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Cerebral Palsy: Early Markers of Clinical Phenotype and Functional Outcome
C. Einspieler, AF. Bos, M. Krieber-Tomantschger, E. Alvarado, VM. Barbosa, N. Bertoncelli, M. Burger, O. Chorna, S. Del Secco, RA. DeRegnier, B. Hüning, J. Ko, L. Lucaccioni, T. Maeda, V. Marchi, E. Martín, C. Morgan, A. Mutlu, A. Nogolová, J....
Language English Country Switzerland
Document type Journal Article
Grant support
OPP 1128871
Bill and Melinda Gates Foundation
P16430
Oesterreichische Nationalbank
A16-0012
Shaw Research Grant in Nursing and Allied Health Professions
R15-96
Fondazione Pierfranco e Luisa Mariani
15K11705; 18K10748
JSPS KAKENHI
1116442
Australasian Cerebral Palsy Clinical Trials Network
1153176
National Health and Medical Research Council of Australia, Centre of Excellence
1108714
National Health and Medical Research Council of Australia, Career Development Fellowship
2019SY032
Shanghai Municipal Commission of Health and Family Planning
NLK
Free Medical Journals
from 2012
PubMed Central
from 2012
Europe PubMed Central
from 2012
ProQuest Central
from 2019-01-01
Open Access Digital Library
from 2012-01-01
Open Access Digital Library
from 2012-01-01
Health & Medicine (ProQuest)
from 2019-01-01
ROAD: Directory of Open Access Scholarly Resources
from 2012
PubMed
31590221
DOI
10.3390/jcm8101616
Knihovny.cz E-resources
- Publication type
- Journal Article MeSH
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.
Ann and Robert H Lurie Children's Hospital of Chicago Chicago IL 60611 USA
Cerebral Palsy Association Eastern Cape Port Elizabeth 6001 South Africa
Children's Hospital of Fudan University Department of Rehabilitation Shanghai 201102 China
Children's Rehabilitation Institute Teleton 72825 Puebla Mexico
Daegu Health College Department of Physical Therapy 41453 Daegu Korea
IRCCS Fondazione Stella Maris Department of Developmental Neuroscience 56128 Pisa Italy
Kiran Society for Rehabilitation and Education of Children with Disabilities Varanasi 221011 India
Lady Davis Carmel Medical Center NICU Developmental Follow up Clinic 34362 Haifa Israel
National Rehabilitation Institute Cerebral Palsy Department 14389 Mexico City Mexico
Oita University Faculty of Medicine Department of Pediatrics 879 5593 Oita Japan
Rede SARAH de Hospitais de Reabilitação Reabilitação Infantil 30510 000 Belo Horizonte Brazil
Research Unit iDN Division of Phoniatrics Medical University of Graz 8036 Graz Austria
University Hospital Essen Department of Pediatrics 1 45122 Essen Germany
University of New England Maine LEND Program Portland ME 04103 USA
References provided by Crossref.org
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- $a 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.
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- $a Morgan, Catherine $u The University of Sydney Medical School, Children's Hospital at Westmead Clinical School, The Discipline of Child and Adolescent Health, Sydney 2050, NSW, Australia. CMorgan@cerebralpalsy.org.au. The University of Sydney, Cerebral Palsy Alliance Research Institute, Sydney 2050, NSW, Australia. CMorgan@cerebralpalsy.org.au.
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