Procena spontane motoričke aktivnosti novorođenčeta i odojčeta

Introduction: Conventional methods of neurological assessment of newborns and infants include neurological examination, neurokinesiological examination, quantitative assessment using scales and tests, and the use of supplementary diagnostic neuroimaging procedures. All the above methods are of great importance for the common clinical practice. They enable rapid detection of central (and peripheral) nervous system damage, but also have common defect which is the inability to adequately predict neurological deficits. In this study Prechtl’s method of the qualitative assessments of spontaneous motor activity was used. In former studies this method had demonstrated high level of reliability in very early prediction of neurological abnormalities in new-borns and infants. Aim: To evaluate the quality of the spontaneous motor activity during neonatal period, to evaluate the quality of spontaneous motor activity during infancy, to determine neurological outcome and motor functional status during the period of 24 months of corrected calendar age, to determine predictive value of the spontaneous motor activity for neurological and functional outcome at 24 moths corrected calendar age. Research methods: The study was conducted as prospective clinical study which included children born in the maternity ward in Clinical Center Nis in 2012, ≤ 37 weeks gestational age. Whole research included 80 respondents. The observation of spontaneous motor activity was conducted according to the basic principles of the Prechtl Method. The evaluation of spontaneous activity was conducted by the educated person with valid license for evaluation of spontaneous motor activities. The evaluation was based on video analysis. Spontaneous motor activity was observed in three time periods: within 5 days of birth, period of 44.- 46. gestation weeks, and period of 50. – 54. gestation weeks postmenstrual age. Definitive neurological outcome was evaluated on the basis of a detailed neurological examination at 24 months (corrected calendar age). Neurological outcome is classified as: normal result, minimal neurological dysfunction and cerebral palsy. Results: All respondents with normal patterns of spontaneous movements in the neonatal and infant period had a normal neurological functional outcome at 24 months. Respondents with pathological patterns of spontaneous movements (cramped synchronized movements or absence of “fidgety” movements) in the neonatal and infant period in the final outcome had minimal neurological dysfunction or cerebral palsy. Conclusion: Thanks to the Prechtl Method it is possible to recognize specific neurological symptoms in preterm infants which are excellent indicators of later neurological development. Early detection of symptoms of minimal neurological deficit and cerebral palsy is of crucial importance because it enables timely inclusion of children in neurodevelopmental treatment, which contributes to the improvement of functional motor status at later age, taking into account biological phenomenon “brain plasticity”