Measuring Spontaneous Leg Movement of Infants At-Risk for Cerebral Palsy: Preliminary Findings

Research Objectives To quantify early spontaneous leg movements of infants at-risk for cerebral palsy (CP) during the first four months of life. This will inform future efforts in developing personalized prone and upright rehabilitation for children with CP. Design These data are from the observational period of a larger, 18-month intervention study (NCT04561232). Full-day leg movement data were recorded using inertial sensors on each ankle. Data were recorded for two consecutive days every month, for four months, starting at one month of age. Previously validated kinematic characteristics of full-day infant leg movement were derived from tri-axial accelerometer and gyroscope data. Setting Participants wore inertial sensors in their natural environments (home or Neonatal Intensive Care Unit (NICU)) while caregivers were asked to proceed with the infants’ typical daily activities. Participants 31 infants with a history of an early brain injury associated with risk for CP. Participants were recruited primarily from the NICU at the Children's Hospital of Philadelphia. Interventions Not applicable. Main Outcome Measures Leg movement quantity and acceleration, for each participant and each day: number of movements per hour of awake time, median acceleration during the movements, and median of peak acceleration during the movements. Results Summary results from all days collected are reported: median (interquartile range), for the left and right leg. Number of movements per hour awake were 439 (271-692) and 420 (268-647). Acceleration during movements was 1.27 (1.16-1.41) m/s2 and 1.29 (1.17-1.42) m/s2. Peak acceleration during the movements was 2.44 (2.19-2.72) m/s2 and 2.45 (2.20-2.71) m/s2, respectively. Conclusions We present kinematic characteristics of full-day leg movements for infants at-risk for CP during the first four months of life. Results indicate noticeably lower performance compared to typically developing infants from previous studies, indicating a potential for improvement through rehabilitation. As we gather more data, we will be able to retrospectively analyze the early movement data of infants in relation to their later functional outcomes and response to prone and upright rehabilitation. Author(s) Disclosures None.