Related Experiment Video
Updated: Feb 5, 2026
The Mouse Stroke Unit Protocol with Standardized Neurological Scoring for Translational Mouse Stroke Studies
Published on: February 7, 2025
Development of a Symmetry Score for Infantile Postural and Movement Asymmetries: Preliminary Results of a Pilot Study
Robby Sacher1, Dana Loudovici-Krug2,3, Marc Wuttke1
1Practice for Manual Medicine, Freistuhl, Dortmund, Germany.
Insights
A new 4-item symmetry score reliably quantifies infantile postural and movement asymmetries in infants aged 3-6 months. Early intervention including manual medicine and "tummy time" shows positive results.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Musculoskeletal Disorders
Background:
- Infantile postural and movement asymmetries are common concerns in early development.
- Objective quantification of these asymmetries is crucial for timely diagnosis and intervention.
Purpose of the Study:
- To develop and validate a reliable and quantifiable symmetry score for assessing infantile postural and movement asymmetries.
Main Methods:
- Developed a 4-item symmetry score based on reliability studies involving 24 infants with postural abnormalities.
- Assessed inter-rater, intra-rater, and test-retest reliability using intraclass correlation coefficient (ICC) and Cohen's kappa.
- Validated the score through expert opinion and comparison with clinical assessments in 26 infants.
Main Results:
- The 4-item symmetry score demonstrated high reliability (ICC >0.8, Cohen's κ >0.6).
- Expert opinion showed majority agreement, and the score agreed with clinical testing in 84.6% of cases.
- A pilot study indicated that 63% of infants receiving manual medicine and a "tummy time" program improved.
Conclusions:
- The 4-item symmetry score is a reliable and valid tool for diagnosing, evaluating, and monitoring infants aged 3-6 months with postural and movement asymmetries.
- A single manual medicine treatment combined with a home "tummy time" program positively impacts symmetry in infants.
Objective:
The purpose of this study was to develop and verify a quantifiable symmetry score for infantile postural and movement asymmetries.
Methods:
Three studies were conducted. For reliability, 6 test items examining postural and movement asymmetries, which came under consideration, were investigated in 24 infants with postural abnormality (range: 14-24 weeks). The inter-rater reliability was chosen as the primary endpoint. Furthermore, intrarater reliability and test-retest reliability were determined. Analysis and weighting of the items were performed by calculating the intraclass correlation coefficient. The validity was reviewed by expert opinion and by using a study with 26 infants (range: 12-28 weeks) of a cross-section population. The pilot study involved 38 infants, aged 14 to 24 weeks, who were examined using video. Their autonomic symptoms were recorded, and subsequently, they were treated once by means of manual medicine. The parents were instructed to a daily home program that focused on "tummy time."
Results:
The reliability tests led to a 4-item symmetry score with a point value between 4 points (very symmetrical) and 17 points (very asymmetrical). The chosen items achieved an intraclass correlation coefficient >0.8 and Cohen's κ >0.6, respectively. The experts' opinions matched mainly to a majority agreement (>50%). Furthermore, a comparison between the outcome of clinical testing and the symmetry score applied to 26 children without diagnosed abnormalities displayed an agreement of 84.6%. The pilot study showed a good reduction of the postural and movement abnormalities because 63% of the manual treated children were assessed as being symmetric afterward.
Conclusion:
The reliable and valid 4-item symmetry score served for the diagnosis, evaluation, and follow-up of infants aged 3 to 6 months with infantile postural and movement asymmetries. The results of a pilot study showed the positive effect of a single manual medical treatment session along with a home program focusing on "tummy time."
Related Concept Videos
01:26Symmetry
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:21Pilot and Numeric Relaying
01:27Gauss's Law: Planar Symmetry
01:19Membrane Asymmetry Regulating Transporters
Flippase
Eukaryotic flippases are type-IV P-type ATPases or P4-ATPases belonging to P-type ATPase family proteins that are membrane-bound pumps involved in the ATP-mediated transport of ions and molecules across the membrane. Flippases flip specific phospholipids from the outer to the inner leaflet of a membrane. All P4-ATPases have one...
01:06Introduction to z Scores
z scores...