Posture, spontaneous movements, and behavioural state organisation in infants affected by brain malformations

Ferrari, Fabrizio; Prechtl, H.F.R.; Cioni, Giovanni; Roversi, Maria Federica; Einspieler, Christa; Gallo, Claudio; Paolicelli, Paola B.; Cavazzuti, G. B.

doi:10.1016/s0378-3782(97)00095-9

Cited by 38 publications

(20 citation statements)

References 18 publications

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“…The subscores for upper (median 11 [10-13]; range 4-18) versus lower extremities (median 11 [9][10][11][12][13]; range 3-18) did not differ (p=0.14).…”

Section: Poor Repertoire General Movements Assessed In Detailmentioning

confidence: 98%

“…The occurrence of cramped components increased with age in both the upper (from 10% to 78%; q=À0.48; p<0.01) and the lower limbs (from 29% to 70%: q=À0.31; p<0.01; Table IV). The following differences were found between the upper and lower extremities: across all age groups, fluent and elegant rotations were more frequent in the shoulders than in the hips (34% vs 25%; p<0.01); at the moderate and late preterm periods, fluent and elegant rotations were more frequent in wrists than in ankles (p<0.01; Table IV); and across all age groups, cramped components were more frequent in the lower than in the upper extremities (51% vs 31%; p<0.01).The subscores for upper (median 11 [10-13]; range 4-18) versus lower extremities (median 11 [9][10][11][12][13]; range 3-18) did not differ (p=0.14).Within the global category of poor repertoire general movements, the GMOS slightly decreased with age (q=À0.21; p<0.01). …”

mentioning

confidence: 96%

“…A detailed assessment of general movements at preterm and term age was introduced by Ferrari et al 12 The first applications were done in infants with brain malformation, 13 and in infants with Down syndrome 14 -the latter demonstrating that a reduced motor optimality score was associated with more severe motor impairments a few years later.…”

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confidence: 99%

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The general movement optimality score: a detailed assessment of general movements during preterm and term age

Einspieler

Marschik

Pansy

et al. 2015

Develop Med Child Neuro

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GMAGeneral movement assessment GMOS General movement optimality score AIM To explore the appropriateness of applying a detailed assessment of general movements and characterize the relationship between global and detailed assessment. METHOD The analysis was based on 783 video recordings of 233 infants (154 males, 79females) who had been videoed from 27 to 45 weeks postmenstrual age. Apart from assessing the global general movement categories (normal, poor repertoire, crampedsynchronized, or chaotic general movements), we scored the amplitude, speed, spatial range, proximal and distal rotations, onset and offset, tremulous and cramped components of the upper and lower extremities. Applying the optimality concept, the maximum general movement optimality score of 42 indicates the optimal performance. RESULTS General movement optimality scores (GMOS) differentiated between normalgeneral movements (median 39 [25-75th centile 37-41]), poor repertoire general movements (median 25 [22][23][24][25][26][27][28][29]), and cramped-synchronized general movements (median 12 [10-14]; p<0.01). The optimality score for chaotic general movements (mainly occurring at late preterm age) was similar to those for cramped-synchronized general movements (median 14 [12-17]). Short-lasting tremulous movements occurred from very preterm age (<32wks) to post-term age across all general movement categories, including normal general movements.The detailed score at post-term age was slightly lower compared to the scores at preterm and term age for both normal (p=0.02) and poor repertoire general movements (p<0.01).INTERPRETATION Further research might demonstrate that the GMOS provides a solid base for the prediction of improvement versus deterioration within an individual general movement trajectory.Abnormal general movements are among the most reliable early markers for neurodevelopmental disorders. 1,2Recently, Bosanquet et al. 3 reviewed various structural and functional assessment techniques for which the accuracy of predicting cerebral palsy was reported. Compared to cranial ultrasound, magnetic resonance imaging and neurological examination, the general movement assessment (GMA) provided best evidence, with a sensitivity of 98% (95% confidence interval [CI] 74-100) and a specificity of 91% (95% CI 83-93).3 Apart from the first promising attempts to analyse general movements with the aid of computerbased tools, 4,5 GMA is based on visual Gestalt perception. General movements are considered to be normal if the sequence, amplitude, speed, and intensity are variable. Abnormal general movements are characterized by a lack of variability, especially in the movement sequence. 1,6 Gestalt perception is a powerful tool when it comes to the analysis of complex phenomena. Experienced observers consistently achieved high interscorer agreements, ranging from 89% to 93%. 6 In addition to the global assessment of general movement patterns, it can also be worthwhile to look at different aspects and components of general movements, particularly i...

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“…The subscores for upper (median 11 [10-13]; range 4-18) versus lower extremities (median 11 [9][10][11][12][13]; range 3-18) did not differ (p=0.14).…”

Section: Poor Repertoire General Movements Assessed In Detailmentioning

confidence: 98%

mentioning

confidence: 96%

See 1 more Smart Citation

The general movement optimality score: a detailed assessment of general movements during preterm and term age

Einspieler

Marschik

Pansy

et al. 2015

Develop Med Child Neuro

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“…Recent reports indicate that assessment of GMs can also be useful in evaluating risk for other types of developmental disorders, such as mental retardation and minor neurological defi cits [3] . The quality of GMs may also be aff ected by heterogeneous clinical occurrences: congenital central nervous system lesions and other such lesions acquired early in life, chronic lung disease, infantile apnoeas, early blindness, maternal diabetes, brain malformations and intra-uterine growth retardation [2,5,6] . We present the case of a girl born preterm with congenital thyrotoxicosis due to transplacental passage of maternal TSHR-Abs.…”

Section: Normal Neurological Outcome After Congenital Thyrotoxicosis:mentioning

confidence: 99%

“…General movements (GMs) are a subset of these motor patterns and are displayed by the fetus from as early as 10 weeks postmenstrual age [5] . In the last two decades, Prechtl and coworkers have developed a tool based on the observation of GMs for the functional assessment of newborns and infants at risk of neurological abnormalities [2,5,6] . In longitudinal studies of …”

Section: Normal Neurological Outcome After Congenital Thyrotoxicosis:mentioning

confidence: 99%

Normal Neurological Outcome after Congenital Thyrotoxicosis: Prognostic Value of Observation of General Movements

Gáboli

Aguilera²,

Azcona³

et al. 2008

Neuropediatrics

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We followed up a patient born preterm with congenital thyrotoxicosis by observing her general movements (GMs) in accordance with Prechtl's method. Initially a chaotic pattern was observed. Along with the normalization of thyroid hormones, the GM pattern changed to a poor repertoire at four weeks of life, full-blown writhing movements at six weeks and fidgety movements at the age of four months. This is the first report of chaotic GMs in a neonate reflecting transient neurological dysfunction related to congenital thyrotoxicosis, with subsequent normal neurological and cognitive outcome.

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Cramped Synchronized General Movements in Preterm Infants as an Early Marker for Cerebral Palsy

Ferrari¹,

Cioni²,

Einspieler³

et al. 2002

Arch Pediatr Adolesc Med

231

196

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Posture, spontaneous movements, and behavioural state organisation in infants affected by brain malformations

Cited by 38 publications

References 18 publications

The general movement optimality score: a detailed assessment of general movements during preterm and term age

The general movement optimality score: a detailed assessment of general movements during preterm and term age

Normal Neurological Outcome after Congenital Thyrotoxicosis: Prognostic Value of Observation of General Movements

Cramped Synchronized General Movements in Preterm Infants as an Early Marker for Cerebral Palsy

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