Clinic for Physical Medicine and Rehabilitation, University Clinical Centre Niš, Serbia.
Children's Hospital, Department of Neonatology, University Clinical Center Niš, Serbia.
Folia Neuropathol. 2022;60(4):427-435. doi: 10.5114/fn.2022.119593.
Conventional methods of neurological assessment of infants can detect nervous system damage, but also have a weakness, i.e., the inability to make predictions for neurological deficits. Prechtl's general movement assessment is a diagnostic tool for the functional assessment of young nervous system. The aim of the study was to assess the quality of spontaneous motor activity in preterm newborns as well as to determine the neurological outcome at the age of 24 months. After that, the predictive value of spontaneous motor activity for neuro-developmental outcome at the age of 24 months was determined.
The study included 160 pre-terms children, and designed as a prospective clinical study. Observation of spontaneous motor activity was performed according to the principles of Prechtl's method.
Spontaneous motor activity was observed in three periods for each newborn: within 5 days of birth, in the period of 44-46 gestation weeks, and in the period of 50-54 gestation weeks of post-menstrual age. Neurological outcome was assessed at the age of 24 months, and was classified as: normal finding, minimal neurological dysfunction, and cerebral palsy. All preterms, who presented normal patterns of spontaneous movements in neonatal and infant periods had a normal neurological functional outcomes at the age of 24 months. Newborns with pathological patterns of movement (cramped synchronized and absence of fidgety movements) in neonate and infant periods in the final outcomes had minimal neurological dysfunction or cerebral palsy.
Assessment of general movement in preterms is a valuable method in prediction of dysfunctions in later neurological development. Early detection of symptoms of minimal neurological deficit and cerebral palsy is of crucial importance since it enables timely inclusion of children into neuro-developmental treatment.
传统的婴儿神经评估方法可以检测神经系统损伤，但也有一个弱点，即无法预测神经功能缺陷。普雷希特儿的一般运动评估是一种用于年轻神经系统功能评估的诊断工具。本研究的目的是评估早产儿自发运动活动的质量，并确定 24 个月时的神经发育结果。之后，确定自发运动活动对 24 个月时神经发育结果的预测价值。
该研究纳入了 160 名早产儿，设计为前瞻性临床研究。根据普雷希特儿方法的原则观察自发运动活动。
每个新生儿都观察到三个时期的自发运动活动：出生后 5 天内、妊娠 44-46 周期间和妊娠 50-54 周期间。24 个月时评估神经发育结果，分为正常发现、最小神经功能障碍和脑瘫。新生儿期和婴儿期自发运动模式正常的所有早产儿，24 个月时神经功能正常。新生儿期和婴儿期运动模式异常（紧张同步和缺乏烦躁运动）的新生儿最终结果为最小神经功能障碍或脑瘫。
评估早产儿的一般运动是预测后期神经发育障碍的一种有价值的方法。早期发现最小神经功能缺损和脑瘫的症状非常重要，因为它能使儿童及时纳入神经发育治疗。
