Authors: Christa Einspieler, Daniela Prayer and Heinz FR Prechtl
I came across this book while I was looking into General Movements which was introduced to me a few years ago by fellow chiropractor Jason Leighton.
General movements can be described as the normal movements found in infants. Early detection of an abnormal movement pattern may indicate cerebral palsy or other developmental deficit.
The book starts with the historical perspective of fetal movement and comes with a DVD which include ultrasound studies and MRI, giving the reader an “inside view” as to how the baby moves both in the normal fetus and those with some abnormal movements.
What I found quite fascinating is the question; “Why does the fetus move in the first place?”. Given that once the baby is born the baby requires a sensory stimulus to elicit a motor response. However in the fetal environment arms and legs move in general patterns without a stimulus. Minimal neural structures are capable of generating well organised movements, it is also interesting to note that skeletal muscle differentiation occurs after the onset of foetal movements. The movements help develop the neuromusculoskeletal system and not the other way around.
It has been recorded that the earliest body movements occur at 7 weeks and 2 days (page 21). Generalised movements of the entire body begin at 8-10 weeks.
The book also describes how the environment outside the womb can effect the development of the fetus. How the breech position can effect fetal behaviour, they have a different sensory experience especially where the cervical spine is concerned as they can move their necks more freely. Breech babies also have fewer horizontal eye movements and more vertical and oblique movements of the eyes which suggests a difference in neural control of oculomotor activity. (p126)
The book also explores how abnormalities in amniotic fluid volume can alter intrauterine space, maternal exercise effects on the fetus, maternal emotions, substance abuse as well as the effect of therapeutic drugs. Much more about the maternal environment is explored
Why is any of this important to the chiropractor?
These findings that we may take in our histories give us insight as to the stresses and strains the newborn has undergone prior to presentation in our clinic. Has the infant before us in the clinic been able to develop to their full potential in utero? Were their general movements likely to have been normal then and how do they compare to what we are seeing at this point in time? The earlier abnormal development is noticed the better the outcome.
As a practitioner of newborns and infants you need to be able to understand normal neurodevelopment, only then will the abnormal be easy to see and provide appropriate treatment or referral.
This is an extensively researched book, well worth a read and place on your shelf if you are looking after infants and newborns in your practice.
http://www.mackeith.co.uk/shop/fetal-behaviour-2/
