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Kinematic and qualitative analysis of lower-extremity movements in preterm infants with brain lesions
J van der Heide1, P B Paolicelli, A Boldrini
1Stella Maris Scientific Institute, Pisa, Italy.
Insights
Preterm birth and brain lesions had minimal impact on infant kicking kinematics. Qualitative movement assessments, however, revealed differences in preterm infants with brain lesions, suggesting clinical utility.
Area of Science:
- Developmental Pediatrics
- Neuroscience
- Movement Science
Background:
- Preterm birth and severe brain lesions can affect infant motor development.
- Understanding the impact on early motor skills like kicking is crucial for early intervention.
Purpose of the Study:
- To assess the effects of preterm birth, brain lesions, and postterm age on infant kicking.
- To compare kinematic analysis with qualitative movement assessment for prognostic value.
Main Methods:
- Studied three groups: full-term infants, low-risk preterm infants, and preterm infants with severe brain lesions (periventricular leukomalacia).
- Recorded and analyzed infant motor behavior at 1 and 3 months postterm, measuring kicking kinematics and qualitative movements.
- Utilized kinematic analysis and Prechtl's qualitative movement assessment method.
Main Results:
- Kinematic analysis revealed only minor differences in kicking movements across the infant groups.
- Qualitative assessment identified fewer segmental foot movements and abnormal general movements in preterm infants with brain lesions, especially those with cerebral palsy.
Conclusions:
- Infant kicking mechanisms at young ages are not significantly affected by the extrauterine environment or brain lesions.
- Qualitative assessment of infant movements is more clinically relevant than kinematic analysis for identifying developmental issues.
Background And Purpose:
The purposes of this study were to evaluate the effects of preterm birth, severe brain lesions, and postterm age on kicking movements of young infants and to compare the prognostic value of kinematic analysis of kicking with a qualitative assessment of infants' spontaneous movements.
Subjects:
The subjects were 12 full-term infants without brain injury, 12 low-risk preterm infants without brain injury, and 11 preterm infants with severe brain lesions (periventricular leukomalacia).
Methods:
Videotape recordings of each infant's motor behavior in a supine position were made at 1 and 3 months postterm age. Kicking frequency, temporal organization of the kick cycle, coordination among different joints, and interlimb coordination were measured. A qualitative assessment for lower-extremity movements and a Gestalt judgment of general movement quality according to Prechtl's method were made from the same videotape recordings.
Results:
Kinematic analysis showed only mild differences among the 3 groups of infants. Qualitative assessment of the lower-extremity movements, however, showed that preterm infants with brain lesions, and particularly those who later were found to have cerebral palsy, consistently had fewer segmental movements of the foot and abnormal general movements at both ages.
Conclusion And Discussion:
The data suggest that the mechanisms responsible for kicking movements in newborns and young infants do not appear to be influenced by the extrauterine environment or by brain lesions, at least at the ages studied. Qualitative assessment of lower-extremity and general movements seems to be more appropriate for clinical purposes.