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Published on: January 11, 2016
Upper-limb movement in infants at risk for unilateral spastic cerebral palsy: A scoping review
Cornelia H Verhage1, Martijn Kooij1, Linda S De Vries2
1Center for Child Development and Exercise, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
Insights
Early signs of unilateral spastic cerebral palsy (USCP) in infant upper-limb movements appear by 12 weeks. Asymmetries in movement and skills are key indicators for timely diagnosis and intervention.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Movement Science
Background:
- Unilateral spastic cerebral palsy (USCP) impacts infant motor development.
- Early identification of USCP is crucial for effective intervention.
- Understanding early upper-limb movement patterns is key to detecting USCP.
Purpose of the Study:
- To map existing knowledge on early upper-limb movements in infants (0-12 months).
- To identify movement characteristics indicative of developing USCP.
- To inform early detection strategies for USCP.
Main Methods:
- A comprehensive scoping review of scientific literature.
- Systematic searches in PubMed/MEDLINE, Embase, and CINAHL databases.
- Inclusion of studies on infants at risk for USCP reporting specific upper-limb movements.
Main Results:
- Twelve studies met the inclusion criteria.
- Identified movement categories: spontaneous movements, pre-reaching, and upper-limb skills.
- Observed asymmetry in wrist/digit movements, pre-reaching, and hand use in infants who developed USCP, becoming more evident from 15 weeks.
Conclusions:
- Clinical signs of USCP in upper-limb movements are detectable from 12 weeks.
- Subtle preceding signs may exist.
- Advanced technologies like 3D motion analysis and wearable sensors can improve early detection and intervention for USCP.
Aim:
To identify and map current knowledge regarding early upper-limb movement in infants from birth to 12 months, which are indicative for development of unilateral spastic cerebral palsy (USCP).
Method:
A scoping review was conducted involving a comprehensive and systematic literature search in PubMed/MEDLINE, Embase, and CINAHL. Articles were screened according to title and abstract and relevant data were extracted. Studies were eligible if they included infants aged 0 to 12 months at risk of developing USCP and reported early upper-limb movement characteristics indicative of USCP.
Results:
Twelve of 5482 studies were included. Three categories of assessments were recognized: (1) spontaneous upper-limb movements; (2) pre-reaching; and (3) upper-limb skills. Across these categories, asymmetry was observed, namely in spontaneous wrist and digit movements, pre-reaching trajectories, and reduced use of the contralesional hand in infants who developed USCP. From 15 weeks of age onwards, asymmetry was more evident not only in upper-limb movement patterns but also in object-related upper-limb skills.
Interpretation:
Clinical signs of USCP in upper-limb movements are noticeable from the age of 12 weeks. Preceding signs may be subtle. Three-dimensional motion analysis and wearable sensors may enhance early detection, enabling timely diagnosis and intervention.
