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General movements assessment and Alberta Infant Motor Scale in neurodevelopmental outcome of preterm infants
Canan Yildirim1, Ayşegül Asalioğlu2, Yeşim Coşkun3
1Okan University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Neurology, Istanbul, Turkey.
Insights
General Movement Assessment (GMA) and Alberta Infant Motor Scale (AIMS) effectively predict cerebral palsy (CP) and neurodevelopmental delay (NDD) in preterm infants. Combining GMOS, MOS, and AIMS enhances diagnostic accuracy for CP and NDD.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Movement assessment
Background:
- Preterm infants are at higher risk for neurodevelopmental disorders.
- Early detection of cerebral palsy (CP) and neurodevelopmental delay (NDD) is crucial for timely intervention.
- General Movement Assessment (GMA) and Alberta Infant Motor Scale (AIMS) are established tools for assessing infant motor development.
Purpose of the Study:
- To compare the predictive accuracy of GMA and AIMS for CP and NDD in preterm infants.
- To evaluate the diagnostic compatibility of General Movement Optimality Score (GMOS), Motor Optimality Score (MOS), and AIMS in detecting CP and NDD.
Main Methods:
- Seventy-five preterm infants (gestational age 24-37 weeks) were assessed using GMOS, MOS, and AIMS at different developmental periods.
- Infants were categorized into three groups based on gestational age.
- Statistical analyses were performed to assess compatibility and association with CP and NDD.
Main Results:
- Abnormal movement patterns (cramped-synchronized, poor repertoire) were observed in a significant proportion of infants.
- Absent fidgety movements were noted in 46% of infants.
- High compatibility was found between AIMS and GMOS (Kappa: 0.709) and AIMS and MOS (Kappa: 0.804).
- GMOS, MOS, and AIMS were all significantly associated with the presence of CP and NDD (p < 0.001).
Conclusions:
- General Movement Assessment (GMA) is a valuable tool for predicting CP and NDD in preterm infants.
- The combined application of GMOS, MOS, and AIMS can improve the reliability and validity of CP and NDD diagnosis.
- These assessments can guide clinical practice for early identification and management of neurodevelopmental issues in preterm infants.
Aim:
We aimed to compare the General Movement Assessment (GMA) and the Alberta Infant Motor Scale (AIMS) in preterm infants for the prediction of cerebral palsy (CP) and neurodevelopmental delay (NDD). Additionally, we aimed to evaluate the diagnostic compatibility of the General Movement Optimality Score (GMOS), the Motor Optimality Score (MOS), and AIMS for detecting CP and NDD.
Method:
Seventy-five preterm infants with gestational age (GA) 24-37 weeks were enrolled. Group 1 was composed of infants with 24-28 GA (n = 22); groups 2 and 3 consisted of infants with 29-32 GA weeks (n = 23) and 33-37 GA (n = 30) weeks, respectively. The infants were assessed during the writhing period, the fidgety period, and at 6-12 months of corrected age with GMOS, MOS, and AIMS, respectively.
Results:
In the writhing period, a cramped-synchronized pattern was observed in 17 (22%) infants, whereas a poor repertoire pattern was observed in 34 (45%) infants. In the fidgety period of the 63 infants, 29 (46%) presented with fidgety movements absent. The MOS and AIMS scores of the infants in group 1 were significantly lower than the other groups, which were statistically significant (p = 0.004, p˂0.001). High and positive compatibility (Kappa coefficient: 0.709; p = 0.001) was found between AIMS and GMOS scores and between AIMS and MOS scores (Kappa coefficient: 0.804; p < 0.001). In all groups, a statistically significant association was found between total GMOS scores (p = 0.003) and the presence of fidgety movements (p = 0.003). GMOS, MOS, and AIMS were found to be associated with CP and NDD (p < 0.001).
Conclusion:
GMA is an important tool for the prediction of CP and NDD. The combined use of GMOS, MOS, and AIMS may guide the clinical practice for the valid and reliable diagnosis of CP and NDD.
