Patterns of postural asymmetry in infants: a standardized video-based analysis
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Published on: January 15, 2016
Heike Philippi1, Andreas Faldum, Tatjana Jung
1Children's University Hospital, Department of Paediatric Neurology, Im Neuenheimer Feld 150, 69120, Heidelberg, Germany. Heike.Philippi@med.uni-heidelberg.de
Insights
Infantile postural asymmetry (IPA) involves cervical rotation deficit and trunk convexity, often linked with other issues. This study reveals that infants with apparent single signs of IPA actually have more widespread disturbances.
Area of Science:
- Pediatrics
- Developmental Biology
- Clinical Neurology
Background:
- Infantile postural asymmetry (IPA) is characterized by cervical rotation deficit (CRD) and trunk convexity (TC).
- Limited data exist on the comprehensive clinical spectrum of IPA and its associated features.
- Understanding the full range of IPA symptoms is crucial for accurate diagnosis and management.
Purpose of the Study:
- To analyze the complete clinical spectrum of infantile postural asymmetry (IPA).
- To investigate the association between CRD, TC, and other asymmetric features using standardized video documentation.
- To provide a detailed assessment of the entire symptom complex in infants diagnosed with IPA.
Main Methods:
- A cohort of 45 infants diagnosed with IPA (asymmetry score >= 12) was selected from previous studies.
- Standardized video documentation was used to assess CRD and TC in prone and supine positions by independent observers.
- Associated features including plagiocephaly, oblique body position, foot position, and hip dysplasia were also evaluated.
Main Results:
- Reactive movement patterns included "scoliosis" (6 infants), "torticollis" (9 infants), "mixed prone" (13 infants), and "mixed" (26 infants).
- Concordance of TC and CRD was observed in 27 infants, with a left-sided prevalence in two-thirds.
- Associated anomalies found were plagiocephaly (27 infants), oblique body position (13 infants), hip dysplasia (4 infants), and calcaneus foot (11 infants).
Conclusions:
- Morphological and functional anomalies in IPA are intricately interconnected.
- Infants presenting with a single apparent sign of asymmetry often exhibit a more generalized disturbance.
- IPA assessment requires a holistic approach considering the entire spectrum of clinical signs.
Abstract:
Cervical rotation deficit (CRD) and trunk convexity (TC) constitute the diagnosis of infantile postural asymmetry (IPA), which is often associated with further asymmetric features. However, very little data on the entire symptom complex are currently available. The aim of this study was to analyse the entire clinical spectrum of IPA based on a standardized video documentation. Forty-five infants (27 male) with an asymmetry score of > or = 12 points (scale: 4-24) at a median post-term age of 10 weeks (range: 6-16) were selected from two previously studies using predefined criteria. CRD and TC as reactive movements to an orienting head turn in the prone and supine position were assessed from video recordings by three independent observers. Plagiocephaly, oblique body position and asymmetric foot position were descriptively assessed by consent of the same observers. Hip dysplasia data were derived from sonography charts. The assessment of the reactive movements showed a "scoliosis" pattern in sox infants, a "torticollis" pattern in nine infants, a "mixed prone" pattern in 13 infants and a "mixed" pattern in 26 infants. Side agreement in the prone and supine position of TC and CRD was seen in 27 infants, with a left-sided convexity and left-sided head rotation deficit in two-thirds of the infants. Plagiocephaly was present in 27 infants, oblique body position in 13 infants, hip dysplasia in 4 infants and calcaneus foot in 11 infants. In conclusion, infantile asymmetry pattern analysis showed that morphological and functional anomalies are intricately linked and that infants with only a single apparent sign of asymmetry have actually a much more generalized disturbance.
