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Predictive validity of a qualitative and quantitative Prechtl’s General Movement Assessment at term age: comparison between preterm infants and term infants with hypoxic ischaemic encephalopathy

Predictive validity of a qualitative and quantitative Prechtl’s General Movement Assessment at term age: comparison between preterm infants and term infants with hypoxic ischaemic encephalopathy
Predictive validity of a qualitative and quantitative Prechtl’s General Movement Assessment at term age: comparison between preterm infants and term infants with hypoxic ischaemic encephalopathy
Aim: to determine (1) if the General Movement Optimality Score (GMOS) at term age enhances prediction of motor impairment at 12 and 24 months of age in high-risk infants, when compared to a global General Movement Assessment (GMA), and (2) compare predictive validity for two high-risk populations: infants born preterm and infants born at term with hypoxic ischaemic encephalopathy who have received therapeutic hypothermia.

Methods: fifty-nine extremely preterm or term age infants with hypoxic ischaemic encephalopathy underwent term age GMA. A GMA score of normal or abnormal, and a comparative numerical General Movement Optimality Score (GMOS, total values 5-42) were assigned. Neurology and motor assessment were carried out at age 12 and 24 months using standardised assessments; Alberta Infant Motor Scale, Bayley Scales of Infant and Toddler Development or Ages and Stages Questionnaire. Outcomes were recorded as normal, motor delayed or cerebral palsy. Motor outcome prediction at 12 and 24 months of age was calculated using the GMA and, using ROC analysis, GMOS cut-off scores were determined.

Results: at both 12 and 24 months global GMA sensitivity for preterms was 80% and 100% for term HIE infants. Specificity values for preterm infants at 12 and 24 months were 68.8% and 60% versus 28.8% and 21.4% for term HIE. Median GMOS scores were lower in the term HIE group than the preterm group in the normal and poor repertoire categories. Optimality cut off scores enhanced specificity, but values remained low.

Interpretation: at term age, specificity for identification of infants with later normal motor outcome is low. The GMOS may assist identification of infants with the highest probability of motor impairment, enabling targeted intervention during critical periods for neuroplasticity.
0378-3782
Robinson, Helen
05e6818e-668a-4b9a-8197-9296918afc5c
Denise, Hart
16e842cd-24e1-41dc-8030-868b295e48f1
Vollmer, Brigitte
044f8b55-ba36-4fb2-8e7e-756ab77653ba
Robinson, Helen
05e6818e-668a-4b9a-8197-9296918afc5c
Denise, Hart
16e842cd-24e1-41dc-8030-868b295e48f1
Vollmer, Brigitte
044f8b55-ba36-4fb2-8e7e-756ab77653ba

Robinson, Helen, Denise, Hart and Vollmer, Brigitte (2021) Predictive validity of a qualitative and quantitative Prechtl’s General Movement Assessment at term age: comparison between preterm infants and term infants with hypoxic ischaemic encephalopathy. Early Human Development. (In Press)

Record type: Article

Abstract

Aim: to determine (1) if the General Movement Optimality Score (GMOS) at term age enhances prediction of motor impairment at 12 and 24 months of age in high-risk infants, when compared to a global General Movement Assessment (GMA), and (2) compare predictive validity for two high-risk populations: infants born preterm and infants born at term with hypoxic ischaemic encephalopathy who have received therapeutic hypothermia.

Methods: fifty-nine extremely preterm or term age infants with hypoxic ischaemic encephalopathy underwent term age GMA. A GMA score of normal or abnormal, and a comparative numerical General Movement Optimality Score (GMOS, total values 5-42) were assigned. Neurology and motor assessment were carried out at age 12 and 24 months using standardised assessments; Alberta Infant Motor Scale, Bayley Scales of Infant and Toddler Development or Ages and Stages Questionnaire. Outcomes were recorded as normal, motor delayed or cerebral palsy. Motor outcome prediction at 12 and 24 months of age was calculated using the GMA and, using ROC analysis, GMOS cut-off scores were determined.

Results: at both 12 and 24 months global GMA sensitivity for preterms was 80% and 100% for term HIE infants. Specificity values for preterm infants at 12 and 24 months were 68.8% and 60% versus 28.8% and 21.4% for term HIE. Median GMOS scores were lower in the term HIE group than the preterm group in the normal and poor repertoire categories. Optimality cut off scores enhanced specificity, but values remained low.

Interpretation: at term age, specificity for identification of infants with later normal motor outcome is low. The GMOS may assist identification of infants with the highest probability of motor impairment, enabling targeted intervention during critical periods for neuroplasticity.

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Robinson et al 2021 - Accepted Manuscript
Restricted to Repository staff only until 2 August 2022.
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Accepted/In Press date: 2 August 2021

Identifiers

Local EPrints ID: 450786
URI: http://eprints.soton.ac.uk/id/eprint/450786
ISSN: 0378-3782
PURE UUID: 7539e6de-e5c4-48b4-991d-d3c67082fafc
ORCID for Brigitte Vollmer: ORCID iD orcid.org/0000-0003-4088-5336

Catalogue record

Date deposited: 11 Aug 2021 16:31
Last modified: 12 Aug 2021 01:42

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Contributors

Author: Helen Robinson
Author: Hart Denise

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