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Developmental changes in muscle coordination patterns of normal and abnormal general movements (GMs) are described. GMs were studied simultaneously with video-recording and polymyography (polyEMG). GMs of normal full-term infants gradually lose their neonatally slow and ‘writhing' character, to be turned into the elegant flow of small movements of ‘fidgety' GMs at the age of 2–3 months. This transformation coincides with changes in the polyEMG. Tonic background activity decreases concurrent with a reduction in amplitude and duration of phasic bursts. The coordination between antagonistic muscles does not change, co-activation remains the prevailing pattern. Secondly, preliminary results on healthy preterms ( n = 6) are presented. At the examination age of 33–34 weeks postmenstrual age the preterms showed so-called ‘preterm' GMs, which are characterized by variation and graceful complexity. EMG burst duration was significantly longer during ‘preterm' GMs than during ‘writhing' GMs of full-term newborns. The percentage of co-activation during ‘preterm' GMs varied considerably. The polyEMG of ‘writhing' GMs of two preterms, who were followed longitudinally, differed from that of ‘writhing' GMs of full-terms. At ‘fidgety' age the EMG differences between preterms and full-terms had disappeared. Finally the first results on abnormal GMs are reported. A synchronized onset of muscle activity in all extremity muscles and ‘packaging' of EMG-bursts into subunits of 5–8 Hz. seemed to be specific properties of these abnormal GMs. This could indicate a loss of supraspinal control.

Encounter #1 Hand-drawn Spaces: I step around the corner and into a small room, pitch black except for the dull glow of three projection screens; the center one flat in front of me, the other two angling out like welcoming arms reaching to the edges of the darkness. I stay back, keeping what distance is allowed me, so I can take it all in. With little fanfare, a figure moves into view. The figure is clearly a representation of a human, a biped whose movement quality is instinctually recognizable, yet it lacks all of the features by which we categorize and contextualize in that instant of perceiving an “other.” (Check the order of your personal list and see how you were socialized—Gender? Age? Race? Ability?) Instead, this figure is formed, or perhaps I should say indicated, by lines: a chest cavity of swirling blue; a kinked, mustard-yellow appendage extending out from what seem like perpetually hunched shoulders.From even a few feet away I feel a bit detached from this “dancer.” Lacking individuality in the way I am used to experiencing it, I don't feel compelled to attend to its dancing. So I step closer. Here, almost surrounded by the screens, my customary fourth wall protection is lost. As if on stage, I finally join this dance, beginning to feel some of that sense, that connection—my body to your body, your moving to my moving—that has kept me in this field through many lean years. Yet who am I connecting with?More figures begin to appear and disappear: some retreat out of sight; some seem to step off into the darkness only to emerge on a different screen; and some eerily advance at me, growing into looming giants just moments before fading into darkness. It's as if they are attempting to leave their screened-in world, but disappointed to find themselves no more than projected pixels of light.

The possibility of studying fetal motor behaviour by ultrasound techniques has provoked research on its potential application for assessment of prenatal neurological conditions. The characteristics ('quality') of one particular movement pattern, the 'general movement', has been shown to be discriminative between uncomplicated pregnancy and major pathology of the developing central nervous system. Some recent studies have investigated whether the quality and/or the quantity of fetal movements correlated with other clinical variables during complicated pregnancies, and whether they provided prognostic information for the neurological outcome. Longitudinal research encompassing the pre- and postnatal periods was performed on uncomplicated pregnancies and on pregnancies complicated by intrauterine growth retardation, oligohydramnios (due to premature rupture of the amniotic membranes), or fetal breech position. Although the quantity of both fetal general movements and fetal breathing movements were found to be related to clinical variables of the fetal condition (such as heart rate variability, heart rate decelerations), clinical application seems limited due to large inter- and intra-individual variabilities. In contrast, the quality of fetal general movements appeared highly correlated with parameters of fetal clinical condition in individual cases and fulfilled several prerequisites for serving as a reliable diagnostic tool for prediction of the fetal condition and for assessment of the integrity of the central nervous system.

SUMMARY The sequential development of postural reactions was examined in 20 infants with Down syndrome aged two to 24 months, and was compared to the sequence for non-handicapped infants. Protective reactions appeared relatively earlier in the sequential pattern for infants with Down syndrome than for non-handicapped infants. The study documents dissimilar sequences of postural reaction development for the two infant groups. The data suggest that both the delay and the dissimilar sequence of postural reactions should be considered when evaluating the motor development and movement quality of infants with Down syndrome. RESUME Le developpement des reactions posturales de nourrissons mongoliens Le developpement sequentiel des reactions posturales a ete etudie chez 20 nourrissons mongoliens âges de deux a 24 mois et compare a la sequence observee chez des nourrissons non handicapes. Des reactions de defense apparaissent relativement plus precocement dans la distribution sequentielle des mongoliens que chez les nourrissons non-handicapes. L'etude souligne des sequences de developpement de reactions posturales dissemblables entre les deux groupes de nourrissons. Les donnees suggerent de considerer a la fois le retard et la dissemblance des sequences de reactions posturales lors de l'evaluation du developpement moteur et de la qualite du mouvement chez les nourrissons mongoliens. ZUSAMMENFASSUNG Entwicklung von Stellreaktionen bei Kindern mit Down-Syndrom Bei 20 Kindern mit Down-Syndrom im Alter zwischen zwei und 24 Monaten wurde der Entwicklungsverlauf von Stellreaktionen untersucht und mit dem bei nicht behinderten Kindern verglichen. Die protektiven Reaktionen erschienen in Sequenzmuster der Kinder mit Down-Syndrom relativ fruher als bei den nicht behinderten Kindern. Die Studie dokumentiert einen ungleichen Entwicklungsverlauf der Stellreaktionen bei beiden Gruppen. Die Daten weisen darauf hin, das sowohl die Verzogerung, als auch der unterschiedliche Entwicklungsverlauf der Stellreaktionen berucksichtigt werden sollten, wenn bei Kindern mit Down-Syndrom die motorische Entwicklung und das Bewegungsmuster beurteilt werden. RESUMEN Desarrollo de las reacciones posturales en ninos con sindrome de Down Se examino el desarrollo secuencial de las reacciones posturales en 20 lactantes con sindrome de Down y de edades entre dos y 24 meses y fue comparado con la secuencia observada en ninos normales. Las reacciones de proteccion aparecieron relativamente mas pronto en los esquemas secuenciales en ninos con el sindrome de Down que en los normales. El estudio muestra unas secuencias de desarrollo postural disimilares en los dos grupos. Los datos sugieren que tanto el retraso como la secuencia disimilar en las reacciones posturales, deben ser tomados en consideracion al evaluar el desarrollo motor y la cualidad de movimiento en ninos con sindrome de Down.

The possibility of studying fetal motor behaviour by ultrasound techniques has provoked research on its potential application for assessment of prenatal neurological conditions. The characteristics ('quality') of one particular movement pattern, the 'general movement', has been shown to be discriminative between uncomplicated pregnancy and major pathology of the developing central nervous system. Some recent studies have investigated whether the quality and/or the quantity of fetal movements correlated with other clinical variables during complicated pregnancies, and whether they provided prognostic information for the neurological outcome. Longitudinal research encompassing the pre- and postnatal periods was performed on uncomplicated pregnancies and on pregnancies complicated by intrauterine growth retardation, oligohydramnios (due to premature rupture of the amniotic membranes), or fetal breech position. Although the quantity of both fetal general movements and fetal breathing movements were found to be related to clinical variables of the fetal condition (such as heart rate variability, heart rate decelerations), clinical application seems limited due to large inter- and intra-individual variabilities. In contrast, the quality of fetal general movements appeared highly correlated with parameters of fetal clinical condition in individual cases and fulfilled several prerequisites for serving as a reliable diagnostic tool for prediction of the fetal condition and for assessment of the integrity of the central nervous system.

Aims: Associated movements (AMs) are an indicator of poor movement quality, and are prevalent in children with motor impairment. The ability of children to inhibit AMs has been demonstrated in the hands, but the possibility of reducing AMs that involve both the upper and lower limbs has not been investigated. The aims of this study were to explore the possibility of reducing the AMs and to examine if the reduction of the AMs impacts on locomotion. Methods: An AM reduction intervention under stress gait conditions was piloted in nine children with developmental coordination disorder. A single-case alternating treatment design was used to evaluate the intervention effects of AM reduction training (experimental treatment) and strength training (control treatment) on the AMs under stress gait and running form, over a period of six months. Findings: Visual inspection of individual time-series plots from four children with intact data revealed a reduction of AMs, but the effect was temporary in two cases. The reduction of AMs did not coincide with the improvement of running form. Conclusions: This study highlighted the possibility of reducing AMs under stress gait, and indicated that the reduction of AMs did not improve the movement quality of running form.

Background. Some studies suggest that in prematurely born children developmental coordination disorder (DCD) and/or minor neurological dysfunction (MND) (both terms cover partly overlapping problems) can be predicted by qualitative General Movements Assesment. To our knowledge, there are no studies available investigating the predictive value of non-standardized observation of movement quality in infants and toddlers. Neither is it clear if the terminology used to describe movement quality is well-defined. Aim. The present study investigates if Belgian physiotherapists describe deviant movement quality in infants and toddlers in a consistent way. Methods. Up to now 25 experienced Belgian pediatric physiotherapist have been enrolled in the study, data collection is ongoing. Twenty short videos of children under the age of three were presented in three focus groups. Participants were asked to describe the observed movement quality in the videos and to discuss the terminology. Qualitative content analysis was applied to analyze the audio recorded focus groups using Nvivo 11 data analysis software. Results. Four descriptive themes, affecting the terminology used by physiotherapists, were established. (1) “We look at the same, but describe it differently”. A large number of synonyms were often used to describe a specific movement characteristic. Even when participants seemed to agree, they were persistent in their efforts to find other terminology or descriptions to make themselves more clear. The other themes were (2) ‘Creating the unknown’, (3) ‘It takes all kinds of examinations’ and (4) ‘Importance of a theoretical framework’. Conclusion. Terminology to describe movement quality has been used rather inconsistently. Educational background of the physiotherapist might have an important influence. Physiotherapists prefer to have knowledge about the child’s environment and context to interpret the observations. They often suggest that it is necessary to perform a hands-on-evaluation and that video observations are insufficient for an extensive evaluation.

To investigate the minimal duration of exclusive breastfeeding for optimal neurological outcome, we assessed the quality of general movements (GM) at 3 mo of 147 breastfed healthy term infants that were followed from birth. The quality of GM is a sensitive marker of neurological condition. The quality of GM was classified as normal-optimal, normal-suboptimal, mildly abnormal and definitely abnormal. Information on social and pre- and perinatal conditions and the duration of breastfeeding was collected prospectively. Logistical regression analyses were used to adjust for confounders. There was a positive association between breastfeeding duration and movement quality, with a saturation effect at the age of approximately 6 wk. In the group of infants breastfed foror = 6 wk (n = 55), 18% exhibited normal-optimal GM, 47% normal-suboptimal GM, and 47% mildly abnormal GM. In contrast, in the group of infants breastfed for6 wk (n = 92), 43% exhibited normal-optimal GM, 45% normal-suboptimal GM, and 12% mildly abnormal GM. Exclusive breastfeeding for6 wk was therefore associated with markedly less abnormal and more normal-optimal GM. Thus, we conclude that breastfeeding for6 wk might improve the neurological condition in infants.