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The predictive validity of general movements--a systematic review
Marlette Burger1, Quinette A Louw
1Division of Physiotherapy, Department of Interdisciplinary Health Science, Faculty of Health Sciences, Stellenbosch University, PO Box 19063, Tygerberg 7505, Cape Town, South Africa. mbu@sun.ac.za
Insights
Assessing general movements (GMs) in early infancy, particularly during the fidgety period, can accurately predict neurodevelopmental outcomes. This method helps identify infants with potential neurological deficits for early intervention.
Area of Science:
- Pediatric Neurology
- Developmental Neuroscience
- Movement Science
Background:
- General movements (GMs) assessment, pioneered by Prechtl, offers early identification of neurological deficits in infants.
- Early detection is crucial for timely intervention and improved neurodevelopmental outcomes.
Purpose of the Study:
- To systematically review evidence on the predictive value of general movements in early infancy for neurodevelopmental outcomes at 12 and 24 months.
- To assess the reliability of GMs as a prognostic tool for identifying infants at risk.
Main Methods:
- A systematic literature search was conducted across multiple databases (Medline, CINAHL, Pedro, Cochrane, etc.).
- Key terms included 'general movements,' 'spontaneous motor activity,' 'nervous system diseases,' and 'developmental disabilities.'
- Methodological quality was appraised using the McMaster University Critical Review Form.
Main Results:
- Seventeen studies were included in the review.
- A significant relationship (sensitivity >92%, specificity >82%) was found between the quality of GMs (8-20 weeks postterm) and neurodevelopmental outcomes.
- The fidgety movements' period showed particular predictive value.
Conclusions:
- Qualitative assessment of general movements is a reliable prognostic tool.
- This assessment, especially during the fidgety movements' period, aids in identifying infants with neurodevelopmental disabilities.
Background:
The assessment of general movements (GMs), introduced by Professor Heinz Prechtl and his co-workers in the early 1990s, may offer the opportunity to identify infants with neurological deficits at a very early age.
Aim:
The aim of this review was to systematically assess available data in order to determine the evidence of general movements in early infancy to predict the neurodevelopmental outcome in 12- and 24-month-old infants.
Method:
A systematic literature search was performed using the following computerised databases: Medline, CINAHL, Pedro, The Cochrane Library, Science Direct, ProQuest: Science Journals, Medical Library & Social Science Journals, Journals @ OVID and PsycINFO. The following key terms were used: general movements, spontaneous motor activity, nervous system diseases [MeSH] and developmental disabilities [MeSH]. A comprehensive author search was also conducted. The methodological quality of eligible studies was critically appraised by two reviewers using the Critical Review Form for Quantitative Studies of the McMaster University Occupational Therapy Evidence-Based Practice Research Group.
Results:
Seventeen studies were eligible for this review. The average score of the studies was 8.82 (73.5%) from a total of 12 (SD 0.73). Fifteen of the 17 studies found a high relationship (sensitivity > or =92%; specificity > or =82%; p<0.01) between the quality of general movements at 8-20 weeks postterm (fidgety movements' period) and the infants' neurodevelopmental outcome.
Conclusion:
The results of this systematic review indicate that the qualitative assessment of general movements, especially during the fidgety movements' period, can be used as a prognostic tool to identify infants with neurodevelopmental disabilities.
