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The forward parachute reaction and independent walking in infants with brain lesions
Domenico M Romeo1, Daniela Ricci, Giovanni Baranello
1Paediatric Neurology Unit, Catholic University, Rome, Italy.
Insights
Delayed development of the forward parachute reaction (FPR) in infants with brain lesions may signal broader delays in functional maturation and walking ability. Early FPR assessment can predict walking age.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Clinical Neurology
Background:
- The forward parachute reaction (FPR) is a key developmental reflex.
- Assessing FPR in infants with brain lesions is crucial for understanding motor development.
- Early identification of developmental delays can inform interventions.
Purpose of the Study:
- To evaluate the onset of the forward parachute reaction (FPR) in infants with brain lesions.
- To determine the correlation between FPR development and the age of achieving independent walking.
- To identify potential early markers for delayed functional maturation.
Main Methods:
- 140 infants with brain lesions (mean gestational age 31 weeks) were assessed for FPR at 6, 9, and 12 months.
- Cranial ultrasound identified mild (n=62) or major (n=78) abnormalities; 86 infants developed cerebral palsy.
- Infants were followed for 5 years to record independent walking age, excluding specific high-risk groups.
Main Results:
- Complete FPR was observed in 8% at 6 months, 30% at 9 months, and 51% at 12 months.
- At 12 months, 21% had incomplete FPR and 29% had absent FPR.
- Complete FPR at 12 months strongly predicted independent walking, with earlier onset correlating with earlier walking.
Conclusions:
- Late acquisition of a complete FPR is an early indicator of generalized delayed maturation of functional abilities.
- FPR assessment provides valuable insights into neurodevelopmental trajectories in at-risk infants.
- The findings support the use of FPR as a predictive tool for motor development outcomes.
Aim:
The aim of this study was to assess the onset of forward parachute reaction (FPR) in infants with brain lesions and its correlation with age of walking.
Method:
FPR was assessed at 6, 9, and 12 months in 140 infants with brain lesions (78 males, 62 females; mean gestational age 31 wks; SD 3.6 wks; mean birthweight 1450 g, SD 252 g). On cranial ultrasound 62 infants had mild and 78 had major abnormalities; 86 developed cerebral palsy. All were followed for 5 years, and the age at which each child achieved independent walking was recorded. Infants who had been born small for gestational age (weight <10th centile) were excluded, as were those who had major congenital malformations, severe postnatal infectious diseases, or metabolic or haematological complications.
Results:
A complete FPR was present in eight infants at 6 months, in 42 at 9 months, and in 71 at 12 months. At 12 months, 29 infants presented incomplete FPR and 40 presented absent FPR. Seventy-three infants were able to walk independently between the ages of 11 months and 60 months (67 with complete FPR and six with incomplete FPR at 12 mo). A complete FPR at 12 months was a good predictor of independent walking. The age at onset of complete FPR was also a good predictor of age of walking.
Interpretation:
The late acquisition of a complete FPR appears to be an early sign of a more general delayed maturation of functional abilities.
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