Are sporadic fidgety movements as clinically relevant as is their absence?
BACKGROUND
Infants with normal fidgety movements at 3 to 5 months after term are very likely to show neurologically normal development, while the absence of fidgety movements is an early marker for an adverse neurological outcome, mainly cerebral palsy (CP). The clinical significance of so-called sporadic fidgety movements (i.e., fidgety movements occur isolated in a few body parts and are of 1- to 3-second-duration) is not yet known.


OBJECTIVE
Our objective was to determine whether infants who had developed CP and had sporadic fidgety movements have a better outcome than infants who did not have fidgety movements.


METHODS
Longitudinal study. Retrospective analysis of prospectively collected data.


METHODS
61 infants who developed CP (46 male, 15 female; 29 infants born preterm; videoed for the assessment of movements and postures at 9 to 16 weeks post-term age).


METHODS
The Gross Motor Function Classification System (GMFCS) was applied at 3 to 5 years of age.


RESULTS
There was no difference between children diagnosed with CP who had sporadic fidgety movements at 9 to 16 weeks post-term age (n = 9) and those who never developed fidgety movements (n = 50) with regard to their functional mobility and activity limitation at 3 to 5 years of age. One infant had normal FMs and developed unilateral CP, GMFCS Level I; the remaining infant had abnormal FMs and developed bilateral CP, GMFCS Level II.


CONCLUSIONS
There is no evidence that the occurrence of occasional isolated fidgety bursts indicates a milder type of CP.
Research Unit iDN, Interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Austria. Electronic address: christa.einspieler@medunigraz.at.
Christa
C
Einspieler
Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, PR China.
Hong
H
Yang
Research Unit iDN, Interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Austria.
Katrin D
KD
Bartl-Pokorny
Department of Pediatrics, Nanjing Maternity and Child Health Hospital, Nanjing Medical University, PR China.
Xia
X
Chi
Department of Rehabilitation, Children's Hospital of Fudan University, Shanghai, PR China.
Fei-Fei
FF
Zang
Research Unit iDN, Interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Austria; Center of Neurodevelopmental Disorders, Karolinska Institutet, Stockholm, Sweden.
Peter B
PB
Marschik
Department of Developmental Neuroscience, University of Pisa, Italy; IRCCS Fondazione Stella Maris, Pisa, Italy.
Andrea
A
Guzzetta
Dept. of Neonatology, University of Modena and Reggio Emilia, Modena, Italy.
Fabrizio
F
Ferrari
Division of Neonatology, Beatrix Children's Hospital, University Medical Center, University of Groningen, The Netherlands.
Arend F
AF
Bos
Department of Developmental Neuroscience, University of Pisa, Italy; IRCCS Fondazione Stella Maris, Pisa, Italy.
Giovanni
G
Cioni
D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009068:Movement
Cerebral palsy; Early marker; Fidgety movements; General movements; Infant; Prediction; Video analysis