Cerebral Palsy: Early Markers Of Clinical Phenotype And Functional Outcome
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Tarih
2019Yazar
Einspieler, Christa
Bos, Arend F.
Krieber-Tomantschger, Magdalena
Alvarado, Elsa
Barbosa, Vanessa M.
Bertoncelli, Natascia
Burger, Marlette
Chorna, Olena
Del Secco, Sabrina
DeRegnier, Raye-Ann
Hüning, Britta
Ko, Jooyeon
Lucaccioni, Laura
Maeda, Tomoki
Marchi, Viviana
Martín, Erika
Morgan, Catherine
Mutlu, Akmer
Nogolová, Alice
Pansy, Jasmin
Peyton, Colleen
Pokorny, Florian B.
Prinsloo, Lucia R.
Ricci, Eileen
Saini, Lokesh
Scheuchenegger, Anna
Silva, Cinthia R. D.
Soloveichick, Marina
Spittle, Alicia J.
Toldo, Moreno
Utsch, Fabiana
van Zyl, Jeanetta
Viñals, Carlos
Wang, Jun
Yang, Hong
Yardımcı-Lokmanoğlu, Bilge N.
Cioni, Giovanni
Ferrari, Fabrizio
Guzzetta, Andrea
Marschik, Peter B.
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The Prechtl General Movement Assessment (GMA) has become a cornerstone assessment in early identification of cerebral palsy (CP), particularly during the fidgety movement period at 3–5 months of age. Additionally, assessment of motor repertoire, such as antigravity movements and postural patterns, which form the Motor Optimality Score (MOS), may provide insight into an infant’s later motor function. This study aimed to identify early specific markers for ambulation, gross motor function (using the Gross Motor Function Classification System, GMFCS), topography (unilateral, bilateral), and type (spastic, dyskinetic, ataxic, and hypotonic) of CP in a large worldwide cohort of 468 infants. We found that 95% of children with CP did not have fidgety movements, with 100% having non-optimal MOS. GMFCS level was strongly correlated to MOS. An MOS > 14 was most likely associated with GMFCS outcomes I or II, whereas GMFCS outcomes IV or V were hardly ever associated with an MOS > 8. A number of different movement patterns were associated with more severe functional impairment (GMFCS III–V), including atypical arching and persistent cramped-synchronized movements. Asymmetrical segmental movements were strongly associated with unilateral CP. Circular arm movements were associated with dyskinetic CP. This study demonstrated that use of the MOS contributes to understanding later CP prognosis, including early markers for type and severity.
Bağlantı
http://dx.doi.org/10.3390/jcm8101616https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6833082/
http://hdl.handle.net/11655/24659