Movements of babies: what do they tell us about the brain?

AF Bos, Divison of Neonatology, Beatrix Children’s Hosptial, University Medical Center Groningen, The Netherlands

General movements (GMs) are part of the spontaneous movement repertoire of young infants. They are present from early fetal life onwards until the end of the first half year after birth. GMs are complex, occur frequently, and last long enough to be observed properly. They involve th whole body in a variable sequence of arm, leg, neck and trunk movements. They have a gradual beginning and end, and wax and wane in intensity, amplitude, force and speed. Rotations along the axis of the limbs and slight changes in the direction of movements make them fluent, and create the impression of complexity and variability. If the nervous system is impaired, GMs loose their complex and variable character and become monotonous and poor. Two specific abnormal GM patterns reliably predict later cerebral palsy:

1) a persistent pattern of cramped-synchronized GMs. The movements appear rigid and lack the normal smooth character. Limb and trunk muscles contract and relax nearly simultaneously.
2) the absence of GMs of a fidgety character at 9 to 16 weeks post term. So-called fidgety movements are small movements of moderate speed with variable acceleration of neck, trunk, and limbs in all directions. Normally, they are the predominant movement pattern in the infant at 3 to 5 months.

The assessment of GMs is quick, non-invasive, non-intrusive, with a high sensitivity and specificity for the prediction of cerebral palsy and milder neurological deficits.

In the workshop video-recordings of movements of young infants will be assessed interactively. In between some theoretical background of the assessment method will be presented. It provides some tools to watch babies with different eyes, both from a clinical, and from a research perspective.