Objektive Bewertung der Spontanmotorik bei gesunden Neugeborenen
- Objektive movement analysis in healthy newborns / vorgelegt von Dorit Kowarzik
Kowarzik, Dorit; Schmitz-Rode, Thomas (Thesis advisor)
Aachen : Publikationsserver der RWTH Aachen University (2008)
Dissertation / PhD Thesis
Aachen, Techn. Hochsch., Diss., 2008
Considering the enormous compound of developmental tests, which on the one hand aim to detect the present stage of a child´s development on the other hand compare it to the same age group and mostly important should enable the observer to make a sincere prediction concerning the prospective developmental status, the observation of spontaneous movements of newborns still represents a small though very important part, since central brain lesions are mostly shown in abnormal spontaneous movements. Up until now, the diagnosis is still based on a visual and thus subjective observation. Trying to find a more objective way to analyse the spontaneous motor activity of newborns the Helmholtz - Intitute developed a tool (ICP Diagnost), which allows the 3- dimensional acquisition of spontaneous movements in newborns, which has been validated and evaluated in this study. Therefore measurements with 11 healthy and 7 affected (infantile cerebral palsy) newborns, regarding the family history, pregnancy, birth and newborn history have been carried out using a standardized setting within the 1./3. and 5. month postpartum. Using a video based 3D motion analysis system (Vicon 370) consisting of 7 infrared cameras with infrared strobes the spontaneous motor activity was recorded. 20 markers placed on predefined body-segments of the infant reflected the infrared light , which was assimilated and converted into 3D movement data. The generated biomechanical model was a full body model. In collaboration with experienced neuropediatrics 35 parameters (velocity, acceleration, range of movement) used during the visual assessment of motor activity and describing the differences between healthy and affected newborns could be extracted from the patient´s 3D movement data. Using the obtained data and a matlab programme (patient classificator) we created 5 evaluation databases and a reliable combination of 8 parameters to match. These databases were used to evaluate the 3 classification systems in ICP Diagnost, regarding sensivity, specificity, predictive value and over all detection rate. In addition detected differences in the spontaneous movements of newborns were evaluated statistically.