Dominik Karch

Kinematic assessment of stereotypy in spontaneous movements in infants

Movement variation constitutes a crucial feature of infant motor development. Reduced variation of spontaneous infant movements, i.e. stereotyped movements, may indicate severe neurological deficit at an early stage. Hitherto evaluation of movement variation has been mainly restricted to subjective assessment based on observation. This article introduces a method for quantitative assessment yielding an objective definition of stereotyped movements which may be used for the prognosis of neurological deficits such as cerebral palsy (CP). Movements of 3-month-old infants were recorded with an electromagnetic tracking system facilitating the analysis of joint angles of the upper and lower limb. A stereotypy score based on dynamic time warping has been developed describing movements which are self-similar in multiple degrees of freedom. For clinical evaluation, this measure was calculated in a group of infants at risk for neurological disorders (n=54) and a control group of typically developing children (n=21) on the basis of spontaneous movements at the age of 3 months. The stereotypy score was related to outcome at the age of 24 months in terms of CP (n=10) or no-CP (n=53). Using the stereotypy score of upper limb movements CP cases could be identified with a sensitivity of 90% and a specificity of 96%. The corresponding score of the leg movements did not allow for valid discrimination of the groups. The presented stereotypy feature is a promising candidate for a marker that may be used as a simple and noninvasive quantitative measure in the prediction of CP. The method can be adopted for the assessment of infant movement variation in research and clinical applications.

Computer‐based analysis of general movements reveals stereotypies predicting cerebral palsy

To evaluate a kinematic paradigm of automatic general movements analysis in comparison to clinical assessment in 3‐month‐old infants and its prediction for neurodevelopmental outcome.

Quantitative score for the evaluation of kinematic recordings in neuropediatric diagnostics. Detection of complex patterns in spontaneous limb movements.

OBJECTIVE Evaluation of spontaneous infant movements is an important tool for the detection of neurological impairments. One important aspect of this evaluation is the observation of movements which exhibit certain complex properties. This article presents a method to automatically extract segments which contain such complex patterns in order to quantitatively assess them. METHODS Expert knowledge is represented in a principal component model which captures the term complexity as the multivariate interactions in the kinematic chains of the upper and the lower limb. A complexity score is introduced which is used to quantify the similarity of new movements to this model. It was applied to the recordings of 53 infants which were diagnosed by physicians as normal or pathologic. RESULTS Time segments marked as complex (from five infants) by physicians could be detected with a mean accuracy of 0.77 by the automated approach. The median of the best complexity scores of the pathologic group (n = 21) is significantly lower (p = 0.001) than the median of the normal group (n = 27). CONCLUSION Using the complexity score we were able to quantify movement complexity in regard of the understanding of physicians. This could be useful for clinical applications.

Objective analysis of lower limb movements of infants for diagnostic purposes: calculation of the knee joint center

Quantified movement analysis is a valuable tool for the diagnosis of infant movement disorders due to neurological damages of the brain. A crucial task for this purpose is the calculation of joint positions. For the leg it is challenging to determine the knee joint center. This article compares two methods to calculate the knee joint center of infants from movement data recorded with an electromagnetic tracking system. We applied both methods to calculate the knee joint centers of the recorded movements of 20 infants at the age of 3 months. A least squares approach is shown to be favorable. Furthermore an application of the method to quantify normal and abnormal movement patterns is demonstrated. The quantification showed different movement patterns for children whose movements were diagnosed abnormal by physicians. In our future work we will analyze these movement patterns to give decision support for physicians.

Detection of complex movement patterns in multivariate kinematic time series for diagnostics in pediatric neurology

Evaluation of spontaneous infant movements is an important tool for the detection of neurological impairments. It is necessary to automatically detect movement phases which exhibit certain complex characteristics in order to quantitatively assess these movements. This article presents a method to extract segments of complex movements from multivariate kinematic tracking data. Expert knowledge is represented in a principal component model. Evaluation shows a good concordance between the segments marked by the experts and the results of the automated approach. It is further shown that normal infant movements can be discriminated from pathologic movement patterns.

Sensorische Integrationstherapie nach Jean Ayres

EINLEITUNG Die Sensorische Integrationstherapie wurde von Frau Jean Ayres entwickelt mit dem Ziel, Kindern mit Lerndefiziten zu helfen. Ausgehend von dem Wissen der 50er und 60er Jahre uber die normale kindliche Entwicklung sowie die Zusammenhange zwischen den neuralen Prozessen bei der Wahrnehmung und dem Verhalten des Kindes erarbeitete sie eine Theorie uber mogliche basale Wahrnehmungsund Verarbeitungsprozesse und deren Funktionsstorungen. Sie wollte damit nicht nur die Ursachen fur Lerndefizite beschreiben sondern daraus spezielle Behandlungstechniken ableiten. Die Integration von Sinneseindrucken, deren Ordnung und sinnvolle Vernetzung wurde von ihr als ein neurologischer Prozess angesehen, den sie als „Sensorische Integration“ bezeichnete. In zahlreichen Publikationen und Monographien wurden die Verfahren zur Erkennung von neurophysiologisch begrundeten Dysfunktionen und ihrer Behandlung dargestellt, deren Weiterentwicklung durch Fisher et al. 1998 erfolgte.