Montgomery Cecilia, Johansen Kine, Lucas Steven, Strömberg Bo, Persson Kristina
Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala University, Sweden.
Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala University, Sweden.
Early Hum Dev. 2017 Oct;113:31-39. doi: 10.1016/j.earlhumdev.2017.07.009. Epub 2017 Jul 17.
The detection of motor problems in infancy requires a detailed assessment method that measures both the infants' level of motor development and movement quality.
To evaluate the ability of the Structured Observation of Motor Performance in Infants (SOMP-I) to detect cerebral palsy (CP) in neonatal intensive care recipients.
Prospective cohort study analyzed retrospectively.
212 (girls: 96) neonatal intensive care recipients (mean gestational age 34weeks, range: 23-43). Twenty infants were diagnosed with CP.
The infants were assessed using SOMP-I at 2, 4, 6 and 10months' corrected age. Accuracy measures were calculated for level of motor development, quality of motor performance and a combination of the two to detect CP at single and repeated assessments.
At 2months, 17 of 20 infants with CP were detected, giving a sensitivity of 85% (95% CI 62-97%) and a specificity of 48% (95% CI 40-55%), while the negative likelihood ratio was 0.3 (95% CI 0.1-0.9) and the positive likelihood ratio was 1.6 (95% CI 1.3-2.0). At 6months all infants with CP were detected using SOMP-I, and all infants had repeatedly been assessed outside the cut-offs. Specificity was generally lower for all assessment ages, however, for repeated assessments sensitivity reached 90% (95% CI 68-99%) and specificity 85% (95% CI 79-90%).
SOMP-I is sensitive for detecting CP early, but using the chosen cut-off can lead to false positives for CP. Assessing level and quality in combination and at repeated assessments improved predictive ability.
婴儿期运动问题的检测需要一种详细的评估方法，该方法能够测量婴儿的运动发育水平和运动质量。
评估婴儿运动表现结构化观察法（SOMP-I）在新生儿重症监护患儿中检测脑瘫（CP）的能力。
前瞻性队列研究，进行回顾性分析。
212名（女孩96名）新生儿重症监护患儿（平均胎龄34周，范围：23 - 43周）。20名婴儿被诊断为脑瘫。
在矫正年龄2个月、4个月、6个月和10个月时，使用SOMP-I对婴儿进行评估。计算运动发育水平、运动表现质量以及两者结合在单次和重复评估中检测脑瘫的准确性指标。
在2个月时，20名脑瘫婴儿中有17名被检测出，灵敏度为85%（95%可信区间62 - 97%），特异度为48%（95%可信区间40 - 55%），阴性似然比为0.3（95%可信区间0.1 - 0.9），阳性似然比为1.6（95%可信区间1.3 - 2.0）。在6个月时，使用SOMP-I检测出了所有脑瘫婴儿，并且所有婴儿均在临界值之外进行了重复评估。然而，所有评估年龄的特异度普遍较低，对于重复评估，灵敏度达到90%（95%可信区间68 - 99%），特异度为85%（95%可信区间79 - 90%）。
SOMP-I对早期检测脑瘫敏感，但使用选定的临界值可能导致脑瘫的假阳性结果。结合水平和质量并进行重复评估可提高预测能力。
