Stability of the Motor Optimality Score Revised (MOS-R) in medically complex infants
Colleen Peyton1, David Aaby2, Ryan Millman3
1Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N Michigan Ave, Suite 1100, Chicago, IL, 60611, USA; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Insights
The Motor Optimality Score-Revised (MOS-R) is a stable measure for infants hospitalized in the NICU. However, higher medical complexity in infants may lead to less stable MOS-R scores at certain thresholds.
Area of Science:
- Neonatal Development
- Pediatric Neurology
- Clinical Assessment
Background:
- The Motor Optimality Score-Revised (MOS-R) assesses infant spontaneous movement at 3-5 months.
- MOS-R is linked to neurodevelopmental outcomes in medically complex infants.
- The stability of MOS-R scores across different infant developmental ages is not well-established.
Purpose of the Study:
- To evaluate the consistency of repeated MOS-R scoring in young infants at different developmental ages.
- To determine if MOS-R scores remain stable when administered at two distinct time points.
Main Methods:
- Prospective cohort study involving 85 infants with a history of neonatal intensive care unit (NICU) hospitalization.
- Infants were tested twice with the MOS-R: between 12-13 weeks corrected age (CA) and again at 14-16 weeks CA.
- Bland Altman plots assessed score agreement, while Fisher's exact test analyzed changes over time within higher and lower medical complexity groups.
Main Results:
- High agreement was observed between repeated MOS-R scores, with negligible bias (0.058).
- Infants with higher medical complexity were more likely to shift MOS-R score groups at a cut point of 19 (p=0.008).
- This difference in score stability was not significant at MOS-R cut points of 20 or 21.
Conclusions:
- Repeated MOS-R measurements demonstrate stability in infants previously hospitalized in the NICU.
- Infants with higher medical complexity exhibited less stable MOS-R scores at specific thresholds compared to those with lower medical complexity.
Background:
The Motor Optimality Score-Revised (MOS-R) is a clinical test of infant spontaneous movement at 3-5 months of age and has been associated with neurodevelopmental outcomes in infants with medical complexity. However the stability of the MOS-R tested at different developmental ages is not yet known.
Aim:
To determine if the repeated scoring of the MOS-R remained consistent when tested at two developmental ages in young infants.
Study Design:
In this prospective cohort study, infants were tested twice with the MOS-R between 12 and 13 weeks corrected age (CA) and 14-16 weeks CA. Bland Altman Plots were used to calculate agreement between the scores. Infants were grouped as having higher or lower medical complexity. MOS-R threshold scores were analyzed to assess changes over time within each group using Fisher's exact test.
Subjects:
85 infants with history of hospitalization in a neonatal intensive care unit (NICU).
Results:
The MOS-R scores had a high agreement with negligible bias (0.058) between timepoints (95 % CI -1.10, 1.22). Using a MOS-R cut point of 19, infants with higher medical complexity were more likely to change groups between timepoints than infants with lower medical complexity (p = 0.008), but this was not significantly different using cut points of 20 or 21.
Conclusion:
The MOS-R scores were stable when measured repeatedly in infants who were hospitalized in a NICU. Infants with high medical complexity had less stable MOS-R scores using certain cut points than infants with lower medical complexity.
