The predictive validity of general movements – A systematic review

Burger, Marlette; Louw, Quinette

doi:10.1016/j.ejpn.2008.09.004

Cited by 128 publications

(110 citation statements)

References 38 publications

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“…Since then, various groups have emphasized the significance of fidgety movements for an early prediction of CP [10][11][12][13]16]. Burger and Louw reviewed 15 studies on the predictive value of fidgety movements and reported a sensitivity >91% and a specificity >81% [11].…”

Section: The Absence Of Fidgety Movements Precedes Cpmentioning

confidence: 99%

“…Burger and Louw reviewed 15 studies on the predictive value of fidgety movements and reported a sensitivity >91% and a specificity >81% [11]. The most comprehensive study so far, in which 903 children participated, yielded a sensitivity of 98% and a specificity of 94% [17].…”

Section: The Absence Of Fidgety Movements Precedes Cpmentioning

confidence: 99%

“…Among the most reliable markers for CP are abnormal 'general movements' (GMs) [8][9][10][11][12][13]. The assessment of spontaneous GMs is based on visual gestalt perception in preterm and term infants aged up to 5 months post-term.…”

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confidence: 99%

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Early Markers For Cerebral Palsy: Insights From the Assessment of General Movements

et al. 2012

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Overt clinical symptoms of cerebral palsy do not emerge before a child is at least half a year old. Among the most reliable early markers for cerebral palsy are abnormal ‘general movements’ (GMs). Two specific abnormal GM patterns predict cerebral palsy: cramped-synchronized GMs (during preterm and term age), which lack the usual smoothness and fluent character; and limb and trunk muscles contract almost simultaneously and relax almost simultaneously. In addition, the absence of so-called fidgety movements at 3–5 months post-term age. Fidgety movements are small movements of the neck, trunk and limbs in all directions and of variable acceleration. Beside a high sensitivity (>91%) and specificity (>81%), the assessment of GMs is quick, nonintrusive and easy to acquire.

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Section: The Absence Of Fidgety Movements Precedes Cpmentioning

confidence: 99%

Section: The Absence Of Fidgety Movements Precedes Cpmentioning

confidence: 99%

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Early Markers For Cerebral Palsy: Insights From the Assessment of General Movements

et al. 2012

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“…6 Two recent systematic reviews of GM and their predictive validity called for more rigorous studies with long-term follow-up because of the many sources of bias in studies to date (eg, the assessors being familiar with the infant' s clinical history). 9,10 The majority of studies have focused on prediction of CP and motor impairment, although some studies have demonstrated that GM are related to other areas of development, such as cognitive and behavioral outcomes. 11,12 The goal of the current study was to assess the validity of GM assessments at 1 and 3 months' corrected age for predicting a range of neurodevelopmental outcomes at 2 and 4 years' corrected age in VP children.…”

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confidence: 99%

General Movements in Very Preterm Children and Neurodevelopment at 2 and 4 Years

et al. 2013

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OBJECTIVE: Although ∼50% of very preterm (VP) children have neurodevelopmental impairments, early prediction of infants who will experience problems later in life remains a challenge. This study evaluated the predictive value of general movements (GM; spontaneous and endogenous movements) at 1 and 3 months’ corrected age for neurodevelopment at 2 and 4 years of age in VP children. METHODS: At 1 and 3 months’ corrected age, infants born <30 weeks’ gestation had GM assessed as normal or abnormal. Motor, cognitive, and language development at 2 years was assessed by using the Bayley Scales of Infant and Toddler Development, Third Edition. At 4 years, cognitive and language outcomes were assessed by using the Differential Ability Scale–Second Edition and motor outcomes with the Movement Assessment Battery for Children–Second Edition; a diagnosis of cerebral palsy was documented. RESULTS: Ninety-nine VP infants were recruited, with 97% and 88% of survivors followed up at age 2 and 4 years, respectively. Abnormal GM at 1 month were associated with worse motor outcomes at 2 and 4 years but not language or cognitive outcomes. Abnormal GM at 3 months were associated with worse motor, cognitive, and language outcomes at both 2 and 4 years. Overall, GM at 1 month demonstrated better sensitivity to impairments at 2 and 4 years, whereas GM at 3 months had better specificity and were more accurate overall at distinguishing between children with and without impairment. CONCLUSIONS: Abnormal GM in VP infants, particularly at 3 months postterm, are predictive of worse neurodevelopment at ages 2 and 4 years.

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“…51,52 Abnormal general movements ("absent fidgety") at 3 months corrected age predicts CP with a sensitivity of $92% (specificity $82%). 53 In light of our study findings, using best practice tools to identify those infants at risk for CP and to tease them apart from those at risk for general delay is very important, as EE interventions can be specifically targeted at motor development if this is expected to be impaired. Also, earlier intervention instituted at a time of greater brain growth and plasticity is likely to be associated with a stronger beneficial effect.…”

Section: Figurementioning

confidence: 92%

Enriched Environments and Motor Outcomes in Cerebral Palsy: Systematic Review and Meta-analysis

2013

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BACKGROUND AND OBJECTIVES: Neuroplasticity evidence from animals favors an early enriched environment for promoting optimal brain injury recovery. In infants, systematic reviews show environmental enrichment (EE) improves cognitive outcomes but the effect on motor skills is less understood. The objective of this review was to appraise the effectiveness evidence about EE for improving the motor outcomes of infants at high risk of cerebral palsy (CP). METHODS:A systematic review was conducted. Cochrane Central Register of Controlled Trials (PubMed), Cumulative Index to Nursing and Allied Health Literature, Education Resource Information Center, SocINDEX, and PsycINFO databases were searched for literature meeting inclusion criteria: randomized controlled trials; high risk of /diagnosis of CP; .25% participants #2 years; parent or infant interventions postdischarge; and motor outcomes reported. Data were extracted using the Cochrane protocol regarding participants, intervention characteristics, and outcomes. Methodological quality was assessed using risk of bias assessment and GRADE.RESULTS: A total of 226 studies were identified. After removing duplicates and unrelated studies, 16 full-text articles were reviewed, of which 7 studies met inclusion criteria. The risk of bias varied between studies with the more recent studies demonstrating the lowest risk. Enrichment interventions varied in type and focus, making comparisons difficult. A meta-analysis was conducted of studies that compared enrichment to standard care (n = 5), and totaled 150 infants. A small positive effect for enrichment was found; standardized mean difference 0.39 (95% confidence interval 0.05-0.72; I 2 = 3%; P = .02)CONCLUSIONS: EE looks promising for CP, and therefore high-quality studies with well-defined EE strategies are urgently required. Ms Morgan and Dr Novak were involved in quality assessment, data extraction, data analysis, and manuscript preparation; Dr Badawi was involved in quality assessment and manuscript critique. All authors were involved in study conception and design, interpretation of data, critical revision, and final approval of the submitted manuscript. Children with cerebral palsy (CP) reach ∼90% of their gross motor potential by age 5 and even younger for the more severely impaired, 1 so effective interventions for optimizing early motor development are vital. As with typically developing children, the first 2 years are critically important for cognitive and motor development 2 because the brain is experiencing continuous spontaneous plasticity. Pediatricians, who are responsible for making the diagnosis of CP and referral to rehabilitation, therefore require up-todate evidence about effective early interventions for children with CP.The value of enriched environments in enhancing brain recovery at both structural and chemical levels has been repeatedly demonstrated in animal studies. 3,4 Effects of enrichment include improved memory and motor function. 4 Replication of animal data findings within humans is still...

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The predictive validity of general movements – A systematic review

Cited by 128 publications

References 38 publications

Early Markers For Cerebral Palsy: Insights From the Assessment of General Movements

Early Markers For Cerebral Palsy: Insights From the Assessment of General Movements

General Movements in Very Preterm Children and Neurodevelopment at 2 and 4 Years

Enriched Environments and Motor Outcomes in Cerebral Palsy: Systematic Review and Meta-analysis

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