Characteristics of general movements in preterm infants assessed by computer-based video analysis.

BACKGROUND: Previous evidence suggests that the variability of the spatial center of infant movements, calculated by computer-based video analysis software, can identify fidgety general movements (GMs) and predict cerebral palsy. AIM: To evaluate whether computer-based video analysis quantifies specific characteristics of normal fidgety movements as opposed to writhing general movements. METHODS: A longitudinal study design was applied. Twenty-seven low-to moderate-risk preterm infants (20 boys, 7 girls; mean gestational age 32 [SD 2.7, range 27-36] weeks, mean birth weight 1790 grams [SD 430g, range 1185-2700g]) were videotaped at the ages of 3-5 weeks (period of writhing GMs) and 10-15 weeks (period of fidgety GMs) post term. GMs were classified according to Prechtl's general movement assessment method (GMA) and by computer-based video analysis. The variability of the centroid of motion (CSD), derived from differences between subsequent video frames, was calculated by means of computer-based video analysis software; group mean differences between GM periods were reported. RESULTS: The mean variability of the centroid of motion (CSD) determined by computer-based video analysis was 7.5% lower during the period of fidgety GMs than during the period of writhing GMs (p = 0.004). CONCLUSION: Our findings support that the variability of the centroid of motion reflects small and variable movements evenly distributed across the body, and hence shows that computer-based video analysis qualifies for assessment of direction and amplitude of FMs in young infants.

Very low birth weight infants in China: the predictive value of the motor repertoire at 3 to 5months for the motor performance at 12months.

BACKGROUND: Studies on motor performance and its early markers are rare in China, especially in very low birth weight (VLBW) infants. OBJECTIVE: Apart from the assessment of the inter-scorer agreement, we aimed to analyze to what extent the motor repertoire at 10 to 18weeks postterm was related to neonatal complications, and gross and fine motor performance at 12months after term. STUDY DESIGN: Exploratory prospective study. SUBJECTS: Seventy-four VLBW infants (58 males; mean gestational age=29weeks; mean birth weight=1252g). METHOD: Five-minute video recordings were performed at 10 to 18weeks after term; fidgety movements and the concurrent motor patterns (resulting in a motor optimality score) were assessed according to the Prechtl general movements assessment (GMA). The gross and fine motor performance was assessed by means of the Peabody Developmental Motor Scales, second edition, at 12months. RESULTS: Reliability was excellent. Pneumonia was associated with absent fidgety movements; the motor optimality score was lower in infants with pneumonia and/or bronchopulmonary dysplasia. Both absent fidgety movements and a lower motor optimality score were associated with a poor or very poor gross and fine motor performance at the 12-month-assessment. CONCLUSION: Both the assessment of fidgety movements and the evaluation of the concurrent motor repertoire contribute significantly to an identification of VLBW children with a poor gross and fine motor outcome at 12months. The results of this study document the need for an early identification of infants at high risk for a poor motor performance.