Related Experiment Videos
[Assessment of general movements at routine medical examination of one-month-old infants]
1Kyoto Prefectural Health Center, Sonobe, Kyoto.
Insights
General movements (GMs) assessment in one-month-old infants effectively identifies developmental abnormalities. This method aids in the follow-up of high-risk infants, showing higher abnormal rates in those with asphyxia or respiratory distress.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Movement assessment
Context:
- Routine medical examinations of one-month-old infants provide an opportunity for developmental assessment.
- General movements (GMs) are a key indicator of neurological development in infants.
- Previous research has established GMs as a valuable tool for early detection of neurodevelopmental disorders.
Purpose:
- To evaluate the utility of qualitative assessment of general movements (GMs) in one-month-old infants during routine medical examinations.
- To determine the reliability and concordance of GM assessments by experienced observers.
- To assess the incidence of abnormal GMs in a cohort of infants, including those with risk factors.
Summary:
- Video recordings of general movements (GMs) were obtained from 252 infants aged 39 postmenstrual to 8 post-term weeks.
- An experienced observer assessed 181 infants twice, achieving high intra-observer concordance (Kappa=0.85).
- Abnormal GMs were identified in 11.0% of infants, with a significantly higher incidence in those with a history of asphyxia and/or respiratory distress.
Impact:
- Qualitative GM assessment by experienced clinicians is a practical and useful method for the follow-up of high-risk infants.
- The findings support the integration of GM assessment into routine neonatal follow-up protocols.
- Early identification of abnormal GMs can facilitate timely intervention and improve neurodevelopmental outcomes.
Abstract:
On routine medical examination of one-month-old infants, general movements (GMs) were video-recorded for about 5 minutes of 252 infants born at Kyoto City Hospital or other hospitals, including the infants discharged from the NICU. Their ages ranged from 39 postmenstrual to 8 post-term weeks. One of the experimenters assessed 181 infants among 252 available for assessment of their GMs twice at intervals of more than one month without being informed about their clinical histories. The subjects included 19 low-birthweight infants, and their average age was 3.5 post-term weeks. The assessment was carried out in comparison to the "gold standard" GMs depicted in a demonstration video produced by the GMs Trust. The Kappa value for intra-observer concordance was 0.85. Twenty (11.0%) out of the 181 infants were judged abnormal because of their poor repertoire of GMs in both the first and second assessment. Neither cramped synchronized GMs nor chaotic ones were observed. Meanwhile, 155 (85.6%) out of the 181 infants were found to be normal. The incidence of abnormal GMs was significantly higher among infants with history of asphyxia and/or respiratory distress than among low-risk infants. There of the experimenters independently assessed GMs of 50 infants among 181 which had been video-recorded between June and September 1998. The inter-observer concordance was higher among the low-birth weight infants than among full-term ones. In conclusion, qualitative assessment of GMs by an experienced observer at routine medical examination of one-month old infants is a useful method for the follow-up of high-risk infants.