Riassunto analitico
BACKGROUND The development of human brain is a long-lasting process, starting during the first weeks of prenatal life and going on during childhood until adult age, through a continuous remodeling. This complex process of neurological maturation leads to a clinical need of an age-specific neurological assessment with the application of neuro-motor evaluation techniques adapted to the age-specific characteristics of the nervous system.
In the early 1990s, Prechtl and his co-workers developed the qualitative assessment of general movements (GMs), spontaneous motor behaviour in early life, which seems to be able of reflecting the condition of the nervous system of the foetus and young infant.
In 3 to 6 month-old infants, other movements may occur together with FMs; they are called concurrent motor repertoire.
Concurrent motor repertoire can be considered as a key of transition between the age of GMs and the appearance of voluntary motility. Considering the concurrent motor repertoire in the fidgety period, movements towards midline (MTM) are critical items to evaluate.
MTM include each antigravity movement in which the four limbs reach and exceed the midline in the infant in a supine position.
AIM OF THE STUDY To describe the ontogeny of movements towards midline in healthy fullterm newborn infants during the age of GMs, the qualitative aspect of MTM and the correlation between MTM and GMs.
MATERIALS AND METHODS The study is a prospective, observational, longitudinal study on developmental changes of MTM through the collection of videos, recorded every 2 weeks, from term age up to 59-64 weeks post-menstrual age (PMA), for a total of 12 videos per subject. Patients enrolled at the NICU of the University of Modena from 9th of September 2016 to 30th of November 2016. 31 patients have been enrolled and 25 have completed the follow-up
RESULTS MTM are detectable since birth and live three different moments: between birth and 44 weeks PMA they are occasional, linked to the in-utero posture and to the writhing GMs. From 44 to 48 weeks they decrease in frequency, associated to a typical postural pattern, and finally they increase again after 48 weeks PMA, first in lower limbs then in upper limbs, changing qualitatively and quantitatively. Each MTM has his own progression and maturation, related to his complexity.
CONCLUSION MTM represent a transition from spontaneous motility age, to the age of voluntary motility, complementary to GMs movements.
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