Abstract
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.
| Original language | English (US) |
|---|---|
| Journal | Journal of Clinical Medicine |
| Volume | 8 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 4 2019 |
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Cerebral Palsy : Early Markers of Clinical Phenotype and Functional Outcome. / 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.
In: Journal of Clinical Medicine, Vol. 8, No. 10, 04.10.2019.Research output: Contribution to journal › Article
TY - JOUR
T1 - Cerebral Palsy
T2 - Early Markers of Clinical Phenotype and Functional Outcome
AU - Einspieler, Christa
AU - Bos, Arend F
AU - Krieber-Tomantschger, Magdalena
AU - Alvarado, Elsa
AU - Barbosa, Vanessa M
AU - Bertoncelli, Natascia
AU - Burger, Marlette
AU - Chorna, Olena
AU - Del Secco, Sabrina
AU - DeRegnier, Raye-Ann
AU - Hüning, Britta
AU - Ko, Jooyeon
AU - Lucaccioni, Laura
AU - Maeda, Tomoki
AU - Marchi, Viviana
AU - Martín, Erika
AU - Morgan, Catherine
AU - Mutlu, Akmer
AU - Nogolová, Alice
AU - Pansy, Jasmin
AU - Peyton, Colleen
AU - Pokorny, Florian B
AU - Prinsloo, Lucia R
AU - Ricci, Eileen
AU - Saini, Lokesh
AU - Scheuchenegger, Anna
AU - Silva, Cinthia R D
AU - Soloveichick, Marina
AU - Spittle, Alicia J
AU - Toldo, Moreno
AU - Utsch, Fabiana
AU - van Zyl, Jeanetta
AU - Viñals, Carlos
AU - Wang, Jun
AU - Yang, Hong
AU - Yardımcı-Lokmanoğlu, Bilge N
AU - Cioni, Giovanni
AU - Ferrari, Fabrizio
AU - Guzzetta, Andrea
AU - Marschik, Peter B
PY - 2019/10/4
Y1 - 2019/10/4
N2 - 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.
AB - 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.
U2 - 10.3390/jcm8101616
DO - 10.3390/jcm8101616
M3 - Article
C2 - 31590221
VL - 8
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
SN - 2077-0383
IS - 10
ER -