Objektive Bewertung der Spontanmotorik bei Neugeborenen mit infantiler Zerebralparese
- Objective apprecation of spontaneous movements with newborn children with infantile cerebral palsy
Kunschke, Anja; Schmitz-Rode, Thomas (Thesis advisor)
Aachen : Publikationsserver der RWTH Aachen University (2007)
Dissertation / PhD Thesis
Aachen, Techn. Hochsch., Diss., 2007
The infantile Zerebralparese which is a not progressive central-motor damage of the movement and holds machine is caused in the early childhood. It is a result of a defect or an injury of the brain in the early development stages of the child. To limit the consequences of the diagnosis of the ICP, physiotherapeutic and medical therapy and care, should begin, as early as possible. However, for this a very early and safe diagnosis position is demanded. We have the movement of child 1, 3. and 5. Month postnatal noted and before certain criteria for choice, e.g. birth and pregnancy process, fixed. The recording of the measuring data the 3D became - motion analysis system Vicon 370 of Oxford Metrics uses. The movements of the baby are in this way three-dimensional seized. From these transaction data later different characteristics of the movement are computed as for example movement extent, speed of individual parts of the body or the change of the joint angles. With the help of these characteristics an objective description and evaluation of the movement of the baby become possible. With the help of the software developed at the chair for applied medical technology ICP Diagnost could recover seize to gotten sick newborn child by the motion analysis data and based on the statements of Professor Heinz F. Prechtl, Graz, Characteristic for the movements of and. Thus a quantitative and objective procedure for an early diagnostics of cerebral paresis was created. 35 parameters could be extracted by the noted movements, which a distinction between healthy and gotten sick newborn child permits. From this the optimal parameter combination of 8 parameters could be determined by the used cluster analysis. Training and evaluation data bases were provided. From this altogether 5 data bases were determined, their bases different data are e.g. different age and number of children. The provided data bases were evaluated with 2 different classification systems (classification by average value and standard deviation and classification by Diskriminanzanalyse 5:1/10:1). As the best data base the data base C was determined, itself with a high sensitivity of 96,7 (5:1und 10:1) and a good specificity of 79,4 (5:1) and/or. 70,6 (10:1) reinforces. Also regarding the Predictive Value the data base C (5:1) with 67% a good result obtains positives. With the "pair of overalls detection guesses/advises" attained the data base B and C, both in the Diskriminanzanalyse 5:1, and in the Diskriminanzanalyse 10:1 with approx. 80% a good result. The classification system after average value and standard deviation is noticeable by its throughout worse results. With the pursuit of the children in your development from 1. to 5. Month could be determined by the application student t-tests significant changes and thus meaningful data regarding the individual 8 parameters be made. A significance stepped only starting from that 3. Month of the children in feature, thus particularly with the comparison of the changes between 1. and 3. and 1. and 5. Month. This covers itself also with the observations of Professor Prechtl, there it significant changes also only starting from the 6. Week postnatal determined. During the evaluated measurements it could be stated that normally developed children and children with infantile cerebral paresis move significantly differently. The courses of motion, the speed, as well as acceleration vary partly very strongly. It can recapitulate be said that the selected measuring procedure, the 3 dimensional motion analysis system Vicon 370 with the used software ICP Diagnost, which recognize to expecting changes in the motor activity of babies with a ICP and evaluate correctly. This is a crucial step to an early, quantitative and objective diagnosis of infantile cerebral paresis to introduce it made possible promptly an effective therapy.