Does a detailed assessment of poor repertoire general movements help to identify those infants who will develop normally?

Background: The assessment of the quality of general movements (GMs) in young infants is a reliable and valid diagnostic tool for detecting brain dysfunction early in Life. Poor repertoire GMs are the most frequently observed abnormal GMs during the preterm, term and early postterm period. However, their predictive value for the neurological outcome is low. Aim: To find out whether a detailed scoring of poor repertoire GMs might lead to a better prediction of the neurological outcome. Subjects: We studied 18 preterm infants who were repeatedly videoed from birth to 22 weeks postterm age, including several recordings assessed as poor repertoire GMs. At 8 to 10 years, six children were neurologically normal, six had mild neurological abnormalities, and the remaining six were classified as cerebral palsy. Study design: Each GM globally assessed as poor repertoire was scored in details according to several aspects of neck and trunk, arm and Leg movements applying Prechtl's optimality concept. Results: By and large, the detailed score of poor repertoire GMs was not related to the neurological outcome. Conclusion: For the clinical application of the GM assessment, it remains important to assess the fidgety movements of those infants with poor repertoire GM trajectories in order to predict their outcome. (C) 2005 Elsevier Ireland Ltd. All rights reserved