Prechtl's method to assess general movements: Inter-rater reliability during the preterm period

Area of Science:

• Neonatal neurology
• Developmental pediatrics
• Movement analysis

Background:

• Prechtl's method (GMA) is a validated tool for assessing the young nervous system's functional status.
• GMA involves global and detailed assessments of general movements (GMs), crucial for early detection of neurological abnormalities.
• Reliability data for GMA in the preterm population are limited, necessitating further investigation.

Purpose of the Study:

• To evaluate the inter-rater reliability of both global and detailed assessments of the preterm writhing general movements assessment (GMA).
• To determine the reliability of classifying general movements as normal or abnormal in preterm infants.
• To assess the reliability of the general movements optimality score (GMOS) using preterm videos.

Main Methods:

• Sixty-nine preterm infants (<37 weeks gestational age) were included.
• Raters were organized into five pairs and assessed infant GMs from videos.
• Gwet's AC1 and Intraclass Correlation Coefficient (ICC) were used to calculate inter-rater reliability for GMs classification and GMOS, respectively.

Main Results:

• The global assessment demonstrated substantial reliability (AC1 = 0.84) for binary GMs classification and moderate reliability (AC1 = 0.67) for classification with abnormal subcategories.
• The detailed assessment showed good reliability (ICC = 0.72) for the general movements optimality score (GMOS).

Conclusions:

• The study found high and substantial inter-rater reliability for the global GMA and good reliability for the detailed GMA in preterm infants.
• Small sample size limited the precision of reliability estimates.
• Areas like neck/trunk assessment and specific movement patterns may challenge preterm GMA reliability, highlighting the need for rater training and further clinical research.