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Peyton C, Frazier M, Aaby D, Millman R, Rodriguez S, Boswell L, Msall ME, Spittle A, de Regnier RA, Barbosa VM, Sukal-Moulton T. Assessing Neonatal Intensive Care Unit (NICU) Graduates Across Varied Settings: A Study on the Feasibility of the Baby Moves App. J Pediatr 2024; 269:113979. [PMID: 38387754 PMCID: PMC11096057 DOI: 10.1016/j.jpeds.2024.113979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/15/2024] [Accepted: 02/16/2024] [Indexed: 02/24/2024]
Abstract
We assessed the feasibility of obtaining parent-collected General Movement Assessment videos using the Baby Moves app. Among 261 participants from 4 Chicago NICUs, 70% submitted videos. Families living in higher areas of childhood opportunity used the app more than those from areas of lower opportunity.
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Affiliation(s)
- Colleen Peyton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago IL; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL.
| | - Mech Frazier
- Department of Research Services, Northwestern University Libraries, Chicago, IL
| | - David Aaby
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - Ryan Millman
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago IL
| | - Sarah Rodriguez
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, IL
| | - Lynn Boswell
- Ann and Robert H Lurie Children's Hospital, Chicago IL
| | - Michael E Msall
- Department of Pediatrics, University of Chicago, Chicago, IL
| | - Alicia Spittle
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Raye-Ann de Regnier
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL; Ann and Robert H Lurie Children's Hospital, Chicago IL
| | | | - Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago IL; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Kahraman A, Mutlu A, Livanelioğlu A. General movements in spinal muscular atrophy type 1. Physiother Theory Pract 2024; 40:1249-1255. [PMID: 36611288 DOI: 10.1080/09593985.2023.2164842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/30/2022] [Accepted: 12/30/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE To investigate the motor repertoire of infants diagnosed with spinal muscular atrophy Type I (SMA Type I) without administration of any disease-modifying agent. METHODS Motor Optimality Score-Revised (MOS-R) was calculated from videos recorded between post-term weeks 9-17 for 22 infants with SMA Type I. The MOS-R of infants with SMA Type I was compared with those of 22 infants with cerebral palsy (CP) and 22 infants with typical development. RESULTS Of the infants with SMA Type I, 17 had absent fidgety movements (FMs) and 5 had sporadic FMs. Age adequate movement repertoire was absent, and the variety of movements in infants was very low. Movements were symmetrical but movements of four limbs remained on the surface level. Antigravity movements were very rare. Movement characterization was monotonous, slow speed, and small amplitude. The MOS-R of infants with SMA Type I was lower than those of infants with typical development but similar to those of infants with CP. CONCLUSIONS Infants with SMA Type I had a motor repertoire similar to infants with CP, while they had a poorer motor repertoire than infants with typical development in the fidgety period as evidenced by MOS-R. Central nervous system involvement in these infants with SMA Type I with absent FMs and reduced MOS-R is unknown. Further studies are needed to determine the role of problems in the afferent and efferent pathways of spinal cord and muscle atrophy in the observation of normal FMs.
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Affiliation(s)
- Aysu Kahraman
- Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazarı, Turkey
| | - Akmer Mutlu
- Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazarı, Turkey
| | - Ayşe Livanelioğlu
- Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazarı, Turkey
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Paleg GS, Williams SA, Livingstone RW. Supported Standing and Supported Stepping Devices for Children with Non-Ambulant Cerebral Palsy: An Interdependence and F-Words Focus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:669. [PMID: 38928915 PMCID: PMC11203597 DOI: 10.3390/ijerph21060669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/10/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
Children functioning at Gross Motor Function Classification System (GMFCS) levels IV-V cannot maintain an aligned standing position or take steps without support. Upright positioning and mobility devices have psycho-social significance for these children and their families, enhancing use of vision, communication, functioning and emotional well-being. Standers and supported stepping devices facilitate opportunities for biomechanical loading, potentially helping to build and maintain muscle and bone integrity, and they promote physical development. However, families are often required to choose between these two devices for their young child. This study aims to synthesize evidence for use and benefits of both supported standing and stepping devices through the lens of two contemporary theoretical frameworks to support clinical reasoning and implementation. The F-words for childhood development (functioning, family, fitness, fun, friends, future) and the interdependence-Human Activity Assistive Technology (iHAAT) models were combined to illustrate the complex interactions between the child, family, caregivers, peers and contextual factors when implementing standing and stepping devices with children at GMFCS levels IV and V. Supported standing and stepping devices provide complementary benefits, and both may be necessary starting at 9-15 months. We propose they both be included ON-Time, along with other age-appropriate positioning and mobility devices, to promote more equitable developmental opportunities for children with non-ambulant cerebral palsy.
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Affiliation(s)
| | - Sian A. Williams
- School of Allied Health, Curtin University, Perth, WA 6009, Australia;
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand
| | - Roslyn W. Livingstone
- Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2B5, Canada;
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Utsch F, Silva LB, da Cunha Júnior AL, Alves EP, Diniz Silva CR, Vilaça DMF, Moraes Antunes AA. The role of fidgety movements and early motor repertoire in predicting mobility outcomes in infants with myelomeningocele. Eur J Paediatr Neurol 2024; 51:41-48. [PMID: 38796917 DOI: 10.1016/j.ejpn.2024.05.006] [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: 10/30/2023] [Revised: 03/22/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE To describe fidgety movements and co-occurring movements and postures in infants with myelomeningocele (MMC) and their association with mobility at preschool ages. METHODS A retrospective cohort with early assessment via general movement assessment, followed by mobility assessment between 36 and 70 months of age. RESULTS Twelve infants were included; 12 of 12 had fidgety movements in the upper limbs, with seven exhibiting them also in the hips and three in both the hips and ankles. The presence of fidgety movements in the lower limbs, kicking, a non-flat posture, a non-monotonous movement character, and a non-absent age-adequate movement repertoire were independently associated with mobility using the Hoffer modified classification and functional mobility scale (FMS) at 5 and 50 m. An optimality score was calculated based on leg movements and postures, ranging from 0 to 10 points. Infants who scored at least 4 points achieved household ambulation and FMS (5 m) of at least level 4. Community ambulation and an FMS (50 m) of level 5 were achieved with a score of at least 7.5. CONCLUSIONS Assessing fidgety movements with other leg movements and postures in infants with MMC provided relevant information that could potentially predict mobility at preschool age and thus could be used for early intervention planning.
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Affiliation(s)
- Fabiana Utsch
- Rede SARAH de Hospitais de Reabilitação, Reabilitação Infantil, Belo Horizonte, Brazil.
| | - Liliane Baía Silva
- Rede SARAH de Hospitais de Reabilitação, Reabilitação Infantil, Belo Horizonte, Brazil
| | | | - Elaine Pessoa Alves
- Rede SARAH de Hospitais de Reabilitação, Reabilitação Infantil, Belo Horizonte, Brazil
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Badgujar S, Dixit J, Kuril BM, Deshmukh LS, Khaire P, Vaidya V, Shelke M. Epidemiological predictors of quality of life and the role of early markers in children with cerebral palsy: A multi-centric cross-sectional study. Pediatr Neonatol 2024:S1875-9572(24)00071-8. [PMID: 38772791 DOI: 10.1016/j.pedneo.2024.04.003] [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: 12/27/2023] [Revised: 03/21/2024] [Accepted: 04/08/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND More than 100 million children in the world have at least one type of disability. Among disabled children, approximately 25% of chronic disabilities are of neurological origin. Cerebral Palsy is the leading cause of chronic disability in children, making them not only physically and mentally handicapped but also socially aloof. METHODS This study was conducted among 200 eligible participants from three centers with Child Guidance or Cerebral Palsy clinics in the outpatient department. All the participants were included in the analysis of the epidemiological profile and the role of early markers. Of these, 70 participants were assessed for quality of life according to the age criteria of a pre-tested Cerebral Palsy Quality of Life questionnaire (CP-QOL). RESULTS Mean ± S.D. age in years was 3.7 ± 2.8. Birth history included 182 (39%) neonatal etiopathology, followed by 173 (38%) perinatal, and 106 (23%) antenatal causes. Mean ± S.D. birth weight was 2.3 ± 1.2 kg. The positive predictors of various domains of Quality of Life were an absence of any associated sensory, neurological, communication, or psychological disorder or disability. While, the negative predictors were decreasing functional capacity, involvement of number of limbs in increasing order, high therapeutic requirements, and dependency. CONCLUSION The association between early diagnosis of cerebral palsy and improved functional capacity, involvement of a lesser number of limbs, better quality of life, and absence of associated disabilities is established from the findings of our study.
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Affiliation(s)
| | - Jagannath Dixit
- Department of Community Medicine, B.J Government Medical College, Pune, India
| | - Bina M Kuril
- Department of Community Medicine, Government Medical College, Aurangabad, India
| | - L S Deshmukh
- Department of Neonatology, Government Medical College, Aurangabad, India
| | - Prabha Khaire
- Department of Pediatrics, Government Medical College, Aurangabad, India
| | - Varsha Vaidya
- Kpond Children' Superspeciality Hospital, Aurangabad, India
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Eto E, Maeda T, Kobayashi O, Ihara K. Intrauterine twin environment and genetic factors subliminally affecting general movements in preterm infants. Brain Dev 2024:S0387-7604(24)00072-X. [PMID: 38705801 DOI: 10.1016/j.braindev.2024.05.002] [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: 01/11/2024] [Revised: 04/30/2024] [Accepted: 05/01/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Understanding background factors is beneficial for interpreting general movements (GMs). This study examines the factors involved in preterm-writhing GMs by comparing twins and singletons. METHOD The subjects were 107 infants cared for at Oita University. The cohort consisted of very-low-birth-weight infants, including twins with a birth weight < 2000 g. The median gestational age (GA) was 29 weeks 1 day. The subjects consisted of 75 singletons, 32 twins (16 pairs), 20 monochorionic twins (M-twins), and 12 dichorionic twins (D-twins). GMs were scored according to the GMs optimality score (GMOS) and integrated into 6 items: the quality, neck-trunk and space, amplitude-speed, rotation, onset-offset and cramped, and tremulous score at 32-34 weeks, 35-36 weeks, and 37-42 weeks' GA. A hierarchical cluster analysis was performed using integrated GMOS, and the characteristics of clusters were examined according to clinical backgrounds. RESULTS Three clusters were identified. Cluster 1 was characterized by good-quality GMs, cluster 2 by a poor repertoire but optimal space and rotatory components, and cluster 3 by overall poor-quality GMs, respectively. The mean GMOSs were 36.6, 31.8 and 24.3 in clusters 1, 2, and 3, respectively. There were no marked differences in proportions within clusters with respect to sex and twins. Small-for-gestational age (SGA) was significantly more frequent in cluster 3 at 32-34 weeks' GA than in other clusters. Perinatal brain injury had a significantly lower proportion in cluster 1 and a higher proportion in cluster 3 at 35-36 weeks' GA and 37-42 weeks' GA. M-twin pairs tended to belong to the same clusters at 35-36 weeks' GA. CONCLUSION Preterm writhing GMs are associated with SGA and perinatal brain injury. Cluster matching in M-twins suggests that certain genetic factors may substantially influence GMs.
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Affiliation(s)
- Eriko Eto
- Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan
| | - Tomoki Maeda
- Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan.
| | - Osamu Kobayashi
- Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan
| | - Kenji Ihara
- Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan
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Peyton C, Aaby D, Millman R, Rodriguez S, Boswell L, Gaebler-Spira D, de Regnier RA, Barbosa VM, Sukal-Moulton T. Stability of the Motor Optimality Score Revised (MOS-R) in medically complex infants. Early Hum Dev 2024; 192:106008. [PMID: 38615539 DOI: 10.1016/j.earlhumdev.2024.106008] [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: 03/18/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND The Motor Optimality Score-Revised (MOS-R) is a clinical test of infant spontaneous movement at 3-5 months of age and has been associated with neurodevelopmental outcomes in infants with medical complexity. However the stability of the MOS-R tested at different developmental ages is not yet known. AIM To determine if the repeated scoring of the MOS-R remained consistent when tested at two developmental ages in young infants. STUDY DESIGN In this prospective cohort study, infants were tested twice with the MOS-R between 12 and 13 weeks corrected age (CA) and 14-16 weeks CA. Bland Altman Plots were used to calculate agreement between the scores. Infants were grouped as having higher or lower medical complexity. MOS-R threshold scores were analyzed to assess changes over time within each group using Fisher's exact test. SUBJECTS 85 infants with history of hospitalization in a neonatal intensive care unit (NICU). RESULTS The MOS-R scores had a high agreement with negligible bias (0.058) between timepoints (95 % CI -1.10, 1.22). Using a MOS-R cut point of 19, infants with higher medical complexity were more likely to change groups between timepoints than infants with lower medical complexity (p = 0.008), but this was not significantly different using cut points of 20 or 21. CONCLUSION The MOS-R scores were stable when measured repeatedly in infants who were hospitalized in a NICU. Infants with high medical complexity had less stable MOS-R scores using certain cut points than infants with lower medical complexity.
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Affiliation(s)
- Colleen Peyton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL, 60611, USA; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - David Aaby
- Department of Research Services, Northwestern University Libraries, Chicago, IL, USA; Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Ryan Millman
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL, 60611, USA
| | - Sarah Rodriguez
- Department of Ophthalmology and Visual Science, University of Chicago, Chicago, IL, USA
| | - Lynn Boswell
- Ann and Robert H Lurie Children's Hospital, Chicago, IL, USA
| | - Deborah Gaebler-Spira
- Ann and Robert H Lurie Children's Hospital, Chicago, IL, USA; Shirley Ryan AbilityLab, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University
| | - Raye-Ann de Regnier
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Ann and Robert H Lurie Children's Hospital, Chicago, IL, USA
| | | | - Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL, 60611, USA; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Luke C, Mick-Ramsamy L, Bos AF, Benfer KA, Bosanquet M, Gordon A, Williams H, Taifalos C, Smith M, Leishman S, Oakes E, Kentish M, McNamara L, Ware RS, Boyd RN. Relationship between early infant motor repertoire and neurodevelopment on the hammersmith infant neurological examination in a developmentally vulnerable First Nations cohort. Early Hum Dev 2024; 192:106004. [PMID: 38636257 DOI: 10.1016/j.earlhumdev.2024.106004] [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: 01/08/2024] [Revised: 03/30/2024] [Accepted: 04/01/2024] [Indexed: 04/20/2024]
Abstract
AIM To implement a culturally-adapted screening program aimed to determine the ability of infant motor repertoire to predict early neurodevelopment on the Hammersmith Infant Neurological Examination (HINE) and improve Australian First Nations families' engagement with neonatal screening. METHODS A prospective cohort of 156 infants (55 % male, mean (standard deviation [SD]) gestational age 33.8 (4.6) weeks) with early life risk factors for adverse neurodevelopmental outcomes (ad-NDO) participated in a culturally-adapted screening program. Infant motor repertoire was assessed using Motor Optimality Score-revised (MOS-R), captured over two videos, 11-13+6 weeks (V1; <14 weeks) and 14-18 weeks (V2; ≥14 weeks) corrected age (CA). At 4-9 months CA neurodevelopment was assessed on the HINE and classified according to age-specific cut-off and optimality scores as; developmentally 'on track' or high chance of either adverse neurodevelopmental outcome (ad-NDO) or cerebral palsy (CP). RESULTS Families were highly engaged, 139/148 (94 %) eligible infants completing MOS-R, 136/150 (91 %), HINE and 123 (83 %) both. Lower MOS-R at V2 was associated with reduced HINE scores (β = 1.73, 95 % confidence interval [CI] = 1.03-2.42) and high chance of CP (OR = 2.63, 95%CI = 1.21-5.69) or ad-NDO (OR = 1.38, 95%CI = 1.10-1.74). The MOS-R sub-category 'observed movement patterns' best predicted HINE, infants who score '4' had mean HINE 19.4 points higher than score '1' (95%CI = 12.0-26.9). Receiver-operator curve analyses determined a MOS-R cut-off of <23 was best for identifying mild to severely reduced HINE scores, with diagnostic accuracy 0.69 (sensitivity 0.86, 95%CI 0.76-0.94 and specificity 0.40, 95 % CI 0.25-0.57). A trajectory of improvement on MOS-R (≥2 point increase in MOS-R from 1st to 2nd video) significantly increased odds of scoring optimally on HINE (OR = 5.91, 95%CI 1.16-29.89) and may be a key biomarker of 'on track' development. INTERPRETATION Implementation of a culturally-adapted program using evidence-based assessments demonstrates high retention. Infant motor repertoire is associated with HINE scores and the early neurodevelopmental status of developmentally vulnerable First Nations infants.
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Affiliation(s)
- Carly Luke
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Australia; Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Brisbane, Australia.
| | - Leeann Mick-Ramsamy
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Arend F Bos
- General Movements Trust, Beatrix Children's Hospital, Division of Neonatology, University of Groningen, Groningen, the Netherlands
| | - Katherine A Benfer
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Margot Bosanquet
- Department of Health and Wellbeing, Townsville Hospital and Health Service District (THHS), Townsville, Australia
| | - Anya Gordon
- Townsville University Hospital (TUH), Townsville Hospital and Health Service District (THHS), Townsville, Australia
| | - Hailey Williams
- Cairns Base Hospital (CBH), Cairns and Hinterland Hospital and Health Service (CHHHS), Cairns, Queensland, Australia
| | - Chloe Taifalos
- Cairns Base Hospital (CBH), Cairns and Hinterland Hospital and Health Service (CHHHS), Cairns, Queensland, Australia
| | - Maria Smith
- Cairns Base Hospital (CBH), Cairns and Hinterland Hospital and Health Service (CHHHS), Cairns, Queensland, Australia
| | - Shaneen Leishman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Ellena Oakes
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Megan Kentish
- Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Lynda McNamara
- Cairns Base Hospital (CBH), Cairns and Hinterland Hospital and Health Service (CHHHS), Cairns, Queensland, Australia
| | - Robert S Ware
- School of Medicine and Dentistry, Griffith University, Brisbane, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Australia
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Wu J, Bai C, Hu M, Guan Q, Li J, Luan X, Yan B. Efficacy of cervical perivascular sympathectomy in improving upper limb motor function in children with cerebral palsy and construction of a predictive model. Clin Neurol Neurosurg 2024; 240:108273. [PMID: 38608351 DOI: 10.1016/j.clineuro.2024.108273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/23/2024] [Accepted: 03/31/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND The effectiveness of cervical perivascular sympathectomy (CPVS) in enhancing upper limb motor function in children with cerebral palsy is unclear, and the factors that influence the effectiveness of the surgery have not been documented. OBJECTIVE To investigate the effectiveness of CPVS in enhancing upper limb motor function in children with cerebral palsy and develop a predictive chart for potential associated adverse outcomes METHODS: The study included 187 children with cerebral palsy who underwent CPVS at the Cerebral Palsy Center, Second Affiliated Hospital of Xinjiang Medical University, between January 2018 and January 2022. Patients were categorized into two groups based on prognostic outcomes: those with adverse and favorable prognoses. Demographic and laboratory data were collected and analyzed from both groups. To identify independent predictors of poor post-CPVS upper limb motor function outcomes, statistical techniques, including univariate analysis and binary logistic regression, were applied. Subsequently, these predictors were integrated to formulate a comprehensive predictive model. RESULTS In this cohort of 187 children with cerebral palsy undergoing CPVS, 68 (36.36%) exhibited a favorable prognosis for upper limb motor function and 119 (63.64%) demonstrated an adverse prognosis. Age, motor function, and serum albumin levels were identified as significant prognostic factors via logistic regression analysis. To develop the model, we divided the sample into a training set (70%, n = 131) and a validation set (30%, n = 56). Employing motor function, serum albumin levels, and age as variables, we crafted a predictive model. The model's performance, reflected by the area under the curve was 0.813 (0.732, 0.894) in the training set and 0.770 (0.647, 0.892) in the validation set, demonstrating its robust predictive capability for post-CPVS adverse outcomes. Furthermore, the consistency curve and Hosmer-Lemeshow test (χ2 = 8.808, p = 0.359) illustrated a strong concordance between the model's predictions of poor prognosis and the actual incidence rate. CONCLUSION CPVS has been shown to be effective in improving upper limb motor function in patients with cerebral palsy. Independent prognostic factors identified encompass motor function, age, and serum albumin levels. The composite predictive model shows potential for clinical applications.
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Affiliation(s)
- Junjie Wu
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang 830063, China
| | - Chao Bai
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang 830063, China
| | - Mingbo Hu
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang 830063, China
| | - Qi Guan
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang 830063, China
| | - Jianglong Li
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang 830063, China
| | - Xinping Luan
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang 830063, China
| | - Baofeng Yan
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang 830063, China.
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Hornby B, Paleg GS, Williams SA, Hidalgo-Robles Á, Livingstone RW, Montufar Wright PE, Taylor A, Shrader MW. Identifying Opportunities for Early Detection of Cerebral Palsy. CHILDREN (BASEL, SWITZERLAND) 2024; 11:515. [PMID: 38790510 PMCID: PMC11119564 DOI: 10.3390/children11050515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/12/2024] [Accepted: 04/21/2024] [Indexed: 05/26/2024]
Abstract
This study aimed to evaluate assessment and referral practices for the early detection and diagnosis of children at risk for or with cerebral palsy (CP) by health care and education providers in Maryland and Delaware. A secondary aim was to identify barriers for using early detection tools and identify opportunities for change to support early diagnosis and improve care. Seventy-two participants answered ≥ 50% of the survey questions. Most were occupational or physical therapists (86%) working in early intervention (61%). Eighty-eight percent indicated awareness that CP can be diagnosed by 12 months. Though 86% stated they typically suspect a diagnosis of CP between 0 and 12 months, only 19% reported that their patients received a CP diagnosis < 12 months. The Developmental Assessment of Young Children (73%) and the Peabody Developmental Motor Scales-2 (59%) were used most. Many respondents indicated never using magnetic resonance imaging (70%), the General Movements Assessment (87%), or the Hammersmith Infant Neurological Exam (69%). Participants identified clinical signs and symptoms prompting a referral for the diagnostic assessment of CP, most commonly stiffness in legs (95%), excessive head lag (93%), and persistent fisting (92%). Policy and organizational change, clinician education, and training are needed to support the implementation of CP early detection guidelines.
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Affiliation(s)
- Brittany Hornby
- Physical Therapy Department, Kennedy Krieger Institute, Baltimore, MD 21205, USA;
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | | | - Sîan A. Williams
- School of Allied Health, Curtin University, Perth, WA 6009, Australia;
- Liggins Institute, University of Auckland, Auckland 1023, New Zealand
| | - Álvaro Hidalgo-Robles
- Facultad de Educación, Universidad Internacional de La Rioja, 26006 Logroño, La Rioja, Spain;
| | - Roslyn W. Livingstone
- Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC V6T 2B5, Canada;
| | | | - Alice Taylor
- Nemours Children’s Health, Wilmington, DE 19803, USA; (P.E.M.W.); (A.T.)
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Reco MDON, Soares-Marangoni DA. Randomized Controlled Trial Protocol on the Effects of a Sensory Motor Intervention Associated with Kangaroo Skin-to-Skin Contact in Preterm Newborns. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:538. [PMID: 38791750 PMCID: PMC11121349 DOI: 10.3390/ijerph21050538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 05/26/2024]
Abstract
There is still very limited evidence on the effects of neonatal interventions on infant neurodevelopmental outcomes, including general movements (GMs). This research will primarily assess the effects of a sensory motor physical therapy intervention combined with kangaroo skin-to-skin contact on the GMs of hospitalized preterm newborns. Secondary outcomes include body weight, posture and muscle tone, behavioral state, length of hospital stay, and breastfeeding. This study protocol details a two-arm parallel clinical trial methodology, involving participants with a postmenstrual age of 34-35 weeks admitted to a Neonatal Intermediate Care Unit (NInCU) with poor repertoire GMs. Thirty-four participants will be randomly assigned to either the experimental group, receiving a 10-day sensory motor physical therapy associated with kangaroo skin-to-skin contact, or the control group, which will only receive kangaroo skin-to-skin contact. The study will measure GMs (primary outcome), and body weight, posture and muscle tone, behavioral state, length of hospital stay, and breastfeeding (secondary outcomes). Data collection occurs in the NInCU before and after the intervention, with follow-up measurements post discharge at 2-4 weeks and 12-15 weeks post-term. SPSS will be used for data analyses. The results will provide novel information on how sensory motor experiences may affect early neurodevelopment and clinical variables in preterm newborns.
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Affiliation(s)
- Mariane de Oliveira Nunes Reco
- Graduate Program in Health and Development, Faculty of Medicine, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil;
| | - Daniele Almeida Soares-Marangoni
- Graduate Program in Movement Sciences, Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
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Wu J, Bai C, Yan B, Mutalifu N, Guan Q, Li J, Luan X. Development and validation of a predictive model for poor prognosis of communication disorders in children with cerebral palsy after cervical perivascular sympathectomy. Neurosurg Rev 2024; 47:142. [PMID: 38587684 PMCID: PMC11001727 DOI: 10.1007/s10143-024-02380-6] [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: 08/08/2023] [Revised: 03/12/2024] [Accepted: 03/30/2024] [Indexed: 04/09/2024]
Abstract
Cervical perivascular sympathectomy (CPVS) can improve communication disorders in children with cerebral palsy (CP); however, there are no research reports on the factors affecting surgical efficacy. This study aimed to establish a nomogram for poor prognosis after CPVS. We collected data from 313 CP patients who underwent CPVS at the Neurosurgery Cerebral Palsy Center of the Second Affiliated Hospital of Xinjiang Medical University from January 2019 to January 2023. Among them, 70% (n = 216) formed the training cohort and 30% (n = 97) the validation cohort. The general data and laboratory examination data of both groups were analyzed. In training cohort, 82 (37.96%) showed improved postoperative communication function. Logistic analysis identified motor function, serum alkaline phosphatase, serum albumin, and prothrombin activity as the prognostic factors. Using these four factors, a prediction model was constructed with an area under the curve (AUC) of 0.807 (95% confidence interval [CI], 0.743-0.870), indicating its ability to predict adverse outcomes after CPVS. The validation cohort results showed an AUC of 0.76 (95% CI, 0.650-0.869). The consistency curve and Hosmer-Lemeshow test (χ2 = 10.988 and p = 0.202, respectively) demonstrated good consistency between the model-predicted incidence and the actual incidence of poor prognosis. Motor function, serum alkaline phosphatase, serum albumin, and prothrombin activity are independent risk factors associated with the prognosis of communication disorders after CPVS. The combined prediction model has a good clinical prediction effect and has promising potential to be used for early prediction of prognosis of CPVS.
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Affiliation(s)
- Junjie Wu
- Department of Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China
| | - Chao Bai
- Department of Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China
| | - Baofeng Yan
- Department of Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China
| | - Nurehemaiti Mutalifu
- Department of Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China
| | - Qi Guan
- Department of Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China
| | - Jianglong Li
- Department of Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China
| | - Xinping Luan
- Department of Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China.
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Toma AI, Dima V, Alexe A, Bojan C, Nemeș AF, Gonț BF, Arghirescu A, Necula AI, Fieraru A, Stoiciu R, Mirea A, Calomfirescu Avramescu A, Isam AJ. Early Intervention Guided by the General Movements Examination at Term Corrected Age-Short Term Outcomes. Life (Basel) 2024; 14:480. [PMID: 38672751 PMCID: PMC11050901 DOI: 10.3390/life14040480] [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: 02/19/2024] [Revised: 03/17/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND AND AIM The early identification of the former premature neonates at risk of neurologic sequelae could lead to early intervention and a better prognosis. This pilot study aimed to investigate whether the General Movement patterns observed at term-equivalent age in former premature infants could serve as predictors for guiding early intervention and improving prognosis. MATERIALS AND METHODS In a population of 44 premature neonates (mean gestational age 33.59 weeks (+2.43 weeks)) examined at term-equivalent age, 10 neonates with a cramped-synchronized General Movements motor pattern were identified. These neonates were included in an early intervention program consisting of physiotherapy executed both by the therapist and by the parents at home. They were again examined at a corrected age of 12 weeks. The presence or absence of fidgety movements and the MOS-R (motor optimality score revised) was noted. The examinations were performed by certified specialists. RESULTS Normal fidgety movements and a MOS-R of 20-24 were presented in 9/10 of the former premature infants, with normal foot to foot contact present in 7/10, and normal hand to hand contact present in 5/10. The atypical patterns noted were side to side movements of the head in 5/10, a non-centered head in 9/10, asymmetric tonic neck reflex in 9/10 and jerky movements in 10/10. One patient presented with no fidgety movements and a MOS-R score of 9. CONCLUSION Early intervention in our group of patients allowed for an improvement in the neurologic status, demonstrated by the presence of fidgety movements. We suggest that early intervention should be indicated in all premature infants that present with a cramped-synchronized GM pattern during examination at term-equivalent age. However, due to the small sample size, the absence of statistical analysis and a control group, and the limited follow-up period, the conclusions must be approached with caution.
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Affiliation(s)
- Adrian Ioan Toma
- Life Memorial Hospital, 010719 Bucharest, Romania
- Faculty of Medicine, University Titu Maiorescu, 040441 Bucharest, Romania
| | - Vlad Dima
- Neonatology Department Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | | | - Cristina Bojan
- Kinetotherapy Department, Pediatric Neurology Alexandru Obregia Hospital, 041914 Bucharest, Romania
| | - Alexandra Floriana Nemeș
- Life Memorial Hospital, 010719 Bucharest, Romania
- Faculty of Medicine, University Titu Maiorescu, 040441 Bucharest, Romania
| | | | | | | | | | | | - Andrada Mirea
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | - Al Jashi Isam
- Faculty of Medicine, University Titu Maiorescu, 040441 Bucharest, Romania
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14
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Wu J, Yan B, Mutalifu N, Guan Q, Bai C, Li J, Luan X. Efficacy and influencing factors of cervical perivascular sympathectomy in children with cerebral palsy. Childs Nerv Syst 2024; 40:1137-1145. [PMID: 37870563 DOI: 10.1007/s00381-023-06191-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND There is a lack of research to determine the efficacy of cervical perivascular sympathectomy (CPVS) in children with cerebral palsy (CP). OBJECTIVE This study aimed to evaluate the efficacy of CPVS in children with CP and analyze the associated influential factors. METHODS Using the method of retrospective cohort studies, children who underwent CPVS were included in the CPVS group, whereas those who underwent selective posterior rhizotomy (SPR) were included in the SPR group. The Communication Function Classification System (CFCS) and Teacher Drooling Scale (TDS) were used to evaluate the communication function and salivation in the two groups before and 12 months after surgery and compare the surgical efficiency between the two groups, and the factors affecting the efficacy were screened by binary logistic regression. RESULTS The study included 406 patients, 202 in the CPVS group and 204 in the SPR group. No significant differences were observed in the baseline characteristics (p > 0.05). The surgical efficacy of the CPVS group (47.01%) was significantly higher than that in the SPR group (9.81%) (χ2 = 71.08, p < 0.001). Binary logic regression analysis showed that preterm birth and Gross Motor Function Classification System (GMFCS) grade were influencing factors of surgical efficacy. Eighteen patients developed postoperative complications. CONCLUSION CPVS is a safe and effective surgery for cerebral palsy. Preterm birth and GMFCS grade are independent factors affecting the efficacy of surgery.
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Affiliation(s)
- Junjie Wu
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China
| | - Baofeng Yan
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China
| | - Nurehemaiti Mutalifu
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China
| | - Qi Guan
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China
| | - Chao Bai
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China
| | - Jianglong Li
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China
| | - Xinping Luan
- Cerebral Palsy Center in Neurosurgery, Second Affiliated Hospital of Xinjiang Medical University, Nanhu North Road, Shuimogou District, Urumqi, Xinjiang, 830063, China.
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Yardımcı-Lokmanoğlu BN, Demir N, Porsnok D, Sırtbaş-Işık G, Cengiz E, Serel-Arslan S, Mutlu A. Are sucking patterns and early spontaneous movements related to later developmental functioning outcomes? A cohort study. Eur J Pediatr 2024; 183:1435-1446. [PMID: 38217695 PMCID: PMC10951042 DOI: 10.1007/s00431-024-05422-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/15/2024]
Abstract
Sucking patterns and early spontaneous movements have an important role in the determination of later developmental problems, but the relationship of the two together with long-term outcomes has not been investigated. The objectives of this study were to (i) examine the relationship between sucking patterns using the Neonatal Oral Motor Assessment Scale (NOMAS) and fidgety movements and other movement patterns using detailed General Movements Assessment (GMA), and (ii) investigate the relationship between these early assessment methods and developmental functioning outcomes at later ages. We analyzed the NOMAS from 34 weeks' postmenstrual age up to 10 weeks post-term and GMA between 9 and 20 weeks post-term age, and the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) was applied for the developmental functioning outcomes to 62 infants (61%, 62/102) between 12 and 42 months of age. Among 102 infants at-risk, 70 (69%) showed a normal sucking pattern, and 85 (83%) had fidgety movements. The median Motor Optimality Score-Revised (MOS-R), as determined by GMA, of all infants was 24. The NOMAS was related to the MOS-R and its subcategories (p < 0.05) in all infants at-risk. The NOMAS, MOS-R and its subcategories were also related to cognitive, language, and motor development at later ages according to Bayley-III (p < 0.05). Conclusion: This longitudinal study showed that the quality of sucking patterns, fidgety movements, and MOS-R were related to later developmental functioning, indicating that abnormal sucking patterns, aberrant fidgety movements, and lower MOS-R might predict developmental disorders. What is Known: • Sucking patterns and early spontaneous movements in which central pattern generators play an important role are related. • Sucking patterns and early spontaneous movements might be used separately to predict developmental outcomes. What is New: • Sucking patterns and early spontaneous movements, when used together, were related to later developmental functioning, including cognitive, language, and motor development in at-risk infants. • Predictive value of sucking patterns was lower for each developmental functioning outcome than early spontaneous movements.
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Affiliation(s)
- Bilge N Yardımcı-Lokmanoğlu
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Ankara, Türkiye.
| | - Numan Demir
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Swallowing Disorders Unit, Ankara, Türkiye
| | - Doğan Porsnok
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Ankara, Türkiye
| | - Gülsen Sırtbaş-Işık
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Ankara, Türkiye
| | - Emre Cengiz
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Swallowing Disorders Unit, Ankara, Türkiye
| | - Selen Serel-Arslan
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Swallowing Disorders Unit, Ankara, Türkiye
| | - Akmer Mutlu
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Ankara, Türkiye
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Kobayashi O, Maeda T, Ihara K. Early infantile spontaneous movement in very low birthweight infants is associated with sensory characteristics at the corrected age of 3 years. Brain Dev 2024; 46:135-141. [PMID: 37978037 DOI: 10.1016/j.braindev.2023.11.003] [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: 06/16/2023] [Revised: 10/23/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023]
Abstract
AIM To clarify the relationship between early infantile spontaneous movement of very-low-birth-weight infants (VLBWIs) and sensory characteristics in childhood. STUDY DESIGN Prospective cohort study. We investigated the association between the Motor Optimality Score-Revised (MOS-R), a detailed assessment of general movements (GMs) at the corrected age of 9-17 weeks and the Infant/Toddler Sensory Profile Japanese version (ITSP-J) at the corrected age of 3 years. A multiple regression analysis was performed to examine the correlation of ITSP-J and MOS-R with patient clinical background factors. SUBJECTS Fifty-three VLBWIs (median gestational age: 28 weeks, 6 days; median birth weight: 997 g) who were managed at the NICU of Oita University from September 2013 to June 2019. RESULTS A multiple regression analysis revealed that the ITSP-J subscale in the sensory section of visual score was significantly correlated with the age-adequate movement repertoire subscore of MOS-R, and in the sensory section of vestibular score was correlated with the fidgety subscore of MOS-R. For both visual and vestibular section scores, intraventricular hemorrhage (IVH) showed an independent association with the MOS-R subscore. CONCLUSION Spontaneous movement characteristics in early infancy were associated with sensory characteristics in early childhood.
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Affiliation(s)
- Osamu Kobayashi
- Department of Pediatrics, Oita University Faculty of Medicine, Japan
| | - Tomoki Maeda
- Department of Pediatrics, Oita University Faculty of Medicine, Japan.
| | - Kenji Ihara
- Department of Pediatrics, Oita University Faculty of Medicine, Japan
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17
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See MSN, Ereno IL, Teh WY, Baral VR, Vaughan RD, Yeo CL. Agreement between Hammersmith Neonatal Neurological Examination (HNNE) and Test of Infant Motor Performance (TIMP) in neurodevelopmental assessment of preterm infants <32 weeks' gestation at term corrected age. Early Hum Dev 2024; 190:105973. [PMID: 38377881 DOI: 10.1016/j.earlhumdev.2024.105973] [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: 11/03/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVES To determine the agreement between HNNE and TIMP at TCA for preterm infants born <32+0 weeks' gestation, and to evaluate their correlation to PDMS-2 at 12-month corrected age (CA). METHODS Infants born between November 2013 to June 2022 who had both HNNE and TIMP performed at TCA of 37+0-41+6 weeks gestation, and motor outcome assessed using the PDMS-2 at 12-month old were enrolled. The HNNE and 12-month PDMS-2 findings were categorized as optimal vs sub-optimal. TIMP was categorized as typical vs atypical. Cohen's kappa was used to determine the agreement between HNNE and TIMP. Sensitivity analysis and Receiver Operating Characteristic (ROC) curves were used to evaluate the predictive values of HNNE and TIMP on motor outcome at CA of 12-months. RESULTS HNNE and TIMP done on 125 infants at TCA do not show reliable agreement. HNNE demonstrated slight and fair agreement with the 12-month Total Motor Quotient (TMQ) and Fine Motor Quotient (FMQ) of the PDMS-2 respectively. TIMP at TCA demonstrated fair agreement with all sub-domains of motor function on PDMS-2 at 12-months. In comparison with TIMP, HNNE at TCA is more sensitive at predicting suboptimal total, gross and fine motor outcomes at 12-month CA with sensitivity of 68.4 %, 51.9 %, and 83.3 % vs 44.4 %, 31.8 % and 53.3 % respectively. Atypical TIMP at TCA is more specific for suboptimal total, gross and fine motor outcomes at 12-month CA with specificity of 90.3 %, 89 % and 90.5 % respectively. Neurobehavioral assessments at TCA using HNNE and TIMP were predictive of suboptimal fine motor quotient at CA of 12-months with AUC of 0.760 (p = 0.011) and 0.718 (p = 0.032) respectively. The difference in AUC between the 2 instruments of 0.042 was not statistically significant (p = 0.741). CONCLUSIONS While the HNNE and TIMP done at TCA did not demonstrate significant agreement, suboptimal HNNE and atypical TIMP at TCA were predictive of suboptimal FMQ on PDMS-2 at 12-month CA.
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Affiliation(s)
| | - Imelda Lustestica Ereno
- Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wan Ying Teh
- Department of Physiotherapy, Singapore General Hospital, Singapore
| | - Vijayendra Ranjan Baral
- Duke-NUS Medical School, Singapore; Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, National Technological University of Singapore, Singapore
| | | | - Cheo Lian Yeo
- Duke-NUS Medical School, Singapore; Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Lee Kong Chian School of Medicine, National Technological University of Singapore, Singapore.
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Oh J, Ordoñez ELT, Velasquez E, Mejía M, Grazioso MDP, Rohloff P, Smith BA. Early full-day leg movement kinematics and swaddling patterns in infants in rural Guatemala: A pilot study. PLoS One 2024; 19:e0298652. [PMID: 38422106 PMCID: PMC10903813 DOI: 10.1371/journal.pone.0298652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 01/30/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Tools to accurately assess infants' neurodevelopmental status very early in their lives are limited. Wearable sensors may provide a novel approach for very early assessment of infant neurodevelopmental status. This may be especially relevant in rural and low-resource global settings. METHODS We conducted a longitudinal observational study and used wearable sensors to repeatedly measure the kinematic leg movement characteristics of 41 infants in rural Guatemala three times across full days between birth and 6 months of age. In addition, we collected sociodemographic data, growth data, and caregiver estimates of swaddling behaviors. We used visual analysis and multivariable linear mixed models to evaluate the associations between two leg movement kinematic variables (awake movement rate, peak acceleration per movement) and infant age, swaddling behaviors, growth, and other covariates. RESULTS Multivariable mixed models of sensor data showed age-dependent increases in leg movement rates (2.16 [95% CI 0.80,3.52] movements/awake hour/day of life) and movement acceleration (5.04e-3 m/s2 [95% CI 3.79e-3, 6.27e-3]/day of life). Swaddling time as well as growth status, poverty status and multiple other clinical and sociodemographic variables had no impact on either movement variable. CONCLUSIONS Collecting wearable sensor data on young infants in a rural low-resource setting is feasible and can be used to monitor age-dependent changes in movement kinematics. Future work will evaluate associations between these kinematic variables from sensors and formal developmental measures, such as the Bayley Scales of Infant and Toddler Development.
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Affiliation(s)
- Jinseok Oh
- Division of Developmental-Behavioral Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California, United States of America
| | | | | | | | | | - Peter Rohloff
- Wuqu’ Kawoq | Maya Health Alliance, Tecpán, Guatemala
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Beth A. Smith
- Division of Developmental-Behavioral Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California, United States of America
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
- Developmental Neuroscience and Neurogenetics Program, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, California, United States of America
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Sermpon N, Gima H. Correlation between pose estimation features regarding movements towards the midline in early infancy. PLoS One 2024; 19:e0299758. [PMID: 38416738 PMCID: PMC10901309 DOI: 10.1371/journal.pone.0299758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/14/2024] [Indexed: 03/01/2024] Open
Abstract
In infants, spontaneous movement towards the midline (MTM) indicates the initiation of anti-gravity ability development. Markerless 2D pose estimation is a cost-effective, time-efficient, and quantifiable alternative to movement assessment. We aimed to establish correlations between pose estimation features and MTM in early-age infants. Ninety-four infant videos were analysed to calculate the percentage and rate of MTM occurrence. 2D Pose estimation processed the videos and determined the distances and areas using wrist and ankle landmark coordinates. We collected data using video recordings from 20 infants aged 8-16 weeks post-term age. Correlations between MTM observations and distance values were evaluated. Differences in areas between groups of videos showing MTM and no MTM in the total, lower-limb, and upper-limb categories were examined. MTM observations revealed common occurrences of hand-to-trunk and foot-to-foot movements. Weak correlations were noted between limb distances to the midbody imaginary line and MTM occurrence values. Lower MTM showed significant differences in the lower part (p = 0.003) and whole area (p = 0.001). Video recording by parents or guardians could extract features using 2D pose estimation, assisting in the early identification of MTM in infants. Further research is required to assess a larger sample size with the diversity of MTM motor behaviour, and later developmental skills, and collect data from at-risk infants.
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Affiliation(s)
- Nisasri Sermpon
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Arakawa, Tokyo, Japan
- Faculty of Physical Therapy, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Hirotaka Gima
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Arakawa, Tokyo, Japan
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20
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Sırtbaş-Işık G, Porsnok D, Yardımcı-Lokmanoğlu BN, Mutlu A. Sleep characteristics, early spontaneous movements, and developmental functioning in preterm infants in the early postnatal period. Sleep Med 2024; 114:151-158. [PMID: 38184924 DOI: 10.1016/j.sleep.2023.12.016] [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: 08/09/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE This study aimed to investigate the following: (i) sleep characteristics in preterm infants at 9-20 weeks of corrected age, and (ii) differences in early spontaneous movements and developmental functioning results between the groups based on some sleep characteristics. METHODS Seventy-four preterm infants (36 female) were included. Sleep characteristics were assessed according to the Brief Infant Sleep Questionnaire (BISQ). The infants were divided into two groups based on total sleep duration: less than 12 h (38 infants), and 12 h and more (36 infants). Video recordings were made for the General Movements Assessment (GMA) and evaluated using the Motor Optimality Score for 3- to 5-Month-Old-Infants-Revised (MOS). Cognitive, language, and motor development were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). RESULTS The total sleep duration of all preterm infants (mean ± SD) was 11.8 ± 3.3 h. Infants who had absent fidgety movements slept less than 12 h, and fidgety movements differed between the groups (p = 0.012). Infants who slept 12 h or more had significantly higher MOS (p = 0.041), cognitive (p = 0.002), language (p < 0.001), and motor (p = 0.002) development results. Infants who snored had lower MOS (p = 0.001), cognitive (p = 0.004), language (p = 0.002), and motor (p = 0.001) development results. Infants with fewer than three nocturnal awakenings had significantly higher Bayley-III cognitive (p = 0.007), language (p = 0.032), and motor (p = 0.005) domain results. Prone and supine sleeping positions showed higher motor domain results than lateral positions (p = 0.001). CONCLUSIONS Sleep in preterm infants might be a key factor in early developmental functioning processes and nervous system integrity. Even in the first months of life, there are substantial differences in cognitive, language, and motor development in association with sleep characteristics.
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Affiliation(s)
- Gülsen Sırtbaş-Işık
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Ankara, Türkiye.
| | - Doğan Porsnok
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Ankara, Türkiye.
| | - Bilge Nur Yardımcı-Lokmanoğlu
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Ankara, Türkiye.
| | - Akmer Mutlu
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Ankara, Türkiye.
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De Campos AC, Hidalgo-Robles Á, Longo E, Shrader C, Paleg G. F-words e ingredientes das intervenções precoces para crianças com paralisia cerebral não deambuladoras: uma revisão de escopo. Dev Med Child Neurol 2024; 66:e12-e22. [PMID: 37491829 DOI: 10.1111/dmcn.15717] [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] [Accepted: 05/23/2023] [Indexed: 07/27/2023]
Abstract
Cuidados centrados na família (incluindo coaching e intervenções fornecidas pelo cuidador) e treinamento parental formal são estratégias eficazes para crianças nos níveis IV e V do GMFCS. Os ingredientes de tecnologia assistiva podem promover várias F-words (funcionalidade, saúde, família, diversão, amigos e futuro). O menor nível de evidência foi encontrado para diversão, amigos e futuro. Outros fatores (prestação de serviços, treinamento profissional, dose de terapia, modificações ambientais) são relevantes para crianças pequenas nos níveis IV e V do GMFCS. Esta revisão de escopo identificou os ingredientes de intervenções precoces para crianças com paralisia cerebral em risco de não serem deambuladoras, e os mapeou-os de acordo com a estrutura das F-words. O treinamento formal dos pais e a tecnologia assistiva se destacaram como estratégias para abordar com várias F-words.
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Affiliation(s)
| | | | - Egmar Longo
- Departamento de Fisioterapia em Pediatria, Universidade Federal da Paraíba, PB, Brasil
| | - Claire Shrader
- HMS School for Children with Cerebral Palsy, Philadelphia, PA, USA
| | - Ginny Paleg
- Montgomery County Infants and Toddlers Program, Rockville, MD, USA
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De Campos AC, Hidalgo-Robles Á, Longo E, Shrader C, Paleg G. F-words and early intervention ingredients for non-ambulant children with cerebral palsy: A scoping review. Dev Med Child Neurol 2024; 66:41-51. [PMID: 37381598 DOI: 10.1111/dmcn.15682] [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: 11/01/2022] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 06/30/2023]
Abstract
AIM To explore the ingredients of early interventions provided to young children with cerebral palsy (CP) who are classified in Gross Motor Function Classification System (GMFCS) levels IV and V, and to identify the 'F-words' addressed by the interventions. METHOD Searches were completed in four electronic databases. Inclusion criteria were the original experimental studies that fitted the following PCC components: population, young children (aged 0-5 years, at least 30% of the sample) with CP and significant motor impairment (GMFCS levels IV or V, at least 30% of the sample); concept, non-surgical and non-pharmacological early intervention services measuring outcomes from any of the International Classification of Functioning, Disability and Health domains; and context, studies published from 2001 to 2021, from all settings and not limited to any specific geographical location. RESULTS Eighty-seven papers were included for review, with qualitative (n = 3), mixed-methods (n = 4), quantitative descriptive (n = 22), quantitative non-randomized (n = 39), and quantitative randomized (n = 19) designs. Fitness (n = 59), family (n = 46), and functioning (n = 33) ingredients were addressed by most experimental studies, whereas studies on fun (n = 6), friends (n = 5), and future (n = 14) were scarce. Several other factors (n = 55) related to the environment, for example, service provision, professional training, therapy dose, and environmental modifications, were also relevant. INTERPRETATION Many studies positively supported formal parent training and use of assistive technology to promote several F-words. A menu of intervention ingredients was provided, with suggestions for future research, to incorporate them into a real context within the family and clinical practice. WHAT THIS PAPER ADDS Family-centred care (including coaching and caregiver-delivered interventions) and formal parental training are effective strategies for children in GMFCS levels IV and V. Assistive technology ingredients (power, mobility, supported, sitting, stepping, and standing) may promote several 'F-words' (functioning, fitness, family, fun, friends, and future). The lowest level of evidence was found for fun, friends, and future. Other factors (service provision, professional training, therapy dose, environmental modifications) are relevant for young children in GMFCS levels IV and V.
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Affiliation(s)
- Ana Carolina De Campos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos-, SP, Brazil
| | | | - Egmar Longo
- Department of Physical therapy in Pediatrics, Federal University of Paraíba, João Pessoa-, PB, Brazil
| | - Claire Shrader
- HMS School for Children with Cerebral Palsy, Philadelphia, PA, USA
| | - Ginny Paleg
- Montgomery County Infants and Toddlers Program, Rockville, MD, USA
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De Campos AC, Hidalgo-Robles Á, Longo E, Shrader C, Paleg G. F-Wörter und Interventionsinhalte in der Frühförderung nicht gehfähiger Kinder mit Cerebralparese: eine umfangreiche Literaturübersicht. Dev Med Child Neurol 2024; 66:e23-e34. [PMID: 37740649 DOI: 10.1111/dmcn.15756] [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] [Received: 08/25/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023]
Abstract
AbstractZielUntersuchung der Inhalte von Frühfördermaßnahmen für Kleinkinder mit Cerebralparese (CP) mit Gross Motor Function Classification System (GMFCS) Level IV und V und die Identifikation von „F‐Wörtern“, die von den Maßnahmen adressiert werden.MethodeRecherche in vier elektronischen Datenbanken. Einschlusskriterien: experimentelle Originalstudien, die die folgenden PCC‐Komponenten erfüllten: Population: Kleinkinder (im Alter von 0–5 Jahre, mindestens 30% der Stichprobe) mit CP und erheblicher motorischer Beeinträchtigung (GMFCS‐Levels IV oder V, mindestens 30% der Stichprobe); Konzept: nicht‐chirurgische und nicht‐pharmakologische Leistungen der Frühförderung, die Ergebnisse aus einem der Bereiche der Internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF) messen; und Kontext: Studien, die zwischen 2001 und 2021 veröffentlicht wurden, in allen Konstellationen und nicht auf einen bestimmten geografischen Ort beschränkt.Ergebnisse87 Studien wurden in dieser Literaturübersicht berücksichtigt, mit qualitativen (n = 3), Mixed Methods (n = 4), quantitativ deskriptiven (n = 22), quantitativ nicht‐randomisierten (n = 39) und quantitativ randomisierten (n = 19) Designs. Die meisten experimentellen Studien befassten sich mit Fitness (n = 59), Familie (n = 46) und Funktion (n = 33), während es nur wenige Studien zu den Bereichen Spaß (n = 6), Freunde (n = 5) und Zukunft (n = 14) gab. Verschiedene Umweltfaktoren (n = 55) waren ebenfalls bedeutsam, z. B. das Angebot an Dienstleistungen, Berufsausbildung, Therapiedosis und Umweltanpassungen.InterpretationViele Studien unterstützen Elternschulungen und den Einsatz assistiver Technologien zur Förderung verschiedener F‐Wörter. Ein „Menü“ von Inhalten der Frühförderung wurden ermittelt, mit Vorschlägen für weitere Forschung, um diese in der klinischen Praxis mit Familien umzusetzen.Was dieser Artikel beiträgt
Familienzentrierte Angebote (einschließlich Beratung von und Intervention durch die Bezugspersonen) und strukturiertes Elterntraining sind wirksame Strategien für Kinder in den GMFCS‐Levels IV und V.
Hilfsmittel (Elektromobilität, unterstütztes Sitzen, Stehen und Gehen) können verschiedene „F‐Wörter“ fördern (Funktion, Fitness, Familie, Spaß, Freunde und Zukunft).
Die geringste Menge an Evidenz wurde für Spaß, Freunde und Zukunft gefunden.
Andere Faktoren (Angebot an Dienstleistungen, Berufsausbildung, Therapiedosis, Umweltanpassungen) sind relevant für Kleinkinder der GMFCS‐Levels IV und V.
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Affiliation(s)
- Ana Carolina De Campos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | | | - Egmar Longo
- Department of Physical therapy in Pediatrics, Federal University of Paraíba, João Pessoa, PB, Brazil
| | - Claire Shrader
- HMS School for Children with Cerebral Palsy, PA, Philadelphia, USA
| | - Ginny Paleg
- Montgomery County Infants and Toddlers Program, Early Childhood Services, MD, Rockville, USA
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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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de Campos AC, Hidalgo-Robles Á, Longo E, Shrader C, Paleg G. F-words e ingredientes de las intervenciones tempranas dirigidas a niños no ambulantes con parálisis cerebral: Una revisión exploratoria. Dev Med Child Neurol 2024; 66:e1-e11. [PMID: 37491808 DOI: 10.1111/dmcn.15716] [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: 07/27/2023]
Abstract
La atención centrada en la familia (incluyendo coaching e intervenciones realizadas por los cuidadores) y el entrenamiento formal de los padres son estrategias efectivas para los niños con niveles IV y V de la GMFCS. Los ingredientes de la tecnología de apoyo pueden promover varias "F-words" (funcionamiento, estado físico, familia, diversión, amigos y futuro). Se encontró el nivel más bajo de evidencia para diversión, amigos y futuro. Otros factores (provisión de servicios, formación profesional, dosis de terapia, modificaciones del entorno) son relevantes para los niños pequeños con niveles IV y V de la GMFCS. Ingredientes de la intervención y F-words en intervenciones tempranas dirigidas a niños no ambulantes con parálisis cerebral.
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Affiliation(s)
- Ana Carolina de Campos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, -SP, Brazil
| | | | - Egmar Longo
- Department of Physical therapy in Pediatrics, Federal University of Paraíba, João Pessoa, -PB, Brazil
| | - Claire Shrader
- HMS School for Children with Cerebral Palsy, Philadelphia, PA, USA
| | - Ginny Paleg
- Montgomery County Infants and Toddlers Program, Rockville, MD, USA
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Toma AI, Dima V, Alexe A, Rusu L, Nemeș AF, Gonț BF, Arghirescu A, Necula A, Fieraru A, Stoiciu R. Correlations between Head Ultrasounds Performed at Term-Equivalent Age in Premature Neonates and General Movements Neurologic Examination Patterns. Life (Basel) 2023; 14:46. [PMID: 38255661 PMCID: PMC10821082 DOI: 10.3390/life14010046] [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: 11/05/2023] [Revised: 12/11/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND AND AIM Our research aims to find correlations between the brain imaging performed at term-corrected age and the atypical general movement (GM) patterns noticed during the same visit a-cramped-synchronized (CS) or poor repertoire (PR)-in formerly premature neonates to provide evidence for the structures involved in the modulation of GM patterns that could be injured and result in the appearance of these patterns and further deficits. MATERIALS AND METHODS A total of 44 preterm neonates ((mean GA, 33.59 weeks (+2.43 weeks)) were examined in the follow-up program at Life Memorial Hospital Bucharest at term-equivalent age (TEA). The GM and ultrasound examinations were performed by trained and certified specialists. Three GM pattens were noted (normal, PR, or CS), and the measurements of the following cerebral structures were conducted via head ultrasounds: ventricular index, the short and long axes of the lateral ventricles, the midbody distance of the lateral ventricle, the diagonal of the caudate nucleus, the width of the basal ganglia, the width of the interhemispheric fissure, the sinocortical width, the length and thickness of the callosal body, the anteroposterior diameter of the pons, the diameter of the vermis, and the transverse diameters of the cerebellum and vermis. The ultrasound measurements were compared between the groups in order to find statistically significant correlations by using the FANOVA test (significance p < 0.05). RESULTS The presence of the CS movement pattern was significantly associated with an increased ventricular index (mean 11.36 vs. 8.90; p = 0.032), increased midbody distance of the lateral ventricle-CS versus PR (8.31 vs. 3.73; p = 0.001); CS versus normal (8.31 vs. 3.34; p = 0.001), increased long and short axes of the lateral ventricles (p < 0.001), and decreased width of the basal ganglia-CS versus PR (11.07 vs. 15.69; p = 0.001); CS versus normal pattern (11.07 vs. 15.15; p = 0.0010). The PR movement pattern was significantly associated with an increased value of the sinocortical width when compared to the CS pattern (p < 0.001) and a decreased anteroposterior diameter of the pons when compared to both the CS (12.06 vs. 16.83; p = 0.001) and normal (12.06 vs. 16.78; p = 0.001) patterns. The same correlations were present when the subgroup of infants with a GA ≤ 32 weeks was analyzed. CONCLUSIONS Our study demonstrated that there are correlations between atypical GM patterns (cramped-synchronized-CS and poor repertoire-PR) and abnormalities in the dimensions of the structures measured via ultrasound at the term-equivalent age. The correlations could provide information about the structures that are affected and could lead to a lack of modulation in the GM patterns.
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Affiliation(s)
- Adrian Ioan Toma
- Life Memorial Hospital, 010719 Bucharest, Romania (B.F.G.)
- Faculty of Medicine, University Titu Maiorescu, 040441 Bucharest, Romania
| | - Vlad Dima
- Filantropia Clinical Hospital, Neonatology Department, 011132 Bucharest, Romania
| | | | - Lidia Rusu
- Regional Center of Public Health, 700465 Iasi, Romania
| | - Alexandra Floriana Nemeș
- Life Memorial Hospital, 010719 Bucharest, Romania (B.F.G.)
- Faculty of Medicine, University Titu Maiorescu, 040441 Bucharest, Romania
| | | | | | - Andreea Necula
- Life Memorial Hospital, 010719 Bucharest, Romania (B.F.G.)
| | - Alina Fieraru
- Life Memorial Hospital, 010719 Bucharest, Romania (B.F.G.)
| | - Roxana Stoiciu
- Life Memorial Hospital, 010719 Bucharest, Romania (B.F.G.)
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Celik HI, Yildiz A, Yildiz R, Mutlu A, Soylu R, Gucuyener K, Duyan-Camurdan A, Koc E, Onal EE, Elbasan B. Using the center of pressure movement analysis in evaluating spontaneous movements in infants: a comparative study with general movements assessment. Ital J Pediatr 2023; 49:165. [PMID: 38124131 PMCID: PMC10731817 DOI: 10.1186/s13052-023-01568-8] [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: 02/21/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Researchers have attempted to automate the spontaneous movement assessment and have sought quantitative and objective methods over the past decade. The purpose of the study was to present a quantitative assessment method of spontaneous movement using center-of-pressure (COP) movement analysis. METHODS A total of 101 infants were included in the study. The infants were placed in the supine position on the force plate with the cranial-caudal orientation. In this position, the recording of video and COP movement data were made simultaneously for 3 min. Video recordings were used to observe global and detailed general movement assessment (GMA), and COP time series data were used to obtain quantitative movement parameters. RESULTS According to the global GMA, 13 infants displayed absent fidgety movements (FMs) and 88 infants displayed normal FMs. The binary logistic regression model indicated significant association between global GMA and COP movement parameters (chi-square = 20.817, p < 0.001). The sensitivity, specificity, and overall accuracy of this model were 85% (95% CI: 55-98), 83% (95% CI: 73-90), and 83% (95% CI: 74-90), respectively. The multiple linear regression model showed a significant association between detailed GMA (motor optimality score-revised/MOS-R) and COP movement parameters (F = 10.349, p < 0.001). The MOS-R total score was predicted with a standard error of approximately 1.8 points (6%). CONCLUSIONS The present study demonstrated the possible avenues for using COP movement analysis to objectively detect the absent FMs and MOS-R total score in clinical settings. Although the method presented in this study requires further validation, it may complement observational GMA and be clinically useful for infant screening purposes, particularly in clinical settings where access to expertise in observational GMA is not available.
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Affiliation(s)
- Halil Ibrahim Celik
- Bilge Çocuk Special Education and Rehabilitation Center, Beysukent, Çankaya, s06800, Ankara, Turkey.
| | - Ayse Yildiz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Erzurum Technical University, Erzurum, Turkey
| | - Ramazan Yildiz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Erzurum Technical University, Erzurum, Turkey
| | - Akmer Mutlu
- Faculty of Physical Therapy and Rehabilitation, Developmental and Early Physiotherapy Unit, Hacettepe University, Ankara, Turkey
| | - Ruhi Soylu
- Faculty of Medicine, Department of Biophysics, Hacettepe University, Ankara, Turkey
| | - Kivilcim Gucuyener
- Faculty of Medicine, Department of Pediatrics, Section of Pediatric Neurology, Gazi University, Ankara, Turkey
| | - Aysu Duyan-Camurdan
- Faculty of Medicine, Department of Pediatrics, Section of Social Pediatrics, Gazi University, Ankara, Turkey
| | - Esin Koc
- Faculty of Medicine, Department of Pediatrics, Section of Neonatal Medicine, Gazi University, Ankara, Turkey
| | - Eray Esra Onal
- Faculty of Medicine, Department of Pediatrics, Section of Neonatal Medicine, Gazi University, Ankara, Turkey
| | - Bulent Elbasan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
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Crowle C, Jackman M, Webb A, Morgan C. Use of the Motor Optimality Score-Revised (MOS-R) to predict neurodevelopmental outcomes in infants with congenital anomalies. Early Hum Dev 2023; 187:105876. [PMID: 37879225 DOI: 10.1016/j.earlhumdev.2023.105876] [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: 08/17/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023]
Abstract
AIMS To describe the Motor Optimality Score-Revised (MOS-R) in infants with congenital anomalies requiring major surgery in the neonatal period; and to determine the predictive validity of the MOS-R, including specific movement and postural patterns, for neurodevelopmental outcomes at 3 years of age. METHOD A retrospective cohort study of 201 infants born with congenital anomalies requiring surgery in the neonatal period (mean gestational age 38.2 weeks, SD 2.2). MOS-R completed using the pre-recorded General Movements Assessment (GMA) videos taken at 12 to 14 weeks post-term age (mean 12.45, SD 1.54). Developmental outcomes were assessed at 3 years of age (38.13 months, SD 1.76) using the Bayley Scales of Infant and Toddler Development (3rd ed). RESULT The mean score for the MOS-R was 21.85 (SD 5.16), with scores ranging from 6 to 28. Fifty-six infants (27.9 %) scored within the optimal range (25-28) with only 12 % demonstrating a normal movement character. A MOS-R total score of <21 was identified as the best performing cut-off to predict a mild, moderate or severe delay or CP diagnosis with sensitivity 0.39 (95 % CI: 0.25, 0.54) and specificity 0.86 (95 % CI: 0.80, 0.91), and an area under the ROC curve of 0.63. Outcome at 3 years was significantly associated with the MOS-R total (p < 0.01) and the subscales for observed movement patterns (p < 0.01) and age adequate repertoire (p = 0.02). CONCLUSION The MOS-R may be an effective tool to use in addition to existing assessments to identify infants who are at risk of adverse developmental outcomes. Our study found that a MOS-R of <21 identified infants who would benefit from referral to early intervention.
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Affiliation(s)
- Cathryn Crowle
- The Children's Hospital Westmead, Hawkesbury Rd, Westmead, NSW 2145, Australia; University of Sydney, Faculty of Medicine and Health, Campderdown, NSW 2006, Australia.
| | - Michelle Jackman
- John Hunter Hospital, Lookout Rd, New Lambton Heights, NSW 2305, Australia; Cerebral Palsy Alliance Research Institute, PO Box 171, Forestville, NSW 2087, Australia
| | - Annabel Webb
- Cerebral Palsy Alliance Research Institute, PO Box 171, Forestville, NSW 2087, Australia
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, PO Box 171, Forestville, NSW 2087, Australia; University of Sydney, Faculty of Medicine and Health, Campderdown, NSW 2006, Australia
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29
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Zhou Q, Cao Y, Zhang L, Erejep N, Xiu WL, Shi JY, Cheng R, Zhou WH, Lee SK. Status of the neonatal follow-up system in China: survey and analysis. World J Pediatr 2023; 19:1104-1110. [PMID: 37452966 PMCID: PMC10533627 DOI: 10.1007/s12519-023-00742-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 06/09/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND There is little information about neonatal follow-up programs (NFUPs) in China. This study aimed to conduct a survey of hospitals participating in the Chinese Neonatal Network (CHNN) to determine the status of NFUPs, including resources available, criteria for enrollment, neurodevelopmental assessments, and duration of follow-up. METHODS We conducted a descriptive study using an online survey of all 72 hospitals participating in CHNN in 2020. The survey included 15 questions that were developed based on the current literature and investigators' knowledge about follow-up practices in China. RESULTS Sixty-four (89%) of the 72 hospitals responded to the survey, with an even distribution of children's (31%), maternity (33%) and general (36%) hospitals. All but one (98%) hospital had NFUPs, with 44 (70%) being established after 2010. Eligibility criteria for follow-up were variable, but common criteria included very preterm infants < 32 weeks or < 2000 g birth weight (100%), small for gestational age (97%), hypoxic ischemic encephalopathy (98%) and postsurgery (90%). The average follow-up rate was 70% (range: 7.5%-100%). Only 12% of hospitals followed up with patients for more than 24 months. There was significant variation in neurodevelopmental assessments, follow-up schedule, composition of staff, and clinic facilities and resources. None of the staff had received formal training, and only four hospitals had sent staff to foreign hospitals as observers. CONCLUSIONS There is significant variation in eligibility criteria, duration of follow-up, types of assessments, staffing, training and facilities available. Coordination and standardization are urgently needed.
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Affiliation(s)
- Qi Zhou
- Department of Neonatology, Children's Hospital of Fudan University, 399 Wanyuan Rd, Minhang District, Shanghai 201102, China
| | - Yun Cao
- Department of Neonatology, Children's Hospital of Fudan University, 399 Wanyuan Rd, Minhang District, Shanghai 201102, China.
| | - Lan Zhang
- Department of Neonatology, Children's Hospital of Fudan University, 399 Wanyuan Rd, Minhang District, Shanghai 201102, China
| | - Nurya Erejep
- Department of Neonatology, Children's Hospital of Xinjiang, Urumqi, China
| | - Wen-Long Xiu
- Department of Neonatology, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
| | - Jing-Yun Shi
- Department of Neonatology, Gansu Provincial Maternal and Child Care Hospital, Lanzhou, China
| | - Rui Cheng
- Department of Neonatology, Nanjing Children's Hospital, Nanjing, China
| | - Wen-Hao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, 399 Wanyuan Rd, Minhang District, Shanghai 201102, China
| | - Shoo K Lee
- Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada
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Kulvicius T, Zhang D, Nielsen-Saines K, Bölte S, Kraft M, Einspieler C, Poustka L, Wörgötter F, Marschik PB. Infant movement classification through pressure distribution analysis. COMMUNICATIONS MEDICINE 2023; 3:112. [PMID: 37587165 PMCID: PMC10432534 DOI: 10.1038/s43856-023-00342-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 08/01/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Aiming at objective early detection of neuromotor disorders such as cerebral palsy, we propose an innovative non-intrusive approach using a pressure sensing device to classify infant general movements. Here we differentiate typical general movement patterns of the "fidgety period" (fidgety movements) vs. the "pre-fidgety period" (writhing movements). METHODS Participants (N = 45) were sampled from a typically-developing infant cohort. Multi-modal sensor data, including pressure data from a pressure sensing mat with 1024 sensors, were prospectively recorded for each infant in seven succeeding laboratory sessions in biweekly intervals from 4 to 16 weeks of post-term age. 1776 pressure data snippets, each 5 s long, from the two targeted age periods were taken for movement classification. Each snippet was pre-annotated based on corresponding synchronised video data by human assessors as either fidgety present or absent. Multiple neural network architectures were tested to distinguish the fidgety present vs. fidgety absent classes, including support vector machines, feed-forward networks, convolutional neural networks, and long short-term memory networks. RESULTS Here we show that the convolution neural network achieved the highest average classification accuracy (81.4%). By comparing the pros and cons of other methods aiming at automated general movement assessment to the pressure sensing approach, we infer that the proposed approach has a high potential for clinical applications. CONCLUSIONS We conclude that the pressure sensing approach has great potential for efficient large-scale motion data acquisition and sharing. This will in return enable improvement of the approach that may prove scalable for daily clinical application for evaluating infant neuromotor functions.
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Affiliation(s)
- Tomas Kulvicius
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.
- Department for Computational Neuroscience, Third Institute of Physics-Biophysics, Georg-August-University of Göttingen, Göttingen, Germany.
| | - Dajie Zhang
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Leibniz-ScienceCampus Primate Cognition, Göttingen, Germany
- iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Karin Nielsen-Saines
- Division of Pediatric Infectious Diseases, David Geffen UCLA School of Medicine, Los Angeles, CA, USA
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Marc Kraft
- Department of Medical Engineering, Technical University Berlin, Berlin, Germany
| | - Christa Einspieler
- iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Luise Poustka
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Leibniz-ScienceCampus Primate Cognition, Göttingen, Germany
| | - Florentin Wörgötter
- Leibniz-ScienceCampus Primate Cognition, Göttingen, Germany
- Department of Medical Engineering, Technical University Berlin, Berlin, Germany
| | - Peter B Marschik
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Leibniz-ScienceCampus Primate Cognition, Göttingen, Germany
- iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Paulsen H, Ljungblad UW, Riiser K, Evensen KAI. Early neurological and motor function in infants born moderate to late preterm or small for gestational age at term: a prospective cohort study. BMC Pediatr 2023; 23:390. [PMID: 37553581 PMCID: PMC10408141 DOI: 10.1186/s12887-023-04220-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/30/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND There are inconsistent findings regarding neurological and motor development in infants born moderate to late preterm and infants born small for gestational age at term. The primary aim of this study was to compare neurological and motor function between preterm, term SGA and term AGA infants aged three to seven months corrected age using several common assessment tools. The secondary aim was to investigate their motor function at two years. METHODS In this prospective cohort study, we included 43 infants born moderate to late preterm with gestational age 32-36 + 6 weeks, 39 infants born small for gestational age (SGA) at term with a birthweight ≤ 10th centile for gestational age, and 170 infants born at term with appropriate weight for gestational age (AGA). Neurological and motor function were assessed once in infancy between three to seven months corrected age by using four standardised assessment tools: Hammersmith Infant Neurological Examination (HINE), Test of Infant Motor Performance, General Movements Assessment and Alberta Infant Motor Scale. The Ages and Stages Questionnaire (ASQ-2) was used at two years. RESULTS At three to seven months corrected age, mean age-corrected HINE scores were 61.8 (95% confidence interval (CI): 60.5 to 63.1) in the preterm group compared with 63.3 (95% CI: 62.6 to 63.9) in the term AGA group. Preterm infants had 5.8 (95% CI: 2.4 to 15.4) higher odds for HINE scores < 10th percentile. The other test scores did not differ between the groups. At two years, the preterm group had 17 (95% CI: 1.9 to 160) higher odds for gross motor scores below cut-off on ASQ-2 compared with the term AGA group. CONCLUSIONS The present study found subtle differences in neurological function between preterm and term AGA infants in infancy. At two years, preterm children had poorer gross motor function. The findings indicate that moderate prematurity in otherwise healthy infants pose a risk for neurological deficits not only during the first year, but also at two years of age when compared with term AGA children.
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Affiliation(s)
- Henriette Paulsen
- Department of Physiotherapy and Rehabilitation, Vestfold Hospital Trust, Post box 1068, Tønsberg, NO-3103, Norway.
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway.
| | | | - Kirsti Riiser
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Kari Anne I Evensen
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olavs Hospital, Children's Clinic, Trondheim University Hospital, Trondheim, Norway
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Santos-Baltuilhe S, Mallmann GS, França ALN, Azambuja KCO, Andrade PHM, Oliveira EF, Soares-Marangoni DA. Motor repertoire in 3- to 5- month-old infants with prenatal exposure to syphilis and toxoplasmosis. Early Hum Dev 2023; 183:105822. [PMID: 37454445 DOI: 10.1016/j.earlhumdev.2023.105822] [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: 05/25/2023] [Revised: 07/07/2023] [Accepted: 07/08/2023] [Indexed: 07/18/2023]
Abstract
AIM To characterize the motor repertoire of 3- to 5-month-old infants who were prenatally exposed to the infectious agents of syphilis and toxoplasmosis. METHODS Exploratory observational study that evaluated 15 exposed infants (34.4 ± 3.5 weeks gestation) recruited from a referral center. Age assessment ranged 12-20 (median 12) weeks post-term. General Movement Assessment, including the Motor Optimality Score-Revised (MOS-R), was used to assess the global quality of fidgety movements (FMs) and to quantify and detail coexisting motor patterns. Clinical variables were also collected. Later motor outcomes were obtained from medical reports when possible. RESULTS MOS-R ranged 10-26 (median 24). There was a higher proportion of infants with normal (80.0 %) than aberrant FMs, but the proportion of infants with reduced MOS-R (80.0 %) was higher compared to optimal MOS-R. One infant with aberrant FMs was later diagnosed with cerebral palsy. Only 13.3 % of the infants showed smooth and fluent movement character. All observed tongue movements were abnormal. CONCLUSION Infants had predominantly normal FMs, but with reduced MOS-R and abnormalities in the coexisting motor repertoire.
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Affiliation(s)
- Sarita Santos-Baltuilhe
- Graduate Program in Movement Sciences, Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil; Specialized Rehabilitation Center, Association of Parents and Friends of Exceptional Children, Campo Grande, MS, Brazil
| | - Geruza Souza Mallmann
- Graduate Program in Movement Sciences, Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Andressa Lagoa Nascimento França
- Graduate Program in Health and Development, Faculty of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | | | - Paulo Henrique Muleta Andrade
- Specialized Rehabilitation Center, Association of Parents and Friends of Exceptional Children, Campo Grande, MS, Brazil
| | - Everton Falcão Oliveira
- Graduate Program in Infectious and Parasitic Diseases, Faculty of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Daniele Almeida Soares-Marangoni
- Graduate Program in Movement Sciences, Institute of Health, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil; Graduate Program in Health and Development, Faculty of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil.
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Örtqvist M, Marschik PB, Toldo M, Zhang D, Fajardo‐Martinez V, Nielsen‐Saines K, Ådén U, Einspieler C. Reliability of the Motor Optimality Score-Revised: A study of infants at elevated likelihood for adverse neurological outcomes. Acta Paediatr 2023; 112:1259-1265. [PMID: 36895106 PMCID: PMC10175189 DOI: 10.1111/apa.16747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/07/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023]
Abstract
AIM To assess the inter-assessor reliability of the Motor Optimality Score-Revised (MOS-R) when used in infants at elevated likelihood for adverse neurological outcome. METHODS MOS-R were assessed in three groups of infants by two assessors/cohort. Infants were recruited from longitudinal projects in Sweden (infants born extremely preterm), India (infants born in low-resource communities) and the USA (infants prenatally exposed to SARS-CoV-2). Intraclass correlation coefficients (ICC) and kappa (κw) were applied. ICC of MOS-R subcategories and total scores were presented for cohorts together and separately and for age-spans: 9-12, 13-16 and 17-25-weeks post-term age. RESULTS 252 infants were included (born extremely preterm n = 97, born in low-resource communities n = 97, prenatally SARS-CoV-2 exposed n = 58). Reliability of the total MOS-R was almost perfect (ICC: 0.98-0.99) for all cohorts, together and separately. Similar result was found for age-spans (ICC: 0.98-0.99). Substantial to perfect reliability was shown for the MOS-R subcategories (κw: 0.67-1.00), with postural patterns showing the lowest value 0.67. CONCLUSION The MOS-R can be used in high-risk populations with substantial to perfect reliability, both in regards of total/subcategory scores as well as in different age groups. However, the subcategory postural patterns as well as the clinical applicability of the MOS-R needs further study.
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Affiliation(s)
- Maria Örtqvist
- Department of Women's and Children's Health, Neonatal research unitKarolinska InstitutetStockholmSweden
- Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals FunctionKarolinska University HospitalStockholmSweden
| | - Peter B. Marschik
- Department of Child and Adolescent Psychiatry and Psychotherapy, SEE—Systemic Ethology and Developmental ScienceUniversity Medical Center Goettingen and Leibniz ScienceCampus Primate CognitionGoettingenGermany
- iDN—Interdisciplinary Developmental Neuroscience, Division of PhoniatricsMedical University of GrazGrazAustria
- Center of Neurodevelopmental Disorders (KIND), Center for Psychiatry Research, Department of Women's and Children's HealthKarolinska Institutet & Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County CouncilStockholmSweden
| | - Moreno Toldo
- Department of Medical RehabilitationKiran Society for Rehabilitation and Education of Children with DisabilitiesVaranasiIndia
| | - Dajie Zhang
- Department of Child and Adolescent Psychiatry and Psychotherapy, SEE—Systemic Ethology and Developmental ScienceUniversity Medical Center Goettingen and Leibniz ScienceCampus Primate CognitionGoettingenGermany
- iDN—Interdisciplinary Developmental Neuroscience, Division of PhoniatricsMedical University of GrazGrazAustria
| | - Viviana Fajardo‐Martinez
- Department of Pediatrics, David Geffen School of MedicineUniversity of CaliforniaCaliforniaLos AngelesUSA
| | - Karin Nielsen‐Saines
- Department of Pediatrics, David Geffen School of MedicineUniversity of CaliforniaCaliforniaLos AngelesUSA
| | - Ulrika Ådén
- Department of Women's and Children's Health, Neonatal research unitKarolinska InstitutetStockholmSweden
- Linköping UniversityLinköpingSweden
- Crown Princess Victoria's Children's and Youth Hospital, University HospitalLinköpingSweden
| | - Christa Einspieler
- iDN—Interdisciplinary Developmental Neuroscience, Division of PhoniatricsMedical University of GrazGrazAustria
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Esterman E, Goyen TA, Jani P, Lowe G, Baird J, Maheshwari R, D'Cruz D, Luig M, Shah D. Systemic postnatal corticosteroid use for the prevention of bronchopulmonary dysplasia and its relationship to early neurodevelopment in extremely preterm infants. World J Pediatr 2023; 19:586-594. [PMID: 36967444 PMCID: PMC10198830 DOI: 10.1007/s12519-023-00708-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 02/16/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Systemic postnatal corticosteroid use in extremely preterm infants poses a risk of adverse neurodevelopmental outcomes. This study explores their use beyond seven days of age with early neurodevelopmental assessments during the fidgety period (9-20 weeks postterm age). METHODS This retrospective single-center cohort study included inborn extremely preterm infants from 1 January 2014 to 31 December 2018. Outborn infants, those with congenital or genetic abnormalities, and those who received postnatal corticosteroids for nonrespiratory reasons were excluded. The cohort was dichotomized based on the status of corticosteroid receipt. Early neurodevelopmental outcomes were reported using Prechtl's General Movements Assessment. RESULTS Of the 282 infants, 67 (23.75%) received corticosteroids. Of these, 34 (50.75%) received them for dependency on invasive ventilation (intermittent positive-pressure ventilation), and the remainder received them for dependency on non-invasive ventilation continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP). Abnormal or absent fidgety movements were observed in 13% of infants (7/54) who received corticosteroids compared to 2% of infants (3/146) who did not. An increased odds for an abnormal general movements assessment from corticosteroid use after adjusting for gestational age [adjusted odds ratio (aOR) = 5.5, 95% confidence interval (CI) = 1.14-26.56] was observed. The motor optimality scores differed between the two groups [corticosteroid group: 25.5 (23-26) versus no-corticosteroid group: 26 (24-28); z = - 2.02]. A motor optimality score < 20 was observed in 14.8% of infants (8/54) in the corticosteroid group compared to 2% of infants (3/146) in the noncorticosteroid group. This difference was significant after adjustment for gestational age (aOR 5.96, 95% CI 1.28-27.74). CONCLUSIONS Abnormal early neurodevelopment was observed in infants who received systemic postnatal corticosteroids. The relationship between these findings and other factors influencing early neurodevelopment needs further exploration.
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Affiliation(s)
- Emilia Esterman
- Department of Neonatology, Westmead Hospital, Westmead, Australia
| | - Traci-Anne Goyen
- Department of Neonatology, Westmead Hospital, Westmead, Australia
| | - Pranav Jani
- Department of Neonatology, Westmead Hospital, Westmead, Australia.
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Gemma Lowe
- Department of Neonatology, Westmead Hospital, Westmead, Australia
| | - Jane Baird
- Department of Neonatology, Westmead Hospital, Westmead, Australia
| | - Rajesh Maheshwari
- Department of Neonatology, Westmead Hospital, Westmead, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Daphne D'Cruz
- Department of Neonatology, Westmead Hospital, Westmead, Australia
| | - Melissa Luig
- Department of Neonatology, Westmead Hospital, Westmead, Australia
| | - Dharmesh Shah
- Department of Neonatology, Westmead Hospital, Westmead, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Marschik PB, Kwong AKL, Silva N, Olsen JE, Schulte-Rüther M, Bölte S, Örtqvist M, Eeles A, Poustka L, Einspieler C, Nielsen-Saines K, Zhang D, Spittle AJ. Mobile Solutions for Clinical Surveillance and Evaluation in Infancy-General Movement Apps. J Clin Med 2023; 12:3576. [PMID: 37240681 PMCID: PMC10218843 DOI: 10.3390/jcm12103576] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
The Prechtl General Movements Assessment (GMA) has become a clinician and researcher toolbox for evaluating neurodevelopment in early infancy. Given that it involves the observation of infant movements from video recordings, utilising smartphone applications to obtain these recordings seems like the natural progression for the field. In this review, we look back on the development of apps for acquiring general movement videos, describe the application and research studies of available apps, and discuss future directions of mobile solutions and their usability in research and clinical practice. We emphasise the importance of understanding the background that has led to these developments while introducing new technologies, including the barriers and facilitators along the pathway. The GMApp and Baby Moves apps were the first ones developed to increase accessibility of the GMA, with two further apps, NeuroMotion and InMotion, designed since. The Baby Moves app has been applied most frequently. For the mobile future of GMA, we advocate collaboration to boost the field's progression and to reduce research waste. We propose future collaborative solutions, including standardisation of cross-site data collection, adaptation to local context and privacy laws, employment of user feedback, and sustainable IT structures enabling continuous software updating.
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Affiliation(s)
- Peter B. Marschik
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Leibniz Science, Campus Primate Cognition, 37075 Göttingen, Germany; (P.B.M.)
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institute, 11330 Stockholm, Sweden
- iDN, Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria
| | - Amanda K. L. Kwong
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- The Royal Women’s Hospital, Parkville, VIC 3052, Australia
- Department of Physiotherapy, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Nelson Silva
- iDN, Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria
| | - Joy E. Olsen
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- The Royal Women’s Hospital, Parkville, VIC 3052, Australia
| | - Martin Schulte-Rüther
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Leibniz Science, Campus Primate Cognition, 37075 Göttingen, Germany; (P.B.M.)
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institute, 11330 Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, 11861 Stockholm, Sweden
| | - Maria Örtqvist
- Neonatal Research Unit, Department of Women’s and Children’s Health, Karolinska Institute, 11330 Stockholm, Sweden
- Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, 11330 Stockholm, Sweden
| | - Abbey Eeles
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- The Royal Women’s Hospital, Parkville, VIC 3052, Australia
- Department of Physiotherapy, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Luise Poustka
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Leibniz Science, Campus Primate Cognition, 37075 Göttingen, Germany; (P.B.M.)
| | - Christa Einspieler
- iDN, Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria
| | - Karin Nielsen-Saines
- Division of Pediatric Infectious Diseases, David Geffen UCLA School of Medicine, Los Angeles, CA 90095, USA
| | - Dajie Zhang
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Leibniz Science, Campus Primate Cognition, 37075 Göttingen, Germany; (P.B.M.)
- iDN, Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria
| | - Alicia J. Spittle
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- The Royal Women’s Hospital, Parkville, VIC 3052, Australia
- Department of Physiotherapy, The University of Melbourne, Parkville, VIC 3052, Australia
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Eliks M, Anna S, Barbara S, Gajewska E. The standardization of the Polish version of the Alberta Infant Motor Scale. BMC Pediatr 2023; 23:236. [PMID: 37173690 PMCID: PMC10176906 DOI: 10.1186/s12887-023-04055-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The Alberta Infant Motor Scale (AIMS) is a standardized tool for assessing gross motor development from birth through independent walking (0-18 months). The AIMS was developed, validated and standardized in the Canadian population. Results of previous studies on the standardization of the AIMS have discerned differences in some samples in comparison with Canadian norms. This study aimed to establish reference values of the AIMS for the Polish population and compare them to Canadian norms. METHODS The research involved 431 infants (219 girls, 212 boys, aged 0-<19 months), divided into nineteen age groups. The translated into Polish and validated version of the AIMS was used. The mean AIMS total scores and percentiles for every age group were calculated and compared with the Canadian reference values. Raw total AIMS scores were converted to 5th, 10th, 25th, 50th, 75th, and 90th percentiles. A one sample t-test was used to compare the AIMS total scores between Polish and Canadian infants (p-value < 0.05). A binomial test was performed to compare percentiles (p-value < 0.05). RESULTS The mean AIMS total scores in the Polish population were significantly lower in the seven age groups: 0-<1, 1-<2, 4-<5, 5-<6, 6-<7, 13-<14, and 15-<16 months of age (with small to large effect size). A few significant differences were found in the comparison of percentile ranks, mostly in the 75th percentile. CONCLUSION Our study provides the norms for the Polish AIMS version. According to differences in the mean AIMS total scores and percentiles, the original Canadian reference values are not congruent for Polish infants. TRIAL REGISTRATION ClinicalTrials.gov ID NCT05264064. URL https://clinicaltrials.gov/ct2/show/NCT05264064 . Date of registration: 03/03/2022.
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Affiliation(s)
- Małgorzata Eliks
- Chair and Clinic of the Developmental Neurology, Poznan University of Medical Sciences, Poznań. Poland, Przybyszewskiego Street 49, Poznan, 60-355, Poland.
- Doctoral School, Poznan University of Medical Sciences, Poznań. Poland, Bukowska Street 70, Poznan, 60-812, Poland.
| | - Sowińska Anna
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Rokietnicka Street 7, 60-806, Poznan, Poland
| | - Steinborn Barbara
- Chair and Clinic of the Developmental Neurology, Poznan University of Medical Sciences, Poznań. Poland, Przybyszewskiego Street 49, Poznan, 60-355, Poland
| | - Ewa Gajewska
- Chair and Clinic of the Developmental Neurology, Poznan University of Medical Sciences, Poznań. Poland, Przybyszewskiego Street 49, Poznan, 60-355, Poland
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Wang J, Shen X, Yang H, Li Z, Liang S, Wu F, Tang X, Mao X, He M, Xu F, Li X, Li C, Qian S, Zhu X, Meng F, Wu Y, Gao H, Cao J, Yin H, Wang Y, Huang Y. Early markers of neurodevelopmental disorders based on general movements for very preterm infants: study protocol for a multicentre prospective cohort study in a clinical setting in China. BMJ Open 2023; 13:e069692. [PMID: 37142311 PMCID: PMC10163464 DOI: 10.1136/bmjopen-2022-069692] [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] [Indexed: 05/06/2023] Open
Abstract
INTRODUCTION Very preterm (VPT) infants may experience varying degrees of neurodevelopmental challenges. Lack of early markers for neurodevelopmental disorders may delay referral to early interventions. The detailed General Movements Assessment (GMA) could help us to identify early markers for VPT infants at risk of atypical neurodevelopmental clinical phenotype in the very early stage of life as soon as possible. Preterm infants with high risk of atypical neurodevelopmental outcomes will have the best possible start to life if early precise intervention in critical developmental windows is allowed. METHODS AND ANALYSIS This is a nationwide, multicentric prospective cohort study that will recruit 577 infants born <32 weeks of age. This study will determine the diagnostic value of the developmental trajectory of general movements (GMs) at writhing and fidgety age with qualitative assessment for different atypical developmental outcomes at 2 years evaluated by the Griffiths Development Scales-Chinese. The difference in the General Movement Optimality Score (GMOS) will be used to distinguish normal (N), poor repertoire (PR) and cramped sychronised (CS) GMs. We plan to build the percentile rank of GMOS (median, 10th, 25th, 75th and 90th percentile rank) in N, PR and CS of each global GM category and analyse the relationship between GMOS in writhing movements and Motor Optimality Score (MOS) in fidgety movements based on the detailed GMA. We explore the subcategories of the GMOS list, and MOS list that may identify specific early markers that help us to identify and predict different clinical phenotypes and functional outcomes in VPT infants. ETHICS AND DISSEMINATION The central ethical approval has been confirmed from the Research Ethical Board of Children's Hospital of Fudan University (ref approval no. 2022(029)) and the local ethical approval has been also obtained by the corresponding ethics committees of the recruitment sites. Critical analysis of the study results will contribute to providing a basis for hierarchical management and precise intervention for preterm infants in very early life. TRIAL REGISTRATION NUMBER ChiCTR2200064521.
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Affiliation(s)
- Jun Wang
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Xiushu Shen
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Hong Yang
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Zhihua Li
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Shuyi Liang
- Department of Rehabilitation, Xiamen Children's Hospital, Xiamen, China
| | - Furong Wu
- Department of Rehabilitation, Xiamen Children's Hospital, Xiamen, China
| | - Xinglu Tang
- Department of Rehabilitation, Taizhou Women and Children's Hospital, Taizhou, China
| | - Xujie Mao
- Department of Neonatology, Yueqing People's Hospital, Yueqing, China
| | - Minsi He
- Department of Rehabilitation, Panyu Maternal and Child Health Hospital, Guangzhou, China
| | - Fengdan Xu
- Department of Neonatology, Dongguan Children's Hospital, Dongguan, China
| | - Xueyan Li
- Department of Rehabilitation, Dehong People's Hospital, Dehong, China
| | - Chengmei Li
- Department of Rehabilitation, Dehong People's Hospital, Dehong, China
| | | | - Xiaoyun Zhu
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Fanzhe Meng
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Yun Wu
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Herong Gao
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Jiayan Cao
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Huanhuan Yin
- Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, China
| | - Yin Wang
- Clinical Trial Unit, Children's Hospital of Fudan University, Shanghai, China
| | - Yanxiang Huang
- Shanghai Medical College of Fudan University, Shanghai, China
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Yardımcı-Lokmanoğlu BN, Livanelioğlu A, Porsnok D, Sırtbaş-Işık G, Topal Y, Mutlu A. Early Spontaneous Movements and Sensory Processing in Preterm Infants. Am J Occup Ther 2023; 77:7703205070. [PMID: 37352432 DOI: 10.5014/ajot.2023.050096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023] Open
Abstract
IMPORTANCE Preterm infants are at higher risk of motor development abnormalities and sensory processing difficulties. Few studies have examined both movement development and sensory processing in the early months of life, and the results are controversial. OBJECTIVE In this cross-sectional study, we investigated (1) differences in early spontaneous movements and sensory processing between preterm infants born at <32 wk gestation and those born at 32 to 36 wk gestation when they reached corrected (postterm) age 3 to 5 mo and (2) the relationship between early spontaneous movements and sensory processing. PARTICIPANTS We included 50 preterm infants born at <32 wk gestation and 61 preterm infants born at 32 to 36 wk gestation. OUTCOMES AND MEASURES We assessed early spontaneous movements, including fidgety movements, using the General Movements Assessment (GMA), which provides the Motor Optimality Score (MOS), and sensory processing using the Infant Sensory Profile-2. RESULTS The preterm infants born at <32 wk gestation had lower MOS results (p = .035) and more sensory processing difficulties (p = .006) than those born at 32 to 36 wk gestation. We found no significant relationship between early spontaneous movements and sensory processing (p > .05). CONCLUSIONS AND RELEVANCE Preterm infants born at <32 wk gestation are at increased risk for motor development abnormalities and sensory processing difficulties. What This Article Adds: Assessment of both motor development and sensory processing can play a crucial role in identifying infants who need early intervention.
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Affiliation(s)
- Bilge Nur Yardımcı-Lokmanoğlu
- Bilge Nur Yardımcı-Lokmanoğlu, PhD, PT, is Assistant Professor, Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey;
| | - Ayşe Livanelioğlu
- Ayşe Livanelioğlu, PhD, PT, is Professor, Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Doğan Porsnok
- Doğan Porsnok, MSc, PT, is Research Assistant, Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Gülsen Sırtbaş-Işık
- Gülsen Sırtbaş-Işık, MSc, PT, is Research Assistant, Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Yusuf Topal
- Yusuf Topal, MSc, PT, is Research Assistant, Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Akmer Mutlu
- Akmer Mutlu, PhD, PT, is Professor, Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Marschik PB, Kulvicius T, Flügge S, Widmann C, Nielsen-Saines K, Schulte-Rüther M, Hüning B, Bölte S, Poustka L, Sigafoos J, Wörgötter F, Einspieler C, Zhang D. Open video data sharing in developmental science and clinical practice. iScience 2023; 26:106348. [PMID: 36994082 PMCID: PMC10040728 DOI: 10.1016/j.isci.2023.106348] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/19/2022] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
In behavioral research and clinical practice video data has rarely been shared or pooled across sites due to ethical concerns of confidentiality, although the need of shared large-scaled datasets remains increasing. This demand is even more imperative when data-heavy computer-based approaches are involved. To share data while abiding by privacy protection rules, a critical question arises whether efforts at data de-identification reduce data utility? We addressed this question by showcasing an established and video-based diagnostic tool for detecting neurological deficits. We demonstrated for the first time that, for analyzing infant neuromotor functions, pseudonymization by face-blurring video recordings is a viable approach. The redaction did not affect classification accuracy for either human assessors or artificial intelligence methods, suggesting an adequate and easy-to-apply solution for sharing behavioral video data. Our work shall encourage more innovative solutions to share and merge stand-alone video datasets into large data pools to advance science and public health.
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Affiliation(s)
- Peter B. Marschik
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women’s and Children’s Health, Karolinska Institutet, 11330 Stockholm, Sweden
- iDN – interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria
- Leibniz-ScienceCampus Primate Cognition, 37075 Göttingen, Germany
| | - Tomas Kulvicius
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
- Department for Computational Neuroscience, Third Institute of Physics-Biophysics, Georg-August-University of Göttingen, 37077 Göttingen, Germany
| | - Sarah Flügge
- Department for Computational Neuroscience, Third Institute of Physics-Biophysics, Georg-August-University of Göttingen, 37077 Göttingen, Germany
| | - Claudius Widmann
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
| | - Karin Nielsen-Saines
- Division of Pediatric Infectious Diseases, David Geffen UCLA School of Medicine Los Angeles, CA 90095, USA
| | - Martin Schulte-Rüther
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
- Leibniz-ScienceCampus Primate Cognition, 37075 Göttingen, Germany
| | - Britta Hüning
- Department of Pediatrics I, Neonatology, University Children’s Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women’s and Children’s Health, Karolinska Institutet, 11330 Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, 11861 Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, 6102 Perth, WA
| | - Luise Poustka
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
- Leibniz-ScienceCampus Primate Cognition, 37075 Göttingen, Germany
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, 6012 Wellington, New Zealand
| | - Florentin Wörgötter
- Leibniz-ScienceCampus Primate Cognition, 37075 Göttingen, Germany
- Department for Computational Neuroscience, Third Institute of Physics-Biophysics, Georg-August-University of Göttingen, 37077 Göttingen, Germany
| | - Christa Einspieler
- iDN – interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria
| | - Dajie Zhang
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
- iDN – interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria
- Leibniz-ScienceCampus Primate Cognition, 37075 Göttingen, Germany
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Topal Y, Yardımcı-Lokmanoğlu BN, Topuz S, Mutlu A. Early spontaneous movements and spatiotemporal gait characteristics in preterm children. Eur J Pediatr 2023:10.1007/s00431-023-04949-7. [PMID: 37060442 DOI: 10.1007/s00431-023-04949-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/16/2023] [Accepted: 03/23/2023] [Indexed: 04/16/2023]
Abstract
This study aimed to analyze spatiotemporal gait characteristics of preterm children from 3 to 4 years of age according to different gestational age groups and to examine the relationship between the detailed general movements assessment and spatiotemporal gait characteristics. A total of 74 preterm children, 32 extremely preterm and very preterm (EP-VP, < 32 weeks gestational age) and 42 moderate to late preterm (MLP, 32 to < 37 weeks gestational age), were included in this prospective study, along with 38 term children. Early spontaneous movements of preterm children were assessed from videos at 9-20 weeks post-term according to the general movements assessment, which determines the Motor Optimality Score-Revised (MOS-R). The spatiotemporal gait characteristics of all children were evaluated using the GAITRite®electronic walkway at self-selected walking speeds. EP-VP children walked with shorter step lengths (p = 0.039), and MLP children walked with greater step length variability (p = 0.003) than their term peers. The MOS-R results were related to step length (r = 0.36, p = 0.042), step length variability (r = -0.56, p = 0.001), and base of support (r = -0.37, p = 0.038) in EP-VP children. The MOS-R subcategories, age-adequate movement repertoire, and postural patterns were related to some of the spatiotemporal gait characteristics, including step length, step length variability, and base of support (p < 0.05). Conclusion: EP-VP and MLP children might catch up to their term peers at 3 to 4 years of age in terms of most gait parameters. In addition to the MOS-R, age-adequate movement repertoire and postural patterns of preterm children without cerebral palsy in early life may be a marker of later neurodevelopmental dysfunction. What is Known: • Preterm children walk with a wider step width, a greater step length asymmetry and step time, and a shorter stride length at 18 to 22 months of age compared with term children at a self-selected speed, while these differences disappear in children 4.5-5 years old and older. What is New: • Early spontaneous movements were related to some spatiotemporal gait characteristics. • Preterm children might catch up to term children at 3-4 years of age in spatiotemporal gait characteristics while walking at a self-selected speed.
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Affiliation(s)
- Yusuf Topal
- Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye.
| | - Bilge Nur Yardımcı-Lokmanoğlu
- Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye
| | - Semra Topuz
- Gait Analysis Laboratory, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye
| | - Akmer Mutlu
- Developmental and Early Physiotherapy Unit, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Türkiye
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Szuflak K, Malak R, Fechner B, Sikorska D, Samborski W, Mojs E, Gerreth K. The Masticatory Structure and Function in Children with Cerebral Palsy—A Pilot Study. Healthcare (Basel) 2023; 11:healthcare11071029. [PMID: 37046956 PMCID: PMC10094554 DOI: 10.3390/healthcare11071029] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/22/2023] [Accepted: 03/29/2023] [Indexed: 04/07/2023] Open
Abstract
(1) Background: Muscle tension around the head and neck influences orofacial functions. The data exist concerning head posture during increased salivation; however, little is known about muscle tightness during this process. This study aims to investigate whether or not any muscles are related to problems with eating, such as drooling in individuals with cerebral palsy; (2) Methods: Nineteen patients between the ages of 1 and 14 were examined prior to the physiotherapy intervention. This intervention lasted three months and consisted of: relaxing muscles via the strain-counterstrain technique, functional exercises based on the NeuroDevelopmental Treatment-Bobath method, and functional exercises for eating; (3) Results: the tone of rectus capitis posterior minor muscle on the left side (p = 0.027) and temporalis muscle on the right side (p = 0.048) before the therapy, and scalene muscle on the right side after the therapy (p = 0.024) were correlated with drooling behavior and were considered statistically significant. Gross motor function was not considered statistically significant with the occurrence of drooling behavior (p ≤ 0.05). Following the therapeutic intervention, the frequency of drooling during feeding decreased from 63.16% to 38.89% of the total sample of examined patients; (4) Conclusions: The tightness of the muscles in the head area can cause drooling during feeding.
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Affiliation(s)
- Karolina Szuflak
- Department of Risk Group Dentistry Chair of Pediatric Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Roksana Malak
- Department and Clinic of Rheumatology, Rehabilitation, and Internal Medicine, Poznan University of Medical Sciences, 61-545 Poznan, Poland
| | - Brittany Fechner
- Department and Clinic of Rheumatology, Rehabilitation, and Internal Medicine, Poznan University of Medical Sciences, 61-545 Poznan, Poland
| | - Dorota Sikorska
- Department and Clinic of Rheumatology, Rehabilitation, and Internal Medicine, Poznan University of Medical Sciences, 61-545 Poznan, Poland
| | - Włodzimierz Samborski
- Department and Clinic of Rheumatology, Rehabilitation, and Internal Medicine, Poznan University of Medical Sciences, 61-545 Poznan, Poland
| | - Ewa Mojs
- Department of Clinical Psychology, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Karolina Gerreth
- Department of Risk Group Dentistry Chair of Pediatric Dentistry, Poznan University of Medical Sciences, 60-812 Poznan, Poland
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Dibbits MHJ, Rodijk LH, den Heijer AE, Bos AF, Verkade HJ, de Kleine RH, Alizadeh BZ, Hulscher JBF, Bruggink JLM. Neurodevelopment in patients with biliary atresia up to toddler age: Outcomes and predictability. Early Hum Dev 2023; 180:105754. [PMID: 37030125 DOI: 10.1016/j.earlhumdev.2023.105754] [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: 02/10/2023] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 04/10/2023]
Abstract
AIM To assess neurodevelopment in young patients with biliary atresia (BA) and to determine the predictive value of General Movement Assessment (GMA) at infant age for neurodevelopmental impairments at toddler age. METHOD Infants diagnosed with BA were prospectively included in a longitudinal study. Neurodevelopmental status was previously assessed before Kasai porto-enterostomy (KPE) and one month after KPE using Prechtl's GMA, including motor optimality scores. At 2-3 years, neurodevelopment was assessed using the Bayley Scales of Infant Development, and compared to the Dutch norm population. The predictive value of GMA at infant age for motor skills and cognition at toddler age was determined. RESULTS Neurodevelopment was assessed in 41 BA patients. At toddler age (n = 38, age 29 ± 5 months, 70 % liver transplantation), 13 (39 %) patients scored below-average on motor skills, and 6 (17 %) patients on cognition. Abnormal GMA after KPE predicted both below-average motor skills and cognitive score at toddler age (sensitivity, 91 % and 80 %; specificity 83 % and 67 %; negative predictive value, 94 % and 94 %; and, positive predictive value, 77 % and 33 %, resp.). INTERPRETATION One-third of toddlers with BA show impaired motor skills. GMA post-KPE has a high predictive value to identify infants with BA at risk of neurodevelopmental impairments.
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Affiliation(s)
- Marloes H J Dibbits
- Section of Pediatric Surgery, Department of Surgery, University Medical Center Groningen, the Netherlands
| | - Lyan H Rodijk
- Section of Pediatric Surgery, Department of Surgery, University Medical Center Groningen, the Netherlands
| | - Anne E den Heijer
- Section of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, the Netherlands
| | - Arend F Bos
- Section of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, the Netherlands
| | - Henkjan J Verkade
- Section of Pediatric Gastroenterology/Hepatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, the Netherlands
| | - Ruben H de Kleine
- Section of Hepato-pancreatico-biliary Surgery and Liver Transplantation, Department of Surgery, University Medical Center Groningen, the Netherlands
| | - Behrooz Z Alizadeh
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Jan B F Hulscher
- Section of Pediatric Surgery, Department of Surgery, University Medical Center Groningen, the Netherlands
| | - Janneke L M Bruggink
- Section of Pediatric Surgery, Department of Surgery, University Medical Center Groningen, the Netherlands.
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Sermpon N, Gima H. Relationship between fidgety movement and frequency of movement toward midline: An observational study. Early Hum Dev 2023; 177-178:105718. [PMID: 36801663 DOI: 10.1016/j.earlhumdev.2023.105718] [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: 10/04/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Infants show other movements and posture patterns during the fidgety movement period, including movement toward midline (MTM). Few studies have quantified MTM occurring during the fidgety movement period. AIMS This study aimed to examine the relationship between fidgety movements (FMs) and MTM frequency and occurrence rate per minute, from two video data sets (video attached to Prechtl video manual and accuracy data from Japan). STUDY DESIGN Observational study. SUBJECTS It encompassed 47 videos. Of these, 32 were deemed normal FMs. The study amalgamated FMs that were sporadic, abnormal, or absent into a category of aberrant (n = 15). OUTCOME MEASURES Infant video data were observed. MTM item occurrences were recorded and calculated for occurrence percentage and MTM rate of occurrence per minute. The differences between groups for the upper limbs, lower limbs, and total MTM were statistically analysed. RESULTS Twenty-three infant videos of normal FMs and seven infant videos of aberrant FMs showed MTM. Eight infant videos of aberrant FMs showed no MTM, and only four with absent FMs were included. There was a significant difference in the total MTM rate of occurrence per minute between normal FMs versus aberrant FMs (p = 0.008). CONCLUSIONS This study presented MTM frequency and rate of occurrence per minute in infants who showed FMs during the fidgety movement period. Those who showed absent FMs also demonstrated no MTM. Further study may need a larger sample size of absent FMs and information on later development.
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Affiliation(s)
- Nisasri Sermpon
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Japan; Faculty of Physical Therapy, Mahidol University, Thailand
| | - Hirotaka Gima
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Japan.
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Fajardo Martinez V, Zhang D, Paiola S, Mok T, Cambou MC, Kerin T, Rao R, Brasil P, Ferreira F, Fuller T, Bhattacharya D, Foo SS, Chen W, Jung J, Einspieler C, Marschik PB, Nielsen-Saines K. Neuromotor repertoires in infants exposed to maternal COVID-19 during pregnancy: a cohort study. BMJ Open 2023; 13:e069194. [PMID: 36690405 PMCID: PMC9871864 DOI: 10.1136/bmjopen-2022-069194] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/06/2023] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To evaluate neuromotor repertoires and developmental milestones in infants exposed to antenatal COVID-19. DESIGN Longitudinal cohort study. SETTING Hospital-based study in Los Angeles, USA and Rio de Janeiro, Brazil between March 2020 and December 2021. PARTICIPANTS Infants born to mothers with COVID-19 during pregnancy and prepandemic control infants from the Graz University Database. INTERVENTIONS General movement assessment (GMA) videos between 3 and 5 months post-term age were collected and clinical assessments/developmental milestones evaluated at 6-8 months of age. Cases were matched by gestational age, gender and post-term age to prepandemic neurotypical unexposed controls from the database. MAIN OUTCOME MEASURES Motor Optimality Scores Revised (MOS-R) at 3-5 months. Presence of developmental delay (DD) at 6-8 months. RESULTS 239 infants were enrolled; 124 cases (83 in the USA/41 in Brazil) and 115 controls. GMA was assessed in 115 cases and 115 controls; 25% were preterm. Median MOS-R in cases was 23 (IQR 21-24, range 9-28) vs 25 (IQR 24-26, range 20-28) in controls, p<0.001. Sixteen infants (14%) had MOS-R scores <20 vs zero controls, p<0.001. At 6-8 months, 13 of 109 case infants (12%) failed to attain developmental milestones; all 115 control infants had normal development. The timing of maternal infection in pregnancy (first, second or third trimester) or COVID-19 disease severity (NIH categories asymptomatic, mild/moderate or severe/critical) was not associated with suboptimal MOS-R or DD. Maternal fever in pregnancy was associated with DD (OR 3.7; 95% CI 1.12 to 12.60) but not suboptimal MOS-R (OR 0.25; 95% CI 0.04 to 0.96). CONCLUSIONS Compared with prepandemic controls, infants exposed to antenatal COVID-19 more frequently had suboptimal neuromotor development.
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Affiliation(s)
- Viviana Fajardo Martinez
- Pediatrics, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Dajie Zhang
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen and Leibniz-ScienceCampus Primate Cognition, Göttingen, Germany
- iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Sophia Paiola
- Pediatrics, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Thalia Mok
- Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Mary C Cambou
- Internal Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Tara Kerin
- Pediatrics, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Rashmi Rao
- Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | | | - Fatima Ferreira
- Pediatrics, Escola de Medicina, Universidade do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Trevon Fuller
- FIOCRUZ, Rio de Janeiro, Brazil
- Institute for the Environment and Sustainability, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Debika Bhattacharya
- Internal Medicine, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
| | - Suan-Sin Foo
- Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Weiqiang Chen
- Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Jae Jung
- Cancer Biology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Christa Einspieler
- iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Peter B Marschik
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen and Leibniz-ScienceCampus Primate Cognition, Göttingen, Germany
- iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Karin Nielsen-Saines
- Pediatrics, David Geffen School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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Marschik-Zhang D, Wang J, Shen X, Zhu X, Gao H, Yang H, Marschik PB. Building Blocks for Deep Phenotyping in Infancy: A Use Case Comparing Spontaneous Neuromotor Functions in Prader-Willi Syndrome and Cerebral Palsy. J Clin Med 2023; 12:784. [PMID: 36769434 PMCID: PMC9917638 DOI: 10.3390/jcm12030784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
With the increasing worldwide application of the Prechtl general movements assessment (GMA) beyond its original field of the early prediction of cerebral palsy (CP), substantial knowledge has been gained on early neuromotor repertoires across a broad spectrum of diagnostic groups. Here, we aimed to profile the neuromotor functions of infants with Prader-Willi syndrome (PWS) and to compare them with two other matched groups. One group included infants with CP; the other included patients who were treated at the same clinic and turned out to have inconspicuous developmental outcomes (IOs). The detailed GMA, i.e., the motor optimality score-revised (MOS-R), was used to prospectively assess the infants' (N = 54) movements. We underwent cross-condition comparisons to characterise both within-group similarities and variations and between-group distinctions and overlaps in infants' neuromotor functions. Although infants in both the PWS and the CP groups scored similarly low on MOS-R, their motor patterns were different. Frog-leg and mantis-hand postures were frequently seen in the PWS group. However, a PWS-specific general movements pattern was not observed. We highlight that pursuing in-depth knowledge within and beyond the motor domain in different groups has the potential to better understand different conditions, improve accurate diagnosis and individualised therapy, and contribute to deep phenotyping for precision medicine.
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Affiliation(s)
- Dajie Marschik-Zhang
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
- Leibniz Science Campus Primate Cognition, 37077 Göttingen, Germany
- iDN—Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria
| | - Jun Wang
- Department of Rehabilitation, Children’s Hospital, Fudan University, Shanghai 201102, China
| | - Xiushu Shen
- Department of Rehabilitation, Children’s Hospital, Fudan University, Shanghai 201102, China
| | - Xiaoyun Zhu
- Department of Rehabilitation, Children’s Hospital, Fudan University, Shanghai 201102, China
| | - Herong Gao
- Department of Rehabilitation, Children’s Hospital, Fudan University, Shanghai 201102, China
| | - Hong Yang
- Department of Rehabilitation, Children’s Hospital, Fudan University, Shanghai 201102, China
| | - Peter B. Marschik
- Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, 37075 Göttingen, Germany
- Leibniz Science Campus Primate Cognition, 37077 Göttingen, Germany
- iDN—Interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, 8036 Graz, Austria
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Child and Adolescent Psychiatry, Region Stockholm, Karolinska Institutet & Stockholm Health Care Services, 17176 Stockholm, Sweden
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The General Movements Motor Optimality Score in High-Risk Infants: A Systematic Scoping Review. Pediatr Phys Ther 2023; 35:2-26. [PMID: 36288244 DOI: 10.1097/pep.0000000000000969] [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: 02/06/2023]
Abstract
PURPOSE The aim of this systematic scoping review was to explore the use of the motor optimality score in the fidgety movement period in clinical practice, and to investigate evidence for the motor optimality score in predicting neurodevelopmental outcomes. SUMMARY OF KEY POINTS Thirty-seven studies, with 3662 infants, were included. Studies were conceptualized and charted into 4 categories based on the motor optimality score: prediction, outcome measure, descriptive, or psychometric properties. The most represented populations were preterm or low-birth-weight infants (16 studies), infants with cerebral palsy or neurological concerns (5 studies), and healthy or term-born infants (4 studies). CONCLUSION The motor optimality score has the potential to add value to existing tools used to predict risk of adverse neurodevelopmental outcomes. Further research is needed regarding the reliability and validity of the motor optimality score to support increased use of this tool in clinical practice. What this adds to the evidence : The motor optimality score has potential to improve the prediction of adverse neurodevelopmental outcomes. Further research on validity and reliability of the motor optimality score is needed; however, a revised version, the motor optimality score-R (with accompanying manual) will likely contribute to more consistency in the reporting of the motor optimality score in future.
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Therapeutic hypothermia is associated with changes in prognostic value of general movements. Eur J Paediatr Neurol 2023; 42:53-59. [PMID: 36563466 DOI: 10.1016/j.ejpn.2022.12.004] [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: 09/02/2021] [Revised: 11/15/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS General movements (GMs) have been recognized as the most accurate clinical tools for predicting cerebral palsy (CP). This study aimed to compare the type and prognostic value of abnormal GMs in infants with hypoxic ischemic encephalopathy treated or not with therapeutic hypothermia (TH). MATERIALS AND METHODS This was a single-center retrospective study. We compared GMs of 55 cooled term infants versus 30 non-cooled term infants with hypoxic ischemic encephalopathy (HIE) and their motor outcome at 24 months of age. We also included data regarding early brain MRI scans. RESULTS Rates of cerebral palsy was 5.4% and 46.7% in cooled and non-cooled infants respectively (p < 0.001). None of cooled infants showed cramped-synchronized GMs, whereas among non-cooled infants the cramped-synchronized pattern was present in 17.2% and 20% of infants at 1 and 3 months of age respectively. Hypokinesis was never seen in cooled infants and it was present in 23.3% of non-cooled ones. Absent fidgety correlated with CP in 14% and 73% of cooled and non-cooled infants respectively. At brain MRI cooled infants had fewer and less severe cerebral lesions compared to non-cooled infants (p = 0.003). CONCLUSIONS Abnormal GMs are reduced in infants treated with TH. Hypokinesis and cramped-synchronized GMs are not observed in cooled infants and the associations between absent fidgety movements and CP it is largely abolished. TH is associated with changes in prognostic value of GMs.
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The Early Motor Repertoire in Preterm Infancy and Cognition in Young Adulthood: Preliminary Findings. J Int Neuropsychol Soc 2023; 29:80-91. [PMID: 34974853 DOI: 10.1017/s1355617721001351] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Preterm birth poses a risk to cognition during childhood. The resulting cognitive problems may persist into young adulthood. The early motor repertoire in infancy is predictive of neurocognitive development in childhood. Our present aim was to investigate whether it also predicts neurocognitive status in young adulthood. METHOD We conducted an explorative observational follow-up study in 37 young adults born at a gestational age of less than 35 weeks and/or with a birth weight below 1200 g. Between 1992 and 1997, these individuals were videotaped up until 3 months' corrected age to assess the quality of their early motor repertoire according to Prechtl. The assessment includes general movements, fidgety movements (FMs), and a motor optimality score (MOS). In young adulthood, the following cognitive domains were assessed: memory, speed of information processing, language, attention, and executive function. RESULTS Participants in whom FMs were absent in infancy obtained lower scores on memory, speed of information processing, and attention than those with normal FMs. Participants with aberrant FMs, that is, absent or abnormal, obtained poorer scores on memory, speed of information processing speed, attention, and executive function compared to peers who had normal FMs. A higher MOS was associated with better executive function. CONCLUSIONS The quality of the early motor repertoire is associated with performance in various cognitive domains in young adulthood. This knowledge may be applied to enable the timely recognition of preterm-born individuals at risk of cognitive dysfunctions.
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Murgia M, de Sire A, Ruiu P, Agostini F, Bai AV, Pintabona G, Paolucci T, Bemporad J, Paoloni M, Bernetti A. Botulinum toxin type A for spasticity in cerebral palsy patients: Which impact on popliteal angle to hamstring length? A proof-of-concept study. J Back Musculoskelet Rehabil 2023; 36:1193-1201. [PMID: 37458025 DOI: 10.3233/bmr-220381] [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] [Indexed: 07/18/2023]
Abstract
BACKGROUND Cerebral palsy (CP) is the most common physical disability in childhood. It is a heterogeneous condition in terms of etiology, motor type and severity of impairments. Clinical impairments, such as increased muscle tone (spasticity), muscle weakness and joint stiffness contribute to the abnormal development of functional activities, including gait. OBJECTIVE The objective of this study was to investigate the popliteal angle to hamstring length after ultrasound guided Incobotulinum toxin A injections for spasticity in CP patients. METHODS In this proof-of-concept study, we included outpatients with CP and crouch gait correlated to hamstrings spasticity referred to the Pediatric Rehabilitation outpatient clinic of Umberto I University Hospital, Sapienza University of Rome, in the period between February and October 2018. METHODS Modified Ashworth Scale (MAS) of hamstring muscles, Popliteal Angle and Modified Popliteal Angle, Passive Knee Extension and 10 Meter Walk Test (10MWT) were assessed at baseline (T0) and three weeks after ultrasound guided injection (T1) of Incobotulinum Toxin A (dose weight and site dependent). RESULTS Thirteen patients (5 male and 8 female), mean aged 9.91 ± 3.59, were included. The clinical evaluation at T0 showed hamstring muscles spasticity, with MAS of 2.4 ± 0.6, popliteal angle -51.7∘± 11.0∘, modified popliteal angle of -39.5∘± 11.0∘, passive knee extension of -14.0∘± 8.7∘ and 10MWT of 14.3 ± 4.6 seconds. At T1, hamstring muscles MAS mean value was 1.7 ± 0.6 (p< 0.01), popliteal angle 41.3∘± 7.0∘ (p< 0.001), modified popliteal angle -32.9∘± 10.4∘ (p< 0.001), passive knee extension -4.0∘± 4.2∘ (p< 0.05) and 10MWT 12.6 ± 4.8 seconds (p< 0.05). None of the treated patients reported any adverse event related to Incobotulinum Toxin A injection. CONCLUSION Incobotulinum toxin A treatment has been proven to be safe and effective for hamstring muscles spasticity management in CP patients. Further studies with larger samples and longer follow-up are warranted to assess the efficacy of this treatment on the popliteal angle.
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Affiliation(s)
- Massimiliano Murgia
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Pierangela Ruiu
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Francesco Agostini
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | | | - Giovanni Pintabona
- Specialist Functional Rehabilitation Unit, Scientific Institute, IRCCS E. Medea, Bosisio Parini, Italy
| | - Teresa Paolucci
- Department of Oral Medical Science and Biotechnology, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | | | - Marco Paoloni
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Andrea Bernetti
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
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Bektas H, Bektas MS, Dasdag S. Effect of mobile phone usage duration during pregnancy on the general motor movements of infants. BIOTECHNOL BIOTEC EQ 2022. [DOI: 10.1080/13102818.2022.2046505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Hava Bektas
- Department of Biophysics, Medical School of Van Yuzuncu Yil University, Van, Turkey
| | - Mehmet Selcuk Bektas
- Division of Neonatology, Department of Pediatrics, Lokman Hekim Hospital, Van, Turkey
| | - Suleyman Dasdag
- Department of Biophysics, Medical School of İstanbul Medeniyet University, İstanbul, Turkey
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