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Spontaneous Leg Movements Measured by Wearable Sensors in Infancy Differentiate Later Risk for Cerebral Palsy
Samuel R Pierce1, Mustafa A Ghazi2, Thubi H A Kolobe3
1Division of Rehabilitation Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Insights
Infants at high risk for cerebral palsy (CP) showed fewer leg movements and shorter movement duration. Wearable sensors can help identify infants needing early intervention for CP.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Biomedical Engineering
Background:
- Infants with perinatal brain injuries are at risk for cerebral palsy (CP).
- Early detection of CP risk is crucial for timely intervention.
- Spontaneous motor activity may indicate neurological status.
Purpose of the Study:
- To investigate if early spontaneous leg movements differentiate CP risk in infants with perinatal brain injury.
- To assess the utility of wearable sensors in characterizing infant leg movements.
- To correlate leg movement parameters with CP risk status.
Main Methods:
- Infants at risk for CP were classified as high-risk (n=33) or not high-risk (n=21) at 4 months using established assessments.
- Wearable inertial sensors on ankles recorded leg movement data from 1 to 4 months.
- Kinematic parameters including movement frequency, acceleration, duration, and entropy were analyzed using mixed-effects models.
Main Results:
- High-risk infants exhibited significantly fewer leg movements per hour awake (P=0.0322).
- High-risk infants had a significantly shorter median leg movement duration (P=0.0023).
- These findings suggest movement patterns differ based on CP risk.
Conclusions:
- Wearable sensors effectively capture infant spontaneous movements in natural settings.
- Characterizing leg movements offers potential for early CP risk identification.
- This approach may guide early intervention and specialist follow-up for infants at risk of CP.
Background:
To determine if early spontaneous leg movements of infants differentiate risk status for cerebral palsy (CP) in infants who had a perinatal brain injury.
Methods:
Infants born at risk for CP (due to a perinatal brain injury) were classified as high risk for CP (n = 33) or not at high risk (n = 21), at 4 months of age, using General Movements Assessment and Test of Infant Motor Performance. Full-day leg movement data were recorded using wearable inertial sensors on each ankle (2 days per month, from age 1 to 4 months). Kinematic parameters were derived from accelerometer and gyroscope data as follows: (1) number of leg movements per hour awake; (2) median leg movement acceleration; (3) median leg movement duration; and (4) fuzzy entropy of peak leg movement acceleration. The leg kinematic parameters measured at month 1 and month 4 were analyzed using mixed-effects models.
Results:
Infants classified as high risk for CP had statistically significantly fewer number of leg movements per hour awake and shorter median leg movement duration than infants not at high risk (P = 0.0322 and P = 0.0023, respectively).
Conclusions:
The spontaneous movements of infants can be characterized in their natural environments using wearable sensors and have potential to inform recommendations for early intervention and follow-up with experts in CP diagnosis.
