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213 ASSESSMENT OF EARLY MOTOR BEHAVIOUR IN PRETERM INFANTS BY EVALUATION OF SPONTANEOUS MOVEMENTS

Videorecordings of spontaneous movements were conducted in 30 preterm infants (24 to 34 weeks of gestation) every two weeks until four months of corrected age at the Perinatal Center of Heidelberg. Qualitative judgement of motor behaviour was done by using visual Gestalt-perception of the “complexity”, “fluency” and “elegance” of spontaneous movements according to Prechtl and Hadders-Algra (Early Hum Dev 1990 & 1992). All children were reexamined by classical neurological exam at 18 months.At term age 12 infants snowed normal and 18 abnormal movements. At 6-12 weeks movement quality changed from a “writhing character” to “transitional patterns” (oscillating, saccadic, fidgety). At four months of age we observed these “transitional movements” (before reaching and grasping developed) in 25 infants, all had a normal neurological examination at 18 months. The other 5 infants did not show “transitional movements”. 4 of these 5 infants developed definite signs of cerebral palsy at 18 months.We conclude that “transitional movements” are a positive developmental sign since all 25 infants with these movements had a normal neurological examination at 18 months (12 had been normal, 13 abnormal at term age). Qualitative evaluation of spontaneous movements in preterm infants by visual Gestalt-perception is proposed as a reliable and valid tool for the neurological assessment in early infancy.