Neuromotor development in infants with cerebral palsy investigated by the Hammersmith Infant Neurological Examination during the first year of age

Eur J Paediatr Neurol. 2008 Jan;12(1):24-31. doi: 10.1016/j.ejpn.2007.05.006. Epub 2007 Jul 2.


Background: The Hammersmith Infant Neurological Examination (HINE) is a simple and scorable method for assessing infants between 2 and 24 months of age.

Aims: The purpose of this retrospective study was firstly, to evaluate the neuromotor development of infants with cerebral palsy (CP) by the HINE, during the first year of age; secondly, to correlate the scoring of this neurological tool with levels of the Gross Motor Function Classification System (GMFCS).

Methods: A cohort of 70 infants with a diagnosis of CP at 2 years of age was evaluated by the HINE at 3, 6, 9 and 12 months of corrected age and by GMFCS at 2 years of age.

Results: The main results indicate that at 3-6 months, infants with quadriplegia (IV and V levels of GMFCS) and those with severe diplegia (III level) scored below 40, whereas those with mild or moderate diplegia (I-II level) and hemiplegia (I-II level) mainly scored between 40-60. Interestingly, the 26% of infants with hemiplegia scored > or =67 at 12 months. We observed a strong (r=-0.82) and significant (p<0.0001) negative correlation between the scores of the neurological examination and the levels of GMFCS.

Conclusions: Our results point out that the HINE can give additional information about neuromotor development of infants with CP from 3-6 months of age, strictly related to the gross motor functional abilities at 2 years of age.

MeSH terms

  • Anthropometry / methods
  • Cerebral Palsy / classification*
  • Cerebral Palsy / physiopathology*
  • Cohort Studies
  • Developmental Disabilities*
  • Disability Evaluation
  • Female
  • Humans
  • Infant
  • Male
  • Movement / physiology
  • Neurologic Examination / methods*
  • Posture / physiology
  • Severity of Illness Index
  • Time Factors