Introduction: Conventional methods of neurological assessment of newborns
and infants include neurological examination, neurokinesiological
examination, quantitative assessment using scales and tests, and the use
of supplementary diagnostic neuroimaging procedures. All the above
methods are of great importance for the common clinical practice. They
enable rapid detection of central (and peripheral) nervous system
damage, but also have common defect which is the inability to
adequately predict neurological deficits. In this study Prechtl’s method
of the qualitative assessments of spontaneous motor activity was used.
In former studies this method had demonstrated high level of reliability
in very early prediction of neurological abnormalities in new-borns and
infants. Aim: To evaluate the quality of the spontaneous motor activity
during neonatal period, to evaluate the quality of spontaneous motor
activity during infancy, to determine neurological outcome and motor
function...al status during the period of 24 months of corrected calendar
age, to determine predictive value of the spontaneous motor activity for
neurological and functional outcome at 24 moths corrected calendar
age. Research methods: The study was conducted as prospective clinical
study which included children born in the maternity ward in Clinical
Center Nis in 2012, ≤ 37 weeks gestational age. Whole research
included 80 respondents. The observation of spontaneous motor activity
was conducted according to the basic principles of the Prechtl Method.
The evaluation of spontaneous activity was conducted by the educated
person with valid license for evaluation of spontaneous motor activities.
The evaluation was based on video analysis. Spontaneous motor activity
was observed in three time periods: within 5 days of birth, period of 44.-
46. gestation weeks, and period of 50. – 54. gestation weeks
postmenstrual age. Definitive neurological outcome was evaluated on
the basis of a detailed neurological examination at 24 months (corrected
calendar age). Neurological outcome is classified as: normal result,
minimal neurological dysfunction and cerebral palsy. Results: All
respondents with normal patterns of spontaneous movements in the
neonatal and infant period had a normal neurological functional
outcome at 24 months. Respondents with pathological patterns of
spontaneous movements (cramped synchronized movements or absence
of “fidgety” movements) in the neonatal and infant period in the final
outcome had minimal neurological dysfunction or cerebral palsy.
Conclusion: Thanks to the Prechtl Method it is possible to recognize
specific neurological symptoms in preterm infants which are excellent
indicators of later neurological development. Early detection of
symptoms of minimal neurological deficit and cerebral palsy is of
crucial importance because it enables timely inclusion of children in
neurodevelopmental treatment, which contributes to the improvement of
functional motor status at later age, taking into account biological
phenomenon “brain plasticity”.
