Prechtl’s Method / General Movements Assessment)
What is the General Movements Assessment?
The General Movements Assessment is a non-invasive and cost-effective way to identify neurological issues which may lead to cerebral palsy and other developmental disabilities. The assessment can be completed from birth to 20 weeks of age (corrected for pre-maturity.
Infants have typical and distinct spontaneous “general movements” from before birth right through to 20 weeks post term. Infants whose general movements are absent or abnormal are at higher risk of neurological conditions, in particular cerebral palsy. The General Movements Assessment is used to identify absent or abnormal general movements and, depending on the type of general movements’ abnormality, can be highly predictive of cerebral palsy by about 3 months of post term age. Intervention can start very early, with potentially better outcomes, if an infant is diagnosed as at risk of cerebral palsy using the General Movements Assessment.
How is the assessment done?
General movements are assessed with the awake infant lying on their back while they are calm and alert. The infant should not have any toys or pacifiers and parents could be watching nearby but not interacting with their baby. The baby is videoed for 3-5 minutes and the assessment is scored from the video. In Australia, a growing number of allied health and medical personnel have been trained to observe and score General Movements Assessments.
Should my child have the General Movements Assessment?
A General Movements Assessment may give information on how your baby’s neurological system is developing if he/she is under 20 weeks post term age and there were medical concerns at birth (such as prematurity, lack of oxygen, stroke, or congenital heart disease).
Please speak to your medical practitioner or therapist if you have any concerns about your baby.
Who can do the assessment?
ICD is equipped to perform the General Movements Assessment. ICD is one of the leading institutes in India whose primary consultant has been trained in the field.
For information about the location of other qualified assessors in India, please email ICD at helpicd@gmail.com
Some facts about Prechtl’e Method of General Movement Assessments
Cerebral palsy & general movements
▪ Among the most reliable markers for cerebral palsy (CP) are abnormal spontaneous ‘general movements’ (GMs).
▪ GMs involve the entire body and manifest themselves in variable sequences of arm, leg, neck and trunk movements; they come and go gradually, varying in intensity and speed.
▪ GMs occur in age-specific patterns; during the post-term age of 3–5 months, they are described as ‘fidgety movements’ – that is, small movements of the neck, trunk and limbs in all directions and of variable acceleration.
The absence of fidgety movements precedes CP
▪ An absence of fidgety movements is followed by neurological abnormalities, most likely CP.
Cramped-synchronized GMs at preterm & term age: an early predictor of spastic CP
▪ Cramped-synchronized GMs appear rigid as they lack the usual smoothness and fluent character; all limb and trunk muscles contract almost simultaneously and relax almost simultaneously.
▪ Observing cramped-synchronized GMs over several weeks during preterm and term age is highly predictive (98%) for the eventual development of spastic CP.
Can we identify a high risk for unilateral CP by means of observation?
▪ Children with unilateral spastic CP show abnormal GMs during their first weeks of life; moreover, they lack fidgety movements at 3–5 months post-term age.
▪ At about the age of 2–4 months, the first asymmetries can be observed: contralateral to the side of the lesion and regardless of the position of the head, the so-called ‘segmental movements’ (i.e., isolated finger and toe movements) are reduced or even absent.
▪ At this age, neurological examination may still yield normal results.
Are there early markers for dyskinetic CP?
▪ Until the second month post-term, infants who later become dyskinetic display a so-called ‘poor repertoire of GMs’, that is, a monotonous sequence of movement components.
▪ Apart from the poor GM repertoire, the infant moves his/her arms circularly and spreads the fingers; these signs are present at least until the age of 5 months post-term.
▪ Fidgety movements are absent.
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