G. Abraham1, R. Asgarpour1
1Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates
Background: Clinical measures after birth and studies such as electroencephalogram (EEG) and brain imaging do not fully predict neurodevelopmental outcomes of infants with hypoxic-ischemic encephalopathy (HIE). HIE accompanied by neonatal asphyxia remains a major cause of brain injury in term infants. Early detection in high-risk infants is essential for ensuring early intervention and rehabilitation in this population. The Prechtls General Movement Assessment (GMA) has shown its merits for the evaluation of the integrity of the young nervous system. It is a reliable tool for identifying infants at risk for neuromotor deficits.
Purpose: This study aimed to describe early spontaneous movements (GMA) and examine the significance of early intervention in an infant of a gestational age (GA) 25 weeks with the HIE. The use of the validated screening tools at regular and repeated intervals incorporated into the workflow of the primary care practice improves early detection.
Methods: Analysis of the detailed general GMA of an infant with HIE, 2 weeks after birth, post term period, and 14 weeks were done, and the Bayley Scales of Infant and Toddler Development-third edition (Bayley-III) were used for the determining and the follow-up of developmental functioning at 10 months corrected age. Early intervention including sensorimotor , as provided for the infant from post term 2 weeks at NICU The evaluation of infants’ qualitative spontaneous movements conducted following the Prechtl’s GMs approach. Each video-recording lasts about 3 min to define longitudinal neonatal GMs trajectories at three different timepoints.
Consent was obtained from the parent prior to study. Scoring of the videos were performed by a certified assessor from the GMs Trust.
Consent was obtained from the parent prior to study. Scoring of the videos were performed by a certified assessor from the GMs Trust.
Results: The motor repertoire appeared significantly reduced. The movement character was monotonous and cramped synchronized pattern till 14 weeks. Fidgety movements were absent at 16 weeks.
The infant achieved developmental milestones with the early intervention program. In Bayley scale ,when the infant's corrected age was 11 months, the raw score equivalent for developmental age for cognitive subtest is 7 months, for receptive communication is 4 months 10 days, expressive communication is 7 months, fine motor is 10 months and gross motor is 9 months, whereas the descriptive classification of the composite score equivalent for motor and socioemotional is low average, cognition is borderline and for language is extremely low. Scaled score profile in the average range of 8-12 is FM and GM
The infant achieved developmental milestones with the early intervention program. In Bayley scale ,when the infant's corrected age was 11 months, the raw score equivalent for developmental age for cognitive subtest is 7 months, for receptive communication is 4 months 10 days, expressive communication is 7 months, fine motor is 10 months and gross motor is 9 months, whereas the descriptive classification of the composite score equivalent for motor and socioemotional is low average, cognition is borderline and for language is extremely low. Scaled score profile in the average range of 8-12 is FM and GM
Conclusions: Abnormal qualitative analysis GMA results, including fidgety movements and concurrent movement patterns seen in HIE can be associated with early signs of neurodevelopmental dysfunction. It demonstrated positive outcome of early intervention in domain areas of motor and socio-emotional and communication, cognitive development of the infant with HIE.
Implications: The study emphasizes the need for the implementation of general movement assessment with neonatal assessments- NBO, HNNE, TIMP in NICU settings and for the early intervention targeting various domain areas to facilitate the early achievement of milestones.
The result of this study helps the neonatal specialized physiotherapists to identify the infants for developmental surveillance and early intervention during the process of evaluation / diagnosis / treatment.
The result of this study helps the neonatal specialized physiotherapists to identify the infants for developmental surveillance and early intervention during the process of evaluation / diagnosis / treatment.
Funding acknowledgements: NIL
Keywords:
HIE
GMA
Bayley scale
HIE
GMA
Bayley scale
Topics:
Paediatrics: cerebral palsy
Paediatrics: cerebral palsy
Did this work require ethics approval? No
Reason:
consent of the patient and approval of the supervisor of site is required.
consent of the patient and approval of the supervisor of site is required.
All authors, affiliations and abstracts have been published as submitted.
