מרינה סולובייצ'יק, מירי הראל, אתי גרשון, רחל נדלר
The possibility of correction of pathological GMs pattern by influencing the sensory input as an appropriate and effective way of early intervention.
Early recognition of neurodevelopmental problems and early adjustment of appropriate intervention are the corner stones in the improvement of neurodevelopmental outcome. Among all the routine methods for early recognition of neurodevelopmental problems, Prechtl’s Method of General Movements Assessment is a highly predictive, easily applicable, and non-invasive early diagnostic tool.
Our locomotor development can be partly described as a chain of alternating CPGs. The fact that most of the babies with CS do not express normal fidgety movements might underline the importance of correctly modulated previous CPG, which is responsible for preterm GMs.
Four extremely preterm babies born in our department were diagnosed as expressing severe CS pattern of GMs were treated by emulating normal GMs pattern. The treatment was started as soon as the CS pattern was observed and was continued after discharge in combination with intensive traditional developmental physiotherapy.
At the age of about 14 weeks all the babies expressed Fidgety movements. In all four cases the Fidgety movements were not expressed so well, and one of the babies had asymmetric posture and age-reduced repertoire of movements. Two of the babies reached the age of 18 months and successfully passed the Bayley 2 test. The other two reached13 months old sitting, crawling, standing with support, walking around furniture, expressing mature transition from posture to posture. Their motor performance already looks normal and age- adequate .
Early recognition of pathological GMs pattern and appropriate intervention at an early stage aimed at bringing it close to the normal GMs pattern might significantly impact the presumptive adverse outcome, which in our cases was cerebral palsy.