Kinematic and qualitative analysis of lower-extremity movements in preterminfants with brain lesions

Background and Purpose. The purposes of this study were to evaluate the eff ects of preterm birth, severe brain lesions, and postterm age on kicking mo vements of young infants and to compare the prognostic value of kinematic a nalysis of kicking with a qualitative assessment of infants' spontaneous mo vements. Subjects. The subjects were 12 full-term infants without brain inj ury, 12 low-risk preterm infants without brain injury, and 11 preterm infan ts with severe brain lesions (periventricular leukomalacia). Methods. Video tape recordings of each infant's motor behavior in a supine position were m ade at 1 and 3 months postterm age. Kicking frequency, temporal organizatio n of the kick cycle, coordination among different joints, and interlimb coo rdination were measured. A qualitative assessment for lower-extremity movem ents and a Gestalt judgment of general movement quality according to Precht l's method were made from the same videotape recordings. Results. Kinematic analysis showed only mild differences among the 3 groups of infants. Quali tative assessment of the lower-extremity movements, however, showed that pr eterm infants with brain lesions, and particularly those who later were fou nd to have cerebral palsy, consistently had fewer segmental movements of th e foot and abnormal general movements at bell? ages. Conclusion and Discuss ion. The data suggest that the mechanisms responsible for kicking movements in newborns and young infants do not appear to be influenced by the extrau terine environment or by brain lesions; at least at the ages studied. Quali tative assessment of lower-extremity and general movements seems to be more appropriate for clinical purposes.