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"Developmental coordination disorder DCD merupakan gangguan koordinasi motorik yang mengganggu prestasi akademik dan kegiatan olahraga. Penelitian ini bertujuan mengetahui nilai diagnostik neurological soft signs NSS dalam mendiagnosis DCD. Subjek terdiri atas 86 anak usia sekolah dasar suspek DCD dan 20 subjek kontrol. Semua subjek menjalani pemeriksaan fisis dan neurologis, anamnesis riwayat perkembangan, prestasi akademik, kesulitan menulis atau olahraga, screen time, dan aktivitas fisis, pemeriksaan antropometri, pemeriksaan NSS, serta pemeriksaan baku Bruininks-Oseretsky Test 2 Short Form BOT-2 SF . Subjek dengan skor BOT-2 SF below average dan well below average didiagnosis DCD. Median usia subjek 10,05 rentang 6,3 sampai 12,5 tahun; 67 adalah lelaki. DCD ditemukan pada 28,3 subjek. Sebanyak 67 subjek memiliki ge;1 NSS positif dan 41,5 memiliki ge;2 positif. NSS berhubungan bermakna dengan DCD apabila ge;2 positif p=0,047 . Nilai cut-off NSS optimal adalah ge;2 positif, dengan sensitivitas 57 dan spesifisitas 64 [area under the curve 0,639 IK95 0,512-0,767 ; p=0,026]. Dengan nilai cut-off ge;4, pemeriksaan ini memiliki sensitivitas 16,7 dan spesifisitas 99 . Pada 20 subjek DCD didapatkan komorbiditas neurodevelopmental lainnya. Sebagai simpulan, pemeriksaan NSS pada DCD merupakan pemeriksaan yang spesifik namun kurang sensitif. Diperlukan penelitian lebih lanjut untuk karakterisasi NSS pada komorbiditas yang dapat menyertai DCD.

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Developmental coordination disorder DCD is a disorder of motor coordination impairing academic and sports performance. We aimed to determine the value of neurological soft signs NSS in diagnosing DCD. Subjects were 86 DCD suspected elementary school children and 20 controls. All underwent physical and neurological examination, interview on developmental and academic history, difficulties in writing or sports, screen time, and physical activity, anthropometric measurement, NSS examination, and the standardized Bruininks Oseretsky Test 2 Short Form BOT 2 SF . Below average and well below average BOT 2 SF scores were classified as DCD. Subjects rsquo median age was 10.05 range 6.3 to 12.5 years 67 were male. DCD was found in 28.3 of subjects. Sixty seven percent and 41.5 of subjects had ge 1 and ge 2 positive NSS, respectively. More than 2 positive NSS was significantly associated with DCD p 0.047 . The optimal NSS cut off value was ge 2 sensitivity 57 specificity 64 area under the curve 0.639 95 CI 0.512 0.767 p 0.026 . Using a cut off value of ge 4, NSS had a sensitivity and specificity of 16.7 and 99 , respectively. Neurodevelopmental comorbidities were found in 20 of DCD subjects. In conclusion, NSS is a specific, but less sensitive, diagnostic test for DCD. Further studies are needed to characterize NSS in comorbid conditions."

"Latar belakang: Malnutrisi berhubungan dengan patologi struktural dan fungsional di otak yang dapat mengganggu maturitas sistem saraf pusat (SSP). Hal ini dapat menyebabkan gangguan belajar dan mempengaruhi kecerdasan anak. Salah satu instrumen untuk menilai maturitas SSP adalah dengan pemeriksaan soft sign neurology yang dapat menilai kelainan motorik atau sensorik tanpa adanya lesi struktural di SSP. Tujuan: Melihat perbandingan neurodevelopment anak dengan gangguan gizi dan anak gizi normal. Metode: Penelitian potong lintang secara konsekutif nonrandom sampling pada anak usia 5-18 tahun dengan gizi normal dan ganguan gizi di wilayah Jakarta yang memenuhi kriteria inklusi dan eksklusi, dilakukan wawancara dengan orang tua, recall makanan, dan pemeriksaan soft sign neurology dengan instrumen Physical and Neurological Examination for Soft Sign (PANESS). PANESS terdiri dari 43 aitem untuk menilai gerakan motorik, graphesthesia, stereognosis, keseimbangan, gerakan berkelanjutan, gerakan bergantian dan string test. Hasil: Dari 170 subyek didapatkan soft sign neurology pada 135 subyek (79,4%) terdiri dari 72 laki-laki (53,3%) dan 63 perempuan (46,7%); 70 subyek (77,8%) kelompok gizi normal dan 65 subyek (81,2%) kelompok gangguan gizi. Terdapat perbedaan yang bermakna secara statistik antara kelompok gizi normal dengan kelompok gangguan gizi usia 5-12 tahun pada penilaian total graphesthesia, total keseimbangan, dan total PANESS (p<0,05). Terdapat perbedaan yang bermakna secara statistik antara kelompok gizi normal dengan kelompok gangguan gizi usia 13-18 tahun pada penilaian gerakan bergantian (p=0,047). Kesimpulan: Terdapat perbedaan soft sign neurology yang bermakna antara kelompok anak gizi normal dengan kelompok anak gangguan gizi terutama pada kelompok usia 5-12 tahun. Hal ini menunjukkan keterlambatan dalam maturitas SSP.

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Background: Malnutrition is associated with structural and functional pathology of the brain, which can disrupt maturity of central nervous system (CNS). Furthermore, this condition will cause learning disability and influence child intellegency. One of instrument to assess maturity of the CNS by using Neurological soft signs (NSSs) which can assess abnormal of motor and sensory findings without a structural lesion in the CNS.

Aim: This study is aimed to assess association of neurodevelopment between malnutrition and normal nutrition children.

Method: This cross-sectional study used consecutive non-randomized sampling by enrolled to children range between 5-18 years old within normal nutrition and undernutrition based at Jakarta regions which had met with inclusion and exclusion criteria, and had undergone interview with their parents, 24 hours recall nutrition, and NSSs examination using Physical and Neurological Examination for Soft Sign (PANESS) instrument. PANESS consist of 43 items was used for the assesment of motor movement, graphestesia, stereognosis, balance, continuity of movement, alternating movement and string test.

Result: From total of 170 subjects, there were 135 subjects (79.4%) have NSSs, consist of 72 boys (53.3%) and 63 girls (46.7%). In normal nutrition group there were found 70 subjects (77.8%) have NSSs and at malnutrition group there were found 65 subjects (81.2%) have NSSs. It showed that there was significant difference between normal nutrition between 5-12 years old compared to malnutrition group in total assessment of graphesthesia, total balance, and total score of PANESS (P<0.05). There were significant difference between normal nutrition group of 13-18 years old with malnutrition group at alternating movement (P=0.047).

Conclusion: There is significant difference of NSSs between normal nutrition and malnutrition especially for children between 5-12 years old. This finding showed delay of the CNS maturity."