Clinical assessment of motor behaviour in developing children
Clinical assessment of motor behaviour in developing children
In this thesis, we clinically assess the motor behaviour of healthy and brain damaged children with movement disorder rating scales. By doing this, we aim to elucidate the influence of age on movement disorder rating scales, which leads to better application of rating scales in children with a movement disorder.In the first part of the thesis, we assess the motor behaviour of healthy children (0-16 years). From new-born age, we observe motor patterns that show similarities with features of movement disorders (dystonia, chorea and myoclonus). From 3 months of age, these features change to mainly ataxic and dystonic features. During childhood, the features become less clear and disappear after puberty. The similarities between motor features and movement disorders can be explained by the incomplete maturation and development of the nervous system. During brain maturation, networks between motor regions of the brain are formed and optimized. This results in better coordination of motor behaviour. With the present insights, the motor behaviour of children who are at risk for developing a movement disorder can be better interpreted. In the second part of the thesis, we implement the insights from the first part to two different groups of children who are at risk of developing a movement disorder, namely 1. children who are at a higher risk of brain damage due to oxygen deprivation during birth and 2. children who were chronically exposed to lead pollution. Outcomes show that the majority of the children in both groups show favourable, but not completely optimal, motor behaviour. Future research is needed to see whether the motor behaviour at adult age is normal, or not.
Definition of movement disorders:
Dystonia: sustained or repetitive muscle contractions resulting in twisting and repetitive movements or abnormal fixed postures
Chorea: jerky involuntary movements affecting especially the face and limbs
Myoclonus: brief, involuntary twitching of a muscle or a group of muscles
Ataxia: lack of voluntary coordination of muscle movements