Bekkedam, L. (Lindsey) (2014) De voetzool- en voetgrijpreactie bij zuigelingen met een hoog risico op cerebrale parese. thesis, Medicine.
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Abstract
Background: Cerebral palsy (CP), the most common cause of motor disorders in pediatric rehabilitation, is a heterogeneous group of disorders of posture and movement, caused by non-progressive damage of the central nervous system. Because the diagnosis requires an age of at least 18 months, it is difficult to predict during infancy whether a high risk infant will develop CP or not. Diagnosing CP at younger age would enable intervention at early age. Early intervention might be effective, because of the plasticity of the infant brain. In LEARN2MOVE 0-2 years (L2M 0-2), a study on the effect of early intervention in infants at very high risk for CP, some abnormalities were observed in the footsole reaction (FSR) and plantar grasp reaction (PGR). These findings led to the current study in which both reactions were assessed. Knowledge of these reactions might contribute to the early detection of children at high risk for CP. Aim: To study a) the development of the FSR and PGR in infants at high risk for developing CP (L2M), compared to that in typically developing infants (TD), and b) the relation between these reactions and the development of CP, motor and cognitive development and type of brain lesion. Methods: Thirty infants at very high risk for CP were included at 1 to 9 months corrected age (CA). A neurological assessment of each infant was video recorded five times, from the age of inclusion until the age of 21 months CA. Videos of the FSR and PGR were analyzed using a standard protocol. Similar data were available of thirty TD infants. Data of brain MRI of L2M infants and neurological outcome at 21 months (CP yes or no) were available. For statistical comparison, non-parametric tests were used (SPSS Statistics 20). Results: During none of the assessments L2M infants showed more often stereotyped FSR reactions than TD infants. However, a developmental trajectory in the sequence of stereotyped – typical – stereotyped reactions was characteristic for the L2M group; this developmental sequence was also related to the development of CP. Stereotyped reactions were not associated with cystic periventricular leukomalacia (cPVL). Clear responses to the PGR were longer present in L2M infants than in TD infants. However, at the age of 21 months clear reactions in high risk infants were related to the absence of CP. Absent PGR responses in high risk infants between 5 and 9 months of age were associated with the development of CP. PGR reactions were not related to cPVL. Conclusion: The repeated presence of stereotyped dorsiflexion FSR reactions in high risk children was associated with the development of CP. Also absent PGR reactions in one or two feet at young age were associated with the development of CP. The data suggest that FSR and PGR may be used as an aid in the early diagnosis of CP in high risk infants.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Hadders-Algra, Prof. Dr. Mijna and Afdeling Ontwikkelingsneurologie and UMC Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:43 |
| Last Modified: | 25 Jun 2020 10:43 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/433 |
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