NeuroMotion smartphone application for remote General Movements Assessment: a feasibility study in Nepal

Area of Science:

• Global health
• Pediatric neurology
• Digital health

Background:

• Cerebral palsy (CP) screening is crucial for early intervention.
• Traditional assessments can be resource-intensive, limiting access in low-resource settings.
• Smartphone technology offers potential for remote health monitoring and screening.

Purpose of the Study:

• To assess the feasibility of the NeuroMotion smartphone application for remote General Movements Assessment (GMA).
• To screen infants at risk for cerebral palsy in Kathmandu, Nepal.
• To evaluate parental engagement and application usability.

Main Methods:

• Thirty-one high-risk infants were recruited for home-based video recording using the NeuroMotion app at 3 months of age.
• Videos were assessed for technical quality and the presence of fidgety movements using Prechtl's General Movements Assessment.
• Parental usability was evaluated via a survey.

Main Results:

• Out of 46 submitted videos, 35 had approved technical quality.
• Sixteen infants had at least one technically adequate video for assessment.
• Three infants were identified as lacking fidgety movements, suggesting potential CP.
• Inter-assessor agreement was acceptable (Krippendorf alpha 0.781).
• Parental feedback on usability was generally positive.

Conclusions:

• Remote General Movements Assessment using smartphone applications is a viable method for screening cerebral palsy in infants.
• This approach can successfully engage parents in screening efforts within urban South Asian settings.
• The NeuroMotion app demonstrates potential for improving CP screening accessibility in lower-middle-income countries.