Assessment of the quality of general movements in newborn infants: a tool to predict developmental disorders at an early age
Keywords:
general movements, Prechtl's method, low birth weight, developmental disorders
Abstract
Background Nowadays, quality assessment of general movements(GMs) in infants can be used as a tool to predict developmental
outcome. Until now, there is no published study in this field in
Indonesia.
Objectives The aim of this study was to evaluate the quality of
GMs of newborn infants.
Methods A prospective study was done at neonatal ward, Dr.
Soetomo Hospital in Surabaya, between December 2006 and
January 2007. A single supine position video recording of newborns
at GMs preterm and writhing age was made using Precthl's method.
Infants were chosen consecutively among singletons above 28
week gestational age. The quality of GMs was assessed by means
of Gestalt perception by one of the authors, who had been trained
and certified in GMs. GMs were classified into: normal-optimal,
normal-suboptimal, mildly-abnormal, and definitely-abnormal.
Correlation tests were used to assess the relationship between
perinatal conditions and the quality of GMs.
Results 106 videos were recorded, and 100 were assessed
completely. Abnormal GMs were found in both 35 preterm
age (normal-optimal 2.9%; normal-suboptimal 28.6%; mildly-
abnormal45. 7o/o; definitely-abnormal22.9o/o) and 65 writhing age
(3.1 o/o; 41.5%; 41.5%; 13.8%, respectively) (P=0.285). There was
a weak negative correlation between birth weight and the quality
ofGMs (r=-0.20, P=0.044).
Conclusions The quality ofGMs in Indonesian newborn infants in
our study was predominantly abnormal, which puts these infants
at high risk for later developmental disorders. The lower the
infants'birth weight, the more likely for abnormal GMs.
References
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identification of children at high risk of developmental
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in Precthl's method on the qualitative assessment of general
movements. Early Hum Dev 2005;81:623-7.
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qualitative assessment of general movements in preterm, term
and young infants-review of methodology. Early Hum Dev
1997 ;50:4 7-60.
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general movement assessment in the neurological outcome of
cerebral lesions in preterm infants. J Pediatr 2004;80 Suppl
4:296-304.
13. Prechtl HFR. Qualitative changes of spontaneous move-
ments in fetus and preterm infant are a marker of neurological
dysfunction. Early Hum Dev 1990;23: 151-8.
14. van Kranen-Mastenbroek V, van Oostenbrugge R, Palmans
L, Stevens A, Kingma H, Blanco C, et al. Inter- and
intraobserver agreement in the assessment of the quality
of spontaneous movements in the newborn. Brain Dev
1992;14:289-93.
15. Hadders-Algra M, Groothuis AMC, Groen SE, Stremmelaar
EF, Martijn A, Butcher PR. Quality of general movements
and the development of minor neurological dysfunction at
toddler and school age. Clin Rehab 2004;18:287-99.
16. Geerdink JJ, Hopkins B. Effects of birth weight status and
gestational age on the quality of general movements in
preterm newborns. Bioi Neonate 1993;63:215-24.
17. van Kranen-Mastenbroek VH, Kingma H, Caberg HB, Ghys
A, Blanco CE, Hasaart TH, et al. Quality of spontaneous
general movements in full-term small-for-gestational age and
appropriate-for-gestational-age newborn infants. Neurope-
diatrics 1994;25: 145-53.
18. Bos AF, van Loon AJ, Hadders-Algra M, Martijn A, Okken
A, Prechtl HF. Spontaneous motility in preterm, small for
gestational age infants. II. Qualitative aspects. Early Hum
Dev 1997;50:131-47.
19. Bouwstra H, Dijck-Brouwer DAJ, Wildeman JAL, Tjoonk
HM, Van der Heide JC, Boersma ER, et al. Long-chain
polyunsaturated fatty acids have a positive effect on the
quality of general movements of term infants. Am J Clin
Nutr 2003;78:313-8.
20. Sival DA, Visser GHA, Prechtl HFR. Does reduction of
amniotic fluid affect fetal movements? Early Hum Dev
1990;23:233-46.
21. Bekedam DJ, VisserGHA, De VriesJJ. Motor behavior in the
growth-retarded fetus. Early Hum Dev 1985; 12:155-65.
22. Sival DA, Visser GHA, Prechtl HFR. The effect of intrauterine
growth retardation on the quality of general movements in the
human fetus. Early Hum Dev 1992;28: 119-32.
23. Kakebeeke TH, Von Siebenthal K, Largo RH. Differences in
movement quality at term among pre term and term infants.
Bioi Neonate 1997;71:367-78.
24. Albers S, Jorch G. Prognostic significance of spontaneous
motility in very immature preterm infants under intensive
care treatment. Bioi Neonatel994;66: 182-7.
25. Bos AF, Martijn A, van Asperen RM, Hadders-Algra M,
Okken A, Prechtl HF. Qualitative assessment of general
movements in high risk preterm infants with chronic
lung disease requiring dexamethasone therapy. J Pediatr
1998;132:300-6.
26. Bos AF, Martijn A, Okken A, Prechtl HFR. Quality of general
movements in preterm infants with transient periventricular
echodensities. Acta Paediatr 1998;87 :328-35.
of very low birth weight infants on recent secular trends in
the prevalence of cerebral palsy. Pediatrics 1993;91:1094-
100.
2. Ornstein M, Ohlson A, Edmonds J. Neonatal follow-up
of very low birth weight infants to school-age: a critical
overview. Acta Paediatr 1991;80:741-8.
3. Hadders-Algra M. Evaluation of motor function in young
infants by means of the assessment of general movements: a
review. Ped Phys Ther 2001;13:27-36.
4. Prechtl HFR. General movement assessment as a method
of developmental neurology: new paradigms and their
consequences. Dev Med Child Neurol2001;43:836-42.
5. Ferrari F, Cioni G, Prechtl HFR. Qualitative changes of
general movements in preterm infants with brain lesions.
Early Hum Dev 1990;23.
6. Prechtl HFR, Ferrari F, Ciani G. Predictive value of general
movements in asphyxiated full term infants. Early Hum Dev
1993;35:91-120.
7. Hadders-Algra M, Groothuis AMC. Quality of general
movements in infancy is related to the development of
neurological dysfunction, attention deficit hyperactivity
disorder and aggressive behavior. Dev Med Child Neurol
1999;41:381-91.
8. Prechtl HFR, Einspieler C, Ciani G, et al. An early marker
of developing neurological handicap after perinatal brain
lesions. Lancet 1997;339: 1361-3.
9. Hadders-Algra M. General movements : a window for early
identification of children at high risk of developmental
disorders. J Pediatr 2004;145:512-8.
10. Valentin T, Uhl K, Einspieler C. The effectiveness of training
in Precthl's method on the qualitative assessment of general
movements. Early Hum Dev 2005;81:623-7.
11. Einspieler C, Prechtl HFR, Ferrari F, Ciani G, Bos AF. The
qualitative assessment of general movements in preterm, term
and young infants-review of methodology. Early Hum Dev
1997 ;50:4 7-60.
12. Garcia JM, Gherpelli JLD, Leone CR. The role of spontaneous
general movement assessment in the neurological outcome of
cerebral lesions in preterm infants. J Pediatr 2004;80 Suppl
4:296-304.
13. Prechtl HFR. Qualitative changes of spontaneous move-
ments in fetus and preterm infant are a marker of neurological
dysfunction. Early Hum Dev 1990;23: 151-8.
14. van Kranen-Mastenbroek V, van Oostenbrugge R, Palmans
L, Stevens A, Kingma H, Blanco C, et al. Inter- and
intraobserver agreement in the assessment of the quality
of spontaneous movements in the newborn. Brain Dev
1992;14:289-93.
15. Hadders-Algra M, Groothuis AMC, Groen SE, Stremmelaar
EF, Martijn A, Butcher PR. Quality of general movements
and the development of minor neurological dysfunction at
toddler and school age. Clin Rehab 2004;18:287-99.
16. Geerdink JJ, Hopkins B. Effects of birth weight status and
gestational age on the quality of general movements in
preterm newborns. Bioi Neonate 1993;63:215-24.
17. van Kranen-Mastenbroek VH, Kingma H, Caberg HB, Ghys
A, Blanco CE, Hasaart TH, et al. Quality of spontaneous
general movements in full-term small-for-gestational age and
appropriate-for-gestational-age newborn infants. Neurope-
diatrics 1994;25: 145-53.
18. Bos AF, van Loon AJ, Hadders-Algra M, Martijn A, Okken
A, Prechtl HF. Spontaneous motility in preterm, small for
gestational age infants. II. Qualitative aspects. Early Hum
Dev 1997;50:131-47.
19. Bouwstra H, Dijck-Brouwer DAJ, Wildeman JAL, Tjoonk
HM, Van der Heide JC, Boersma ER, et al. Long-chain
polyunsaturated fatty acids have a positive effect on the
quality of general movements of term infants. Am J Clin
Nutr 2003;78:313-8.
20. Sival DA, Visser GHA, Prechtl HFR. Does reduction of
amniotic fluid affect fetal movements? Early Hum Dev
1990;23:233-46.
21. Bekedam DJ, VisserGHA, De VriesJJ. Motor behavior in the
growth-retarded fetus. Early Hum Dev 1985; 12:155-65.
22. Sival DA, Visser GHA, Prechtl HFR. The effect of intrauterine
growth retardation on the quality of general movements in the
human fetus. Early Hum Dev 1992;28: 119-32.
23. Kakebeeke TH, Von Siebenthal K, Largo RH. Differences in
movement quality at term among pre term and term infants.
Bioi Neonate 1997;71:367-78.
24. Albers S, Jorch G. Prognostic significance of spontaneous
motility in very immature preterm infants under intensive
care treatment. Bioi Neonatel994;66: 182-7.
25. Bos AF, Martijn A, van Asperen RM, Hadders-Algra M,
Okken A, Prechtl HF. Qualitative assessment of general
movements in high risk preterm infants with chronic
lung disease requiring dexamethasone therapy. J Pediatr
1998;132:300-6.
26. Bos AF, Martijn A, Okken A, Prechtl HFR. Quality of general
movements in preterm infants with transient periventricular
echodensities. Acta Paediatr 1998;87 :328-35.
Published
2016-09-15
How to Cite
1.
Suryawan A, Permono B, Witarini K, Etika R, lndarso F, Narendra M. Assessment of the quality of general movements in newborn infants: a tool to predict developmental disorders at an early age. PI [Internet]. 15Sep.2016 [cited 23Dec.2024];48(5):292-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/609
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Received 2016-09-12
Accepted 2016-09-12
Published 2016-09-15
Accepted 2016-09-12
Published 2016-09-15
