The neuronal group selection theory: promising principles for understanding and treating developmental motor disorders

Hadders‐Algra, Mijna

doi:10.1017/s0012162200001316

Cited by 147 publications

(102 citation statements)

References 107 publications

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“…PT infants are at risk of brain lesions, which can lead to a reduction of movement repertoire and the presence of stereotyped asymmetries. 10,12 Loss of movement fluency is one of the first signs associated with non-optimal neurological condition. 6,13 Preterm birth was not related to the scores on the subscales variability -ability to select and performance.…”

Section: Discussionmentioning

confidence: 99%

“…The finding that quality of motor behaviour, and variation in particular, is an essential parameter to assess the condition of the young nervous system fits well into the concepts of the Neuronal Group Selection Theory (NGST). [7][8][9][10] According to NGST, normal motor development is characterized by two phases of variability. During the phase of primary variability, variation in motor behaviour is not geared to external conditions.…”

mentioning

confidence: 99%

“…The latter problems may be attributed to the absence of specific strategies that force the child to choose in certain conditions among non-optimal strategies and the presence of deficits in the processing of sensory information. [9][10][11] Having noticed that application of motor variability as a means to evaluate neuromotor condition functions so well in early infancy, we embarked on the development of a similar assessment instrument for neuromotor condition at between 3 and 18 months of age. This resulted in the development of the Infant Motor Profile (IMP).…”

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confidence: 99%

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The Infant Motor Profile: a standardized and qualitative method to assess motor behaviour in infancy

Heineman

Bos²,

Hadders‐Algra³

2008

Develop Med Child Neuro

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A reliable and valid instrument to assess neuromotor condition in infancy is a prerequisite for early detection of developmental motor disorders. We developed a video-based assessment of motor behaviour, the Infant Motor Profile (IMP), to evaluate motor abilities, movement variability, ability to select motor strategies, movement symmetry, and fluency. The IMP consists of 80 items and is applicable in children from 3 to 18 months. The present study aimed to test intra-and interobserver reliability and concurrent validity of the IMP with the Alberta Infant Motor Scale (AIMS) and Touwen neurological examination. The study group consisted of 40 low-risk term (median gestational age [GA] 40wks, range 38-42wks) and 40 high-risk preterm infants (median GA 29.6wks, range 26-33wks) with corrected ages 4 to 18 months (31 females, 49 males). Intra-and interobserver agreement of the IMP were satisfactory (Spearman's rho=0.9). Concurrent validity of IMP and AIMS was good (Spearman's rho=0.8, p<0.005). The IMP was able to differentiate between infants with normal neurological condition, simple minor neurological dysfunction (MND), complex MND, and abnormal neurological condition (p<0.005). This means that the IMP may be a promising tool to evaluate neurological integrity during infancy, a suggestion that needs confirmation by means of assessment of larger groups of infants with heterogeneous neurological conditions.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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The Infant Motor Profile: a standardized and qualitative method to assess motor behaviour in infancy

Heineman

Bos²,

Hadders‐Algra³

2008

Develop Med Child Neuro

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“…One could hypothesize that the age at fitting should match typical developmental changes in the brain, a hypothesis that might be guided by the Neuronal Group Selection Theory (NGST) developed by Edelman in 1989. [8][9][10] From the NGST point of view, children with UCBED may lack the representation of the missing part of the limb in the cerebral cortex. As a consequence, the child may have a limited number of motor repertoires for the arm involved.…”

Section: Introductionmentioning

confidence: 99%

Age at First Prosthetic Fitting and Later Functional Outcome in Children and Young Adults with Unilateral Congenital Below-Elbow Deficiency

Huizing¹,

Reinders-Messelink²,

Maathuis³

et al. 2010

Prosthetics &Amp; Orthotics International

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The objective of this study was to evaluate whether prosthetic fitting before the age of one year is associated with better outcomes in children with unilateral congenital below-elbow deficiency compared to children fitted after the age of one. Twenty subjects aged 6-21 years were recruited (five prosthetic users and 15 non-users). The Child Amputee Prosthetics Project-Prosthesis Satisfactory Inventory (CAPP-PSI) and the Prosthetic Upper Extremity Functional Index (PUFI) were used to assess patient satisfaction and functional use of the prosthesis. Videotapes were used to assess motor performance. Initial prosthetic fitting before one year of age was related to use of a prosthesis for at least four years. Age at first fitting was not associated with satisfaction with the prosthesis, functional use of the prosthesis or motor skills. Discrepancies between ease of performance with prosthesis and usefulness of the prosthesis as well as between capacity and performance of activities were found. The video assessments showed impaired movement adaptation to some tasks in six subjects. In conclusion, early prosthetic fitting seems to have a limited impact on prosthesis use during later stages of life.

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“…4 Third, it is conceivable that a better peripheral starting point may alter cortical maps, which, in turn, might be associated with a larger repertoire of hand strategies. [17][18][19] Conclusion At the level of function or activity, the data indicate that surgery may improve grip strategy and induce an increase of the repertoire of grips and spontaneous use of the hand, without affecting dexterity and performance in daily life activities. Whether the putatively better hand function is the result of a better positioning of the hand and fingers and/or of changes in muscle coordination induced by tendon transfer remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Does surgical management of the hand in children with spastic unilateral cerebral palsy affect functional outcome?

Munster

Maathuis

Haga

et al. 2007

Develop Med Child Neuro

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The aim of this review was to examine the literature on the effects of surgery of the spastic hand in children with cerebral palsy on functional outcome and muscle coordination. We performed a search of the relevant literature in Medline, Embase, and Biological Abstracts from 1966 to June 2006. The search resulted in eight studies on the effect of surgery on functional outcome and three studies on the effect of surgery on muscle coordination. Heterogeneity in outcome measures precluded meta-analysis. The studies revealed that -at the level of impairment -surgery has a positive effect on supination and dorsiflexion of the wrist. At the level of function, surgery might improve grip strategy and induce an increase of the repertoire of grips and spontaneous use of the hand. The evidence for the functional effects is, however, limited. Whether the possibly improved function is mediated by alterations in muscle coordination patterns remains unclear. The muscle coordination studies provided inconclusive results. We concluded that surgery improves the position of the hand and there are indications that it might improve hand function. Future research should address the question: does surgery improve hand function and, if so, is this due solely to a better hand position or does change in muscle coordination play an additional role?Cerebral palsy (CP) describes a group of disorders of the development of movement and posture, causing activity limitation that is attributed to non-progressive disturbances which occurred in the developing fetal or infant brain. The motor disorders of CP are often accompanied by disturbances of sensation, cognition, communication, perception, and/or behaviour, and/or by a seizure disorder. 1 Impaired arm and hand function are major problems of children with CP, which contribute to disability in daily functioning. Pathophysiological mechanisms which play a role in these problems are paresis of specific muscles and spasticity and/or reduced muscle length associated with spasticity and disuse. Imbalance between agonistic and antagonistic muscles influences the position of the arm and hand. Secondary contractures and joint deformities often result in adduction and inward rotation of the upper arm, flexion of the elbow, pronation of the forearm, flexion of wrist and fingers, and thumb-in-palm deformity. These impairments contribute to the difficulties experienced in reaching, pointing, grasping, releasing, and manipulating objects. The abnormal hand posture influences the ability for refined grasping of objects of different orientation or shape. 2 One of the treatment options in children with CP is surgery. Surgical treatment, which may include release of spastic muscles and tendon transfers, focuses on improving muscle

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The neuronal group selection theory: promising principles for understanding and treating developmental motor disorders

Cited by 147 publications

References 107 publications

The Infant Motor Profile: a standardized and qualitative method to assess motor behaviour in infancy

The Infant Motor Profile: a standardized and qualitative method to assess motor behaviour in infancy

Age at First Prosthetic Fitting and Later Functional Outcome in Children and Young Adults with Unilateral Congenital Below-Elbow Deficiency

Does surgical management of the hand in children with spastic unilateral cerebral palsy affect functional outcome?

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