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Early Intervention Guided by the General Movements Examination at Term Corrected Age-Short Term Outcomes
Adrian Ioan Toma1,2, Vlad Dima3, Adelina Alexe4
1Life Memorial Hospital, 010719 Bucharest, Romania.
Insights
Early intervention using General Movements assessment in premature infants shows promise for improving neurologic outcomes. Identifying cramped-synchronized patterns at term-equivalent age can guide timely support for better prognosis.
Area of Science:
- Neonatal Neurology
- Developmental Pediatrics
- Movement Science
Background:
- Premature neonates are at risk for neurologic sequelae.
- Early identification of at-risk infants is crucial for intervention and prognosis.
- General Movements (GM) assessment is a tool for evaluating neurodevelopmental status.
Purpose of the Study:
- To investigate if General Movements patterns at term-equivalent age predict neurologic outcomes in former premature infants.
- To assess the efficacy of early intervention guided by GM assessment.
- To explore the potential of GM patterns in guiding early intervention strategies.
Main Methods:
- A pilot study involving 44 premature neonates (mean gestational age 33.59 weeks).
- Assessment of General Movements patterns at term-equivalent age.
- 10 infants with cramped-synchronized GM patterns received early intervention (physiotherapy).
- Follow-up examinations at 12 weeks corrected age, assessing fidgety movements and Motor Optimality Score Revised (MOS-R).
Main Results:
- 9/10 infants in the intervention group showed normal fidgety movements and a MOS-R of 20-24 at 12 weeks.
- Atypical patterns observed included head movements, non-centered head, asymmetric tonic neck reflex, and jerky movements.
- One patient with no fidgety movements had a MOS-R of 9.
Conclusions:
- Early intervention in former premature infants with cramped-synchronized GM patterns appears to improve neurologic status, evidenced by the emergence of fidgety movements.
- The study suggests considering early intervention for all premature infants exhibiting cramped-synchronized GM patterns at term-equivalent age.
- Conclusions should be interpreted cautiously due to small sample size, lack of statistical analysis, no control group, and limited follow-up.
Background And Aim:
The early identification of the former premature neonates at risk of neurologic sequelae could lead to early intervention and a better prognosis. This pilot study aimed to investigate whether the General Movement patterns observed at term-equivalent age in former premature infants could serve as predictors for guiding early intervention and improving prognosis.
Materials And Methods:
In a population of 44 premature neonates (mean gestational age 33.59 weeks (+2.43 weeks)) examined at term-equivalent age, 10 neonates with a cramped-synchronized General Movements motor pattern were identified. These neonates were included in an early intervention program consisting of physiotherapy executed both by the therapist and by the parents at home. They were again examined at a corrected age of 12 weeks. The presence or absence of fidgety movements and the MOS-R (motor optimality score revised) was noted. The examinations were performed by certified specialists.
Results:
Normal fidgety movements and a MOS-R of 20-24 were presented in 9/10 of the former premature infants, with normal foot to foot contact present in 7/10, and normal hand to hand contact present in 5/10. The atypical patterns noted were side to side movements of the head in 5/10, a non-centered head in 9/10, asymmetric tonic neck reflex in 9/10 and jerky movements in 10/10. One patient presented with no fidgety movements and a MOS-R score of 9.
Conclusion:
Early intervention in our group of patients allowed for an improvement in the neurologic status, demonstrated by the presence of fidgety movements. We suggest that early intervention should be indicated in all premature infants that present with a cramped-synchronized GM pattern during examination at term-equivalent age. However, due to the small sample size, the absence of statistical analysis and a control group, and the limited follow-up period, the conclusions must be approached with caution.
