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Related Experiment Video

Updated: Oct 25, 2025

Isokinetic Robotic Device to Improve Test-Retest and Inter-Rater Reliability for Stretch Reflex Measurements in Stroke Patients with Spasticity
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Inter-observer reliability using the General Movement Assessment is influenced by rater experience.

C Peyton1, A Pascal2, L Boswell3

  • 1Department of Physical Therapy and Human Movement Science, Northwestern University, Feinberg School of Medicine, 645 N. Michigan Ave, Chicago, IL 60611, USA; Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA.

Early Human Development
|August 10, 2021
PubMed
Summary
This summary is machine-generated.

The General Movement Assessment (GMA) shows fair to moderate reliability for assessing fidgety movements (FMs) in infants at high risk for cerebral palsy (CP). Reliability improves with rater experience.

Keywords:
General Movement AssessmentHigh-risk infantsInfant assessmentinter-observer reliability

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Area of Science:

  • Neurology
  • Developmental Pediatrics
  • Movement Science

Background:

  • Cerebral palsy (CP) is a common motor disability in children.
  • Early detection of CP is crucial for timely intervention.
  • The General Movement Assessment (GMA) is a validated tool for assessing neurological development in infants.

Purpose of the Study:

  • To evaluate the inter-observer reliability of the Prechtl General Movement Assessment (GMA).
  • To assess the impact of rater experience on GMA reliability.
  • To examine the reliability of classifying fidgety movements (FMs) in high-risk infants.

Main Methods:

  • 150 infants at high risk for CP were video-assessed at 10-15 weeks corrected age.
  • Three Prechtl GMA-certified observers with varying experience rated the videos.
  • Inter-observer agreement was analyzed using Gwet's AC1 statistic for FM temporal organization.

Main Results:

  • Fair to moderate agreement was found for subcategories of normal FMs (AC1 = 0.32-0.57).
  • Moderate to near-perfect agreement was achieved when normal FM categories were combined (AC1 = 0.60-0.95).
  • Higher reliability was observed among more experienced raters (AC1 = 0.57-0.98) compared to less experienced ones (AC1 = 0.32-0.61).

Conclusions:

  • The GMA demonstrates high reliability among experienced raters for categorizing normal FMs.
  • Caution is advised when using the GMA to differentiate between continuous and intermittent FMs.
  • The GMA is a reliable tool for assessing infants at high risk for CP, especially with experienced observers.