High prevalence of abnormal motor repertoire at 3 months corrected age in extremely preterm infants

Fjørtoft, Toril; Evensen, Kari Anne I.; Øberg, Gunn Kristin; Songstad, Nils Thomas; Labori, Cathrine; Silberg, Inger Elisabeth; Loennecken, Marianne; Møinichen, Unn Inger; Vågen, Randi Tynes; Støen, Ragnhild; Adde, Lars

doi:10.1016/j.ejpn.2015.12.009

Cited by 24 publications

(30 citation statements)

References 27 publications

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“…Finding a high prevalence (approximately 50%) of abnormal movement character in our study group (130 infants) is in line with a previous study on extremely preterm-born infants, yet in contrast to a study on 87 healthy term-borns, where the prevalence of abnormal movements was reported to be only 20% [33].…”

Section: Discussionsupporting

confidence: 93%

“…Most infants in the intervention and control groups showed presence of fidgety movements, and in any case a significant effect of the intervention on the group of infants with absence of fidgety movements would have been hard to identify because of the small number of infants in this group. There is no evidence to suggest that the intervention had any effect on abnormal movement character, which has been previously reported to be a characteristic and prevalent finding in infants born preterm [18,33]. The high prevalence of abnormal movements in preterm-born infants was confirmed in the study, with as many as approximately half of the infants in either group showing an abnormal movement character.…”

Section: Discussionsupporting

confidence: 59%

“…It was classified as normal or abnormal. A normal movement character was smooth and fluent; abnormal movements were monotonous, jerky and stiff and could be slow or fast [33]. The fifth subcategory, the global score of "Movement character", was assessed because this item has previously been shown to be predictive of later motor and cognitive outcomes [16].…”

Section: Video Recording and Assessment Of Fidgety Movements And Overmentioning

confidence: 99%

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Does a parent-administrated early motor intervention influence general movements and movement character at 3 months of age in infants born preterm?

Fjørtoft

Ustad

Follestad

et al. 2017

Early Human Development

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No evidence was found in this RCT to suggest that an intervention at 34 to 37weeks gestational age has a significant effect on the fidgety movements or overall movement character of preterm infants. This is in line with the assumption that absent fidgety movements and an abnormal movement character are due to permanent brain injury and are therefore good predictors for later neurological impairments.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 59%

Section: Video Recording and Assessment Of Fidgety Movements And Overmentioning

confidence: 99%

See 1 more Smart Citation

Does a parent-administrated early motor intervention influence general movements and movement character at 3 months of age in infants born preterm?

Fjørtoft

Ustad

Follestad

et al. 2017

Early Human Development

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“…Case 1 even had an age-appropriate normal repertoire of concurrent movements, though Cases 2 to 4 showed no movements towards the midline at the 14-week recording. The lack of movements towards the midline is in accordance with a recently published study on extremely preterm infants who showed fewer antigravity movements at 12 weeks postterm age than their peers born at term (Fjørtoft et al 2016).…”

Section: Discussionsupporting

confidence: 91%

Movement Imitation Therapy for Preterm Babies (MIT-PB): a Novel Approach to Improve the Neurodevelopmental Outcome of Infants at High-Risk for Cerebral Palsy

et al. 2019

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To improve the neurodevelopmental outcome in infants with high grade intraventricular haemorrhage and cramped-synchronised (CS) general movements (GMs). Four very preterm infants with intraventricular haemorrhage grade III (n = 3) or intraventricular haemorrhage with apparent periventricular haemorrhagic infarction (n = 1) were diagnosed with CS GMs at 33 to 35 weeks postmenstrual age. A few days later MIT-PB [Movement Imitation Therapy for Preterm Babies], an early intervention programme, was commenced: the instant an infant showed CS movements, the therapist intervened by gently guiding the infant's limbs so as to manoeuvre and smoothen the movements, thereby imitating normal GM sequences as closely as possible (at least for 10 min, 5 times a day, with increasing frequency over a period of 10 to 12 weeks). After a period of consistent CS GMs, the movements improved. At 14 weeks postterm age, the age specific GM pattern, fidgety movements, were normal in three infants, one infant had abnormal fidgety movements. At preschool age, all participants had a normal neurodevelopmental outcome. This report on four cases demonstrates that mimicking normal and variable GM sequences might have a positive cascading effect on neurodevelopment. The results need to be interpreted with caution and replication studies on larger samples are warranted. Nonetheless, this innovative approach may represent a first step into a new intervention strategy.

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“…The motor repertoire of infants at 3–5 months consists not only of fidgety movements but also of other movements such as antigravity movements to the midline and legs lift, kicking, swiping, or wiggling-oscillating limb movements [13]. A detailed assessment of these age-specific movements including fidgety movements and several postural patterns was proposed in 2004 [5] and has been applied to several high-risk groups (e.g., [6,14,15,16]) but also to typically developing infants [6,17,18]. The scoring is based on the optimality concept [19], with the advantage that its semi-quantitative approach documents small changes in an otherwise categorically assessed motor behavior.…”

Section: Introductionmentioning

confidence: 99%

Cerebral Palsy: Early Markers of Clinical Phenotype and Functional Outcome

Einspieler

Bos

Krieber-Tomantschger

et al. 2019

JCM

146

218

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The Prechtl General Movement Assessment (GMA) has become a cornerstone assessment in early identification of cerebral palsy (CP), particularly during the fidgety movement period at 3–5 months of age. Additionally, assessment of motor repertoire, such as antigravity movements and postural patterns, which form the Motor Optimality Score (MOS), may provide insight into an infant’s later motor function. This study aimed to identify early specific markers for ambulation, gross motor function (using the Gross Motor Function Classification System, GMFCS), topography (unilateral, bilateral), and type (spastic, dyskinetic, ataxic, and hypotonic) of CP in a large worldwide cohort of 468 infants. We found that 95% of children with CP did not have fidgety movements, with 100% having non-optimal MOS. GMFCS level was strongly correlated to MOS. An MOS > 14 was most likely associated with GMFCS outcomes I or II, whereas GMFCS outcomes IV or V were hardly ever associated with an MOS > 8. A number of different movement patterns were associated with more severe functional impairment (GMFCS III–V), including atypical arching and persistent cramped-synchronized movements. Asymmetrical segmental movements were strongly associated with unilateral CP. Circular arm movements were associated with dyskinetic CP. This study demonstrated that use of the MOS contributes to understanding later CP prognosis, including early markers for type and severity.

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High prevalence of abnormal motor repertoire at 3 months corrected age in extremely preterm infants

Cited by 24 publications

References 27 publications

Does a parent-administrated early motor intervention influence general movements and movement character at 3 months of age in infants born preterm?

Does a parent-administrated early motor intervention influence general movements and movement character at 3 months of age in infants born preterm?

Movement Imitation Therapy for Preterm Babies (MIT-PB): a Novel Approach to Improve the Neurodevelopmental Outcome of Infants at High-Risk for Cerebral Palsy

Cerebral Palsy: Early Markers of Clinical Phenotype and Functional Outcome

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