Kinematic assessment of stereotypy in spontaneous movements in infants

Abstract

Movement variation constitutes a crucial feature of infant motor development. Reduced variation of spontaneous infant movements, i.e. stereotyped movements, may indicate severe neurological de cit at an early stage. Hitherto evaluation of movement variation has been mainly restricted to subjective assessment based on observation. is article introduces a method for quantitative assessment yielding an objective de nition of stereotyped movements which may be used for the prognosis of neurological de cits such as cerebral palsy ( ).Movements of 3-months-old infants were recorded with an electromagnetic tracking system facilitating the analysis of joint angles of the upper and lower limb. A stereotypy score based on dynamic time warping has been developed describing movements which are self-similar in multiple degrees of freedom. For clinical evaluation, this measure was calculated in a group of infants at risk for neurological disorders (n=54) and a control group of typically developing children (n=21) on the basis of spontaneous movements at the age of three months. e stereotypy score was related to outcome at the age of 24 months in terms of (n=10) or no-(n=53). Using the stereotypy score of upper limb movements cases could be identi ed with a sensitivity of 90% and a speci city of 96%. e corresponding score of the leg movements did not allow for valid discrimination of the groups. e presented stereotypy feature is a promising candidate for a marker that may be used as a simple and noninvasive quantitative measure in the prediction of . e method can be adopted for the assessment of infant movement variation in research and clinical applications.

CareToy: Stimulation and Assessment of Preterm Infant’s Activity Using a Novel Sensorized System

“…14,42 Kinematic description of upper limb infant motility in natural environment and during play was however despite large importance scarcely studied. 22 A natural setting in combination with adequate sensor systems could be suitable for studying infants' interaction with objects, which could lead to establishment of standard approach development characteristics. Consequently, comparison of these standards against results of infants at risk for neurodevelopmental disorders, particularly Autism spectrum disorders (ASD), could provide the possibility for detection of early signs of disturbed development.…”

Complementary thinking: future perspectives on the assessment of general movements

“…1,2 During the last few years a number of computer-based movement assessment tools using optical flow meters 3,6 or electromagnetic tracking systems 4,7 have aimed to perform quantitative analyses of general movements, and thereby to discriminate more objectively between normal and abnormal movement patterns. Two-dimensional representations of general movements over time were derived from reflective marker signals 4,5,7 or -more convenient for the infant -directly from the monitor after placing infants on a special mattress during the recording. 3,6 Most of the analyses focused on tracking multivariate interactions (or the lack thereof) in the kinematic chains of the upper and lower limbs.…”

“…3,6 Most of the analyses focused on tracking multivariate interactions (or the lack thereof) in the kinematic chains of the upper and lower limbs. 4,7,8 Also, Kanemaru et al 5 proposed that a high correlation between limb velocities of at least two limbs might indicate a lack of normal variability. Indeed, lack of variability is the key feature of abnormal general movements.…”

“…Others applied computer-based general movement analyses at the age of 3 to 4 months, 3,4,[6][7][8] when general movements appear as 'fidgety movements'. The Prechtl assessment of fidgety movements revealed a sensitivity of 94% and a specificity of 82 to 100% when predicting neurodevelopment.…”

“…1 Interestingly, computer-based analyses of general movements at this age also identified infants who later developed cerebral palsy with a sensitivity of 85 to 90% and a specificity of 88 to 96%. 7,8 So far, there are only data on five infants published where both methodological approaches were compared: the mean accuracy between visual Gestalt perception and computer analysis was 0.77. 4 More comparison studies are certainly needed.…”