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The general movement optimality score: a detailed assessment of general movements during preterm and term age
Christa Einspieler1, Peter B Marschik1,2, Jasmin Pansy3
1Research Unit iDN, Interdisciplinary Developmental Neuroscience, Institute of Physiology, Center for Physiological Medicine, Medical University of Graz, Graz, Austria.
Insights
The General Movement Optimality Score (GMOS) effectively distinguishes between different general movement patterns in infants. This detailed assessment shows promise for tracking changes in infant motor development over time.
Area of Science:
- Pediatric neurology
- Developmental neuroscience
- Movement analysis
Background:
- General movements (GMs) are crucial for assessing early neurodevelopmental disorders.
- Current global assessments categorize GMs but lack detailed quantification.
- A detailed assessment may offer more precise insights into motor development.
Purpose of the Study:
- To evaluate the utility of a detailed assessment of general movements in infants.
- To establish the relationship between global GM categories and detailed optimality scores.
Main Methods:
- Analysis of 783 video recordings from 233 infants (27-45 weeks postmenstrual age).
- Global GM assessment (normal, poor repertoire, cramped-synchronized, chaotic).
- Detailed scoring of movement components (amplitude, speed, rotations, etc.) using the optimality concept.
Main Results:
- General Movement Optimality Scores (GMOS) significantly differentiated between normal, poor repertoire, and cramped-synchronized GMs (p<0.01).
- Chaotic GMs had similar optimality scores to cramped-synchronized GMs.
- Detailed scores were slightly lower at post-term age for normal and poor repertoire GMs.
Conclusions:
- The GMOS provides a robust quantitative measure for differentiating GM patterns.
- Further research is warranted to confirm GMOS's predictive value for individual motor trajectory changes.
Aim:
To explore the appropriateness of applying a detailed assessment of general movements and characterize the relationship between global and detailed assessment.
Method:
The analysis was based on 783 video recordings of 233 infants (154 males, 79 females) who had been videoed from 27 to 45 weeks postmenstrual age. Apart from assessing the global general movement categories (normal, poor repertoire, cramped-synchronized, or chaotic general movements), we scored the amplitude, speed, spatial range, proximal and distal rotations, onset and offset, tremulous and cramped components of the upper and lower extremities. Applying the optimality concept, the maximum general movement optimality score of 42 indicates the optimal performance.
Results:
General movement optimality scores (GMOS) differentiated between normal general movements (median 39 [25-75th centile 37-41]), poor repertoire general movements (median 25 [22-29]), and cramped-synchronized general movements (median 12 [10-14]; p<0.01). The optimality score for chaotic general movements (mainly occurring at late preterm age) was similar to those for cramped-synchronized general movements (median 14 [12-17]). Short-lasting tremulous movements occurred from very preterm age (<32wks) to post-term age across all general movement categories, including normal general movements. The detailed score at post-term age was slightly lower compared to the scores at preterm and term age for both normal (p=0.02) and poor repertoire general movements (p<0.01).
Interpretation:
Further research might demonstrate that the GMOS provides a solid base for the prediction of improvement versus deterioration within an individual general movement trajectory.
