The latest evidence shows that the new approaches to Physical Medicine and Rehabilitation, which combine various procedures and tools, will allow early detection of neurodevelopmental disorders in babies under five months of age. Within the framework of the 61st National Congress of the Spanish Society of Physical Medicine and Rehabilitation (SERMEF) that is being held in Santander from May 17 to 20, three specialists have delved into these key results to act as soon as possible against possible movement disorders, learning, etc.
Detect and treat alterations in the neurodevelopment During the first months and years of life it has great advantages. At this stage of life, the brain is in a phase of development and greater plasticity and, therefore, the chances of correcting or mitigating possible sequelae are increased before they become more severe or chronic.
At present, the tools that have the greatest evidence when it comes to early detection of these possible alterations, as Belén Maza, a rehabilitation physician at the Marqués de Valdecilla University Hospital, has pointed out, are “the assessment of general movements ( GM), the Hammersmith Infant Neurological Examination standardized neurological assessment scale (HINE), and MRI. The first two options depend directly on the assessment that the Physical Medicine and Rehabilitation specialists carry out in their consultation.
General movements, a repertoire of spontaneous movements present from fetal life to six months, have shown a reliability and sensitivity of 98% when determining motor or cognitive delay and 100% risk of cerebral palsy.
“Normal children’s GMs are fluid and graceful, creating an impression of complexity and variability. However, in a baby with an impaired nervous system, they lose these characteristics. Identifying this loss, with specific patterns, is crucial to early recognition of high-risk children and planning an early intervention that has optimal therapies,” explained Belén Romero, a specialist in Physical Medicine and Rehabilitation at the Virgen Macarena University Hospital. .
Thus, as Romero has indicated, “the Prechtl GM assessment (in preterm, term, and from the third to fifth month), including the Motor Optimality Score (MOS), identifies pathological patterns of GM, provides information on the neurodevelopment and accurately differentiate between babies with adequate development and those with greater risk of motor or cognitive delay».
Once the risk has been identified, professionals can begin their work to try to reduce the possible sequelae derived from the alteration. On this point, the specialist at the Vall d’Hebron Hospital, Mar Meléndez, highlighted that “in recent years, early intervention in these patients has experienced a significant change based on new knowledge about brain neuroplasticity.”
«The work that children develop and generates changes in their brain consists of a set of actions that they carry out by their own means, motivated by toys and activities (environmental enrichment), which they carry out in their own home with the supervision of their family member. In this way, stimulating activities are generated in the child’s usual environment and that can be repeated until functional objectives are achieved”, explained Meléndez.
