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Does general movements quality in term infants predict cerebral palsy and milder forms of limited mobility at 6
Patricia A M van Iersel1, Saskia C M Bakker2, Arnold J H Jonker1
1Department of Physical Therapy, Gelre Hospital, Apeldoorn, the Netherlands.
Insights
Definitely abnormal general movements in fidgety age predict cerebral palsy (CP) in term infants, though less accurately than in preterm infants. General movements quality does not predict limited mobility in children without CP.
Area of Science:
- Developmental Pediatrics
- Neurology
- Movement Science
Background:
- General movements assessment is a tool to evaluate early neurological development.
- Previous studies suggest its predictive value for neurodevelopmental outcomes, particularly in preterm infants.
Purpose of the Study:
- To assess the association between general movements quality in term infants and their developmental outcomes at six years.
- To determine if general movements predict cerebral palsy (CP) or limited mobility without CP.
Main Methods:
- A prospective study of 145 term infants, assessing general movements at 3 and 13 weeks post-term.
- Follow-up at six years included neurological examination, mobility assessment (Movement Assessment Battery for Children), and behavioral/learning questionnaires.
Main Results:
- Abnormal general movements at fidgety age predicted CP in term infants (sensitivity 60%, specificity 91%).
- General movements quality did not predict limited mobility in children without CP.
- A minor association was found between general movements quality and minor neurological dysfunction (MND) in children without CP.
Conclusions:
- Abnormal general movements at fidgety age are predictive of CP in term infants, but with lower accuracy compared to preterm infants.
- General movements assessment in term infants shows a lower predictive value for CP than in preterm infants.
- General movements quality does not predict limited mobility in children without CP.
Aim:
To evaluate in term infants associations between quality of general movements and developmental outcome in term infants at 6 years with either cerebral palsy (CP) or limited mobility without CP.
Method:
Participants of this prospective study were 145 term infants (86 male, 59 female). Their general movements quality was assessed at 'writhing' and 'fidgety' general movements age (3wks and 13wks post term). The assessment at 6 years consisted of a neurological examination, including assessment of minor neurological dysfunction (MND), evaluation of mobility with the Movement Assessment Battery for Children, and of behaviour and learning problems with questionnaires.
Results:
Definitely abnormal general movements at writhing age were not associated with CP, whereas definitely abnormal general movements at fidgety age were (sensitivity 60%; specificity 91%; positive predictive value 19%, negative predictive value 98%). In children without CP, general movements quality was not associated with limited mobility, but it was associated to a minor extent with MND.
Interpretation:
In term infants, definitely abnormal general movements at fidgety age do predict CP, but with lower accuracy than in preterm infants. General movements quality does not predict limited mobility in children without CP. The study supports suggestions that predictive value of general movements assessment in term infants is lower than that in preterm infants.
