The Clinical Study Of Absence Of Fidgety Movement To Predict Cerebral Palsy At Early Age

Objective：Explore the validity of absence of fidgety movements to predictcerebral palsy at early age, and the possibility of fidgety movements withabnormal concurrent motor repertoire to predict motor developmentaldelay.Methods：The study group consisted of high-risk infants who visited to thedepartment of Pediatric Neurology and Rehabilitation, First BethuneHospital of Jilin University between June2012and March2013, thequality of the subjects’ fidgety movements was assessed, and the qualityassessment was repeated one month later to determine test-retestreliability. The later evaluation was adopted, and the motor outcome wasevaluated at12months of age, then the sensitivity, specificity, positivepredictive value and negative predictive value of absence of fidgetymovements to predict cerebral palsy was calculated. Meanwhile, theinfants with presence of fidgety movements were classified into twogroups according to whether companied abnormal motor repertoire, andthe independent walking age was compared to explore the significance offidgety movements accompanied by abnormal motor repertoire to predictmotor developmental delay.Results：51(32boys and19girls) high-risk infants were included as study participants. The average gestational age was（37.0±3.3）weeks, and theaverage birth weight was(3060.9±780.2)gram. Fidgety movements ofsubjects were recorded at9～20weeks corrected age, and the average agewas(13.5±2.8)weeks. The quality assessment of fidgety movements wasfound a moderate test-retest reliability(κ=0.60， P＜0.01).35infants(68.6%)with presence of normal fidgety movements,15infants(29.4%)without presence of fidgety movements and1infant(2.0%)with presence of abnormal fidgety movements among the51subjects, after follow-up(17～23months)14(93.3%)infants withoutpresence of fidgety movements developed cerebral palsy, the predictivevalidity of absence of fidgety movements to predict cerebral palsy asfollows: sensitivity93,7%,specificity97.1%,positive predictive value93.8%,and negative predictive97.1%.35infants with presence of fidgetymovements were classified into two groups,16infants didn’t companiedabnormal motor repertoire with an average age(12.2±0.9months)ofgetting independent walking ability,19infants companied abnormal motorrepertoire with an average age(13.8±1.4months).The difference wasstatistically significant(t=4.153,P＜0.01).Conclusion：Absence of fidgety movements has high validity to predict cerebralpalsy in infants with high risk factors and fidgety movementsaccompanied with abnormal concurrent motor repertoire maybe play arole to predict motor retardation.