-020-03163-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
ZusammenfassungKinder mit motorischer Entwicklungsstörung profitieren von einer frühen Entwicklungsförderung. Eine frühe Diagnosestellung in der kinderärztlichen Vorsorge (U2–U5) kann durch ein automatisiertes Screening verbessert werden. Bisherige Ansätze einer automatisierten Bewegungsanalyse sind jedoch teuer und aufwendig und nicht in der Breite anwendbar. In diesem Beitrag soll ein neues System zur Videoanalyse, das Kinematic Motion Analysis Tool (KineMAT) vorgestellt werden. Es kann bei Säuglingen angewendet werden und kommt ohne Körpermarker aus. Die Methode wird anhand von 7 Patienten mit unterschiedlichen Diagnosen demonstriert.Mit einer kommerziell erhältlichen Tiefenbildkamera (RGB-D[Red-Green-Blue-Depth]-Kamera) werden 3‑minütige Videosequenzen von sich spontan bewegenden Säuglingen aufgenommen und mit einem virtuellen Säuglingskörpermodell (SMIL[Skinned Multi-infant Linear]-Modell) in Übereinstimmung gebracht. Das so erzeugte virtuelle Abbild erlaubt es, beliebige Messungen in 3‑D mit hoher Präzision durchzuführen. Eine Auswahl möglicher Bewegungsparameter wird mit diagnosespezifischen Bewegungsauffälligkeiten zusammengeführt.Der KineMAT und das SMIL-Modell erlauben eine zuverlässige, dreidimensionale Messung der Spontanaktivität bei Säuglingen mit einer sehr niedrigen Fehlerrate. Basierend auf maschinellen Lernalgorithmen kann der KineMAT trainiert werden, pathologische Spontanmotorik automatisiert zu erkennen. Er ist kostengünstig und einfach anzuwenden und soll als Screeninginstrument für die kinderärztliche Vorsorge weiterentwickelt werden.
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48
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Yamamoto S, Yonghi L, Matsumura U, Tsurusaki T. Diversity and regularity in infant crawling with typical development. J Phys Ther Sci 2020; 32:483-488. [PMID: 32884166 PMCID: PMC7443550 DOI: 10.1589/jpts.32.483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 05/04/2020] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this longitudinal study was to investigate the diversity in infant crawling and examine the quantitative regularity in crawling variations necessary for the acquisition of walking in infants with typical development. [Participants and Methods] Infants with no neurological or orthopedic problems participated in this study. Using Internet Protocol (IP) cameras, crawling was simultaneously filmed from six different angles. Filming was continued until the acquisition of independent walking. The crawling movement in the video was coded. We considered the number of different completed codes as the number of variations and examined the cumulative number during the filming period in each participant. [Results] Nineteen infants completed the study. The pattern of change in the cumulative number of variations with increasing age (in days) varied between cases. Although the cumulative number of crawling variations at the time of acquisition of independent walking was inconsistent, it was negatively correlated with the crawling start age (in days). [Conclusion] Diversity exists in infant crawling. Infants who start crawling at a younger age tend to express more variation, whereas infants who start crawling when older tend to express less variation.
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Affiliation(s)
- Shimpei Yamamoto
- Health Sciences, Nagasaki University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki 852-8520, Japan
| | - Lee Yonghi
- Health Sciences, Nagasaki University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki 852-8520, Japan
| | - Umi Matsumura
- Health Sciences, Nagasaki University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki 852-8520, Japan
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49
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Cappellini G, Sylos-Labini F, MacLellan MJ, Assenza C, Libernini L, Morelli D, Lacquaniti F, Ivanenko Y. Locomotor patterns during obstacle avoidance in children with cerebral palsy. J Neurophysiol 2020; 124:574-590. [DOI: 10.1152/jn.00163.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Previous studies mainly evaluated the neuromuscular pattern generation in cerebral palsy (CP) during unobstructed gait. Here we characterized impairments in the obstacle task performance associated with a limited adaptation of the task-relevant muscle module timed to the foot lift during obstacle crossing. Impaired task performance in children with CP may reflect basic developmental deficits in the adaptable control of gait when the locomotor task is superimposed with the voluntary movement.
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Affiliation(s)
- G. Cappellini
- Laboratory of Neuromotor Physiology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Santa Lucia Foundation, Rome, Italy
- Department of Pediatric Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - F. Sylos-Labini
- Laboratory of Neuromotor Physiology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - M. J. MacLellan
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - C. Assenza
- Department of Pediatric Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - L. Libernini
- Department of Pediatric Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - D. Morelli
- Department of Pediatric Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - F. Lacquaniti
- Laboratory of Neuromotor Physiology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Santa Lucia Foundation, Rome, Italy
- Centre of Space Bio-medicine and Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Y. Ivanenko
- Laboratory of Neuromotor Physiology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Santa Lucia Foundation, Rome, Italy
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Seesahai J, Luther M, Rhoden CC, Church PT, Asztalos E, Banihani R. The general movements assessment in term and late-preterm infants diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by 2 years of age: a scoping review protocol. Syst Rev 2020; 9:154. [PMID: 32622366 PMCID: PMC7335433 DOI: 10.1186/s13643-020-01358-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Prediction of long-term neurodevelopmental outcomes remains an elusive goal for neonatology. Clinical and socioeconomic markers have not proven to be adequately reliable. The limitation in prognostication includes those term and late-preterm infants born with neonatal encephalopathy. The General Movements Assessment tool by Prechtl has demonstrated reliability for identifying infants at risk for neuromotor impairment. This tool is non-invasive and cost-effective. The purpose of this study is to identify the published literature on how this tool applies to the prediction of cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy and so detect the research gaps. METHODS We will conduct a systematic scoping review for data on sensitivity, specificity, positive, and negative predictive value and describe the strengths and limitations of the results. This review will consider studies that included infants more than or equal to 34 + 0 weeks gestational age, diagnosed with neonatal encephalopathy, with a General Movements Assessment done between birth to six months of life and an assessment for cerebral palsy by at least 2 years of age. Experimental and quasi-experimental study designs including randomized controlled trials, non-randomized controlled trials, before and after studies, interrupted time-series studies and systematic reviews will be considered. Case reports, case series, case control, and cross-sectional studies will be included. Text, opinion papers, and animal studies will not be considered for inclusion in this scoping review as this is a highly specific and medical topic. Studies in the English language only will be considered. Studies published from at least 1970 will be included as this is around the time when the General Movements Assessment was first introduced in neonatology as a potential predictor of neuromotor outcomes. We will search five databases (MEDLINE, Embase, PsychINFO, Scopus, and CINAHL). Two reviewers will conduct all screening and data extraction independently. The articles will be categorized according to key findings and a critical appraisal performed. DISCUSSION The results of this review will guide future research to improve early identification and timely intervention in infants with neonatal encephalopathy at risk of neuromotor impairment. SYSTEMATIC REVIEW REGISTRATION Title registration with Joanna Briggs Institute https://joannabriggs.org/ebp/systematic_review_register .
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Affiliation(s)
- Judy Seesahai
- Sunnybrook Health Sciences Centre, Toronto, Canada
- University of Toronto, Toronto, Ontario Canada
| | - Maureen Luther
- Sunnybrook Health Sciences Centre, Toronto, Canada
- University of Toronto, Toronto, Ontario Canada
| | - Carmen Cindy Rhoden
- Sunnybrook Health Sciences Centre, Toronto, Canada
- University of Toronto, Toronto, Ontario Canada
| | - Paige Terrien Church
- Sunnybrook Health Sciences Centre, Toronto, Canada
- University of Toronto, Toronto, Ontario Canada
| | - Elizabeth Asztalos
- Sunnybrook Health Sciences Centre, Toronto, Canada
- University of Toronto, Toronto, Ontario Canada
| | - Rudaina Banihani
- Sunnybrook Health Sciences Centre, Toronto, Canada
- University of Toronto, Toronto, Ontario Canada
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