Kicking in infants with perinatal stroke: can we predict ability and disability?
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Date
2016-08
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The Ohio State University
Abstract
Stroke in very young infants is the most common cause of cerebral palsy, a chronic disorder of motor function impairments with lifetime physical, social, and emotional consequences. While stroke is typically diagnosed within the first week of life, cerebral palsy is diagnosed much later, at 18-24 months of age. Spontaneous kicking is one of the few early movements that has been shown to be indicative of motor ability in young infants with motor disorders. This is a longitudinal trial of children 2.5-7.5 months describing spontaneous kick quantity and quality in infants with and without stroke and those who go on to have CP. Infants were tested in 2 conditions: with and without toys. N=29 infants completed this study (n=11 with perinatal stroke (PS); n=18 typically developing (TD)). Medical chart review at 3 years of age determined cerebral palsy status of infants with stroke. Infants were videotaped kicking freely for eight, thirty-second trials, six with toys, two without. Videos were then analyzed by two trained blinded raters with overall agreement of 0.96. Infants with cerebral palsy showed a statistical interaction with infants without cerebral palsy for total kicks (p=0.019) and two of three kick subtypes (p=0.041; p=0.029). The no toy condition yielded more kicks than the toy condition for total kicks (p=0.025) and two of three kick subtypes (p=0.050; p=0.065). Our findings support the possibility that spontaneous kicking may be used to identify infants with motor deficits at much younger ages than is currently possible. The use of toys in lower extremity analyses is cautioned.
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Keywords
spontaneous, perinatal stroke, early diagnosis