Fidgety movements – tiny in appearance, but huge in impact
Fidgety movements – tiny in appearance, but huge in impact
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DOI：
10.1016/j.jped.2015.12.003
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发表时间：
2016-06-01
影响因子：
3.3
通讯作者：
Marschik, Peter B.
中科院分区：
文献类型：
--
作者：
Einspieler, Christa;Peharz, Robert;Marschik, Peter B.
目的：描述烦躁运动（FMs），即通常发生在足月后3-5个月的自发运动模式，并讨论其临床相关性。来源：使用以下数据库进行全面的文献检索：MEDLINE/PubMed， CINAHL， Cochrane图书馆，Science Direct， PsycINFO和EMBASE。搜索策略包括MeSH术语和搜索字符串（“烦躁运动*”）或[（“一般运动*”）和（“三个月*”）或（“3个月*”）]，以及在一般运动信托网站（www.general-movements-trust.info）上发表的研究。数据总结：如果FMs存在且正常，几乎所有婴儿都发育正常，即使他们的脑超声检查结果和/或临床病史表明以后有神经功能缺陷的倾向。相反，几乎所有从未发生FMs的婴儿都有患脑瘫等神经系统缺陷和晚发性遗传疾病的高风险。如果FMs是正常的，但同时的姿势模式不适合年龄，或者整体运动特征单调，那么学龄期的认知和/或语言技能将是次优的。异常的FMs不具有特异性，预测能力较低，但在后来被诊断为自闭症的婴儿中非常常见。结论：异常、缺失或零星的FMs表明后期神经功能障碍的风险增加，而正常的FMs高度预测正常发育，特别是当它们与其他平滑流畅的运动同时发生时。早期识别神经症状有助于早期干预。重要的是要再次向具有临床危险因素的婴儿的父母保证，如果FMs发育正常，神经学结果将是足够的。(C) 2016年巴西儿科学会。由爱思唯尔编辑有限公司出版。版权所有。
Objectives: To describe fidgety movements (FMs), i.e., the spontaneous movement pattern that typically occurs at 3-5 months after term age, and discuss its clinical relevance.Sources: A comprehensive literature search was performed using the following databases: MEDLINE/PubMed, CINAHL, The Cochrane Library, Science Direct, PsycINFO, and EMBASE. The search strategy included the MeSH terms and search strings ('fidgety movement*') OR [('general movement*') AND ('three month*') OR ('3 month*')], as well as studies published on the General Movements Trust website (www.general-movements-trust.info).Summary of the data: Virtually all infants develop normally if FMs are present and normal, even if their brain ultrasound findings and/or clinical histories indicate a disposition to later neurological deficits. Conversely, almost all infants who never develop FMs have a high risk for neurological deficits such as cerebral palsy, and for genetic disorders with a late onset. If FMs are normal but concurrent postural patterns are not age-adequate or the overall movement character is monotonous, cognitive and/or language skills at school age will be suboptimal. Abnormal FMs are unspecific and have a low predictive power, but occur exceedingly in infants later diagnosed with autism.Conclusions: Abnormal, absent, or sporadic FMs indicate an increased risk for later neurological dysfunction, whereas normal FMs are highly predictive of normal development, especially if they co-occur with other smooth and fluent movements. Early recognition of neurological signs facilitates early intervention. It is important to re-assure parents of infants with clinical risk factors that the neurological outcome will be adequate if FMs develop normally. (C) 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.