Early Spontaneous Movements and Upper Extremity Movement Score in Infants With all Narakas Types of Obstetric Brachial Plexus Palsy.

BACKGROUND: Obstetric brachial plexus palsy (OBPP) is a birth injury that affects upper extremity performance. However, some children with OBPP might have central nervous system disorder or developmental disabilities. This study aimed to investigate (1) the early spontaneous movements using General Movements Assessment (GMA) in infants with OBPP according to the Narakas classification, (2) the differences from typical infants, and (3) the relationship between the GMA and the affected upper extremity movements score. METHODS: Fifty-six infants with OBPP (39 females; median gestational age 40 weeks, range = 34 to 42) and 50 typical infants (20 females; median gestational age 38 weeks, range = 37 to 41) were assessed at age three to five months using the GMA, which is a determined Motor Optimality Score (MOS) for fidgety movements and concurrent motor repertoire, and using the Active Movement Scale (AMS) for affected upper extremity movements. RESULTS: There were no differences in MOS and its subcategories between Narakas types in infants with OBPP (P > 0.05); however, infants with OBPP had a higher degree of aberrant fidgety movements and a lower score in MOS and its subcategories than typical infants (P < 0.05). There was no relationship between AMS scores, and MOS and its subcategories. CONCLUSIONS: Infants with OBPP, except Narakas type I, might have an increased risk of central nervous disorder and developmental problems in addition to peripheral nerve injury. Each test, GMA and AMS, contributes to the identification of their own specific risk in these infants.

Early Spontaneous Movements and Postural Patterns in Infants With Extremely Low Birth Weight.

BACKGROUND: Extremely-low-birth-weight (ELBW) infants are at high risk of morbidity, mortality, and long-term neurodevelopmental disorders. Evaluating infants' early spontaneous movements and postural patterns could facilitate the early detection of neurological dysfunction. This study aimed to analyze the results of global-and detailed-General Movements Assessment (GMA) in ELBW infants at a corrected age of three to five months and to compare with normal-birth-weight (NBW) infants. METHODS: Fifty-two ELBW infants (median birth weight = 915.5 g) and 50 NBW infants were included. All infants were assessed according to GMA using Motor Optimality Score for 3- to 5-Month-Old Infants-Revised score sheet (MOS-R). In addition, later diagnoses of ELBW infants with atypical development were presented. RESULTS: Fidgety movements were observed in 36 (69.2%) of ELBW infants and all NBW infants. MOS-R scores were lower in the ELBW group (median = 24) compared with the NBW group (median = 26). The ELBW infants scored lower than NBW infants in all MOS-R subcategories. Twenty-three (44.2%) of ELBW infants were diagnosed as atypical in the later period, although all control infants had normal development. CONCLUSIONS: The study indicated that ELBW might increase the risk of atypical development in infants. The MOS-R could help us to find the risk of atypical development in infants with ELBW.

Comparison of physical fitness, activity, and quality of life of the children with epilepsy and their healthy peers.

OBJECTIVE: To identify physical fitness and activity levels, and health-related quality of life of children with epilepsy in Turkey and compare the results with their healthy peers. METHODS: The study included 21 children with epilepsy (with no seizures and not taking anti-epileptic drugs for at least a year) and 20 healthy peers. The FitnessGram Physical Fitness Test Battery was used to assess physical fitness, the 6-Minute Walk Test to assess physical performance, the Pediatric Quality of Life Inventory 4.0 (PedsQL) to assess the quality of life, and a pedometer was used to assess the physical activity of the children. RESULTS: The physical fitness assessments including the trunk-lift test and flamingo balance test results were significantly lower in the children with epilepsy (p < 0.05). There was no significant difference between the groups in terms of BMI, the cadence-based curl-up test, the push-up test and the back saver sit/reach test (p > 0.05). Physical activity, physical performance, and quality of life results were significantly lower in children with epilepsy (p < 0.05). CONCLUSION: The presence of epilepsy may negatively affect many aspects of physical fitness, physical activity, and quality of life in childhood. The children with epilepsy adopted a more sedentary lifestyle than their healthy peers. Quality of life outcomes reveal that epilepsy has negative physical and psychosocial effects on children. These results support the necessity of raising awareness in both health professionals and families to encourage their children to be more active.

The Effects of Different Exteroceptive Experiences on the Early Motor Repertoire in Infants With Down Syndrome.

OBJECTIVE: Down syndrome is a chromosomal abnormality in which muscle tone, motor development, and sensory systems are affected. The objectives of this study were to examine the changes in movements and postures of 3- to 5-month-old infants with Down syndrome and infants who were neurotypical controls during exposure to a rough-textured surface and to compare the differences occurring before and during an exteroceptive condition that was different between the 2 groups. METHODS: In this quasi-experimental study, participants were 20 infants with Down syndrome (8 female infants; age range = 10-18 weeks, mean [SD] = 12 weeks 2 days [2 weeks 2 days]) and 20 age-matched infants with typical development (8 female infants; age range = 9-17 weeks, mean (SD) = 12 weeks 6 days [1 week 5 days]). The movements and postures of the infants, including fidgety movements, were assessed according to the General Movements Assessment, which determines the Motor Optimality Score (MOS), on 2 surfaces. RESULTS: The MOS outcomes of the infants with Down syndrome (median = 21.5, range = 6-28) were significantly lower than those of the infants who were neurotypical (median = 28, range = 23-28) on a standard mattress. The postures were found to be significantly better in infants with Down syndrome during exposure to a rough-textured surface. The MOS did not change due to the different exteroceptive experiences in infants with Down syndrome and infants who were neurotypical. CONCLUSION: The different exteroceptive experiences caused only postural alterations, which might play a crucial role in early intervention programs for infants with Down syndrome. IMPACT: This is the first study, to our knowledge, on the effects of different exteroceptive conditions, such as a coco coir mattress covered with muslin fabric, on the early motor repertoire in infants with Down syndrome. The findings showed that infants with Down syndrome had heterogeneity in their fidgety movements and large variability of the MOS, and the MOS results from infants with Down syndrome were lower than those of infants who were neurotypical. Fidgety movements and the MOS did not change due to the different exteroceptive experiences in either group. Significant improvements in posture were observed during exposure to a rough-textured surface. The improvement of posture is essential; clinicians might consider the positive effect of putting an infant with Down syndrome on a rough-textured surface and include this strategy in early intervention programs.