Ricci Eileen, Einspieler Christa, Craig Alexa K
a Department of Physical Therapy , University of New England , Portland , ME.
b Institute of Physiology , Medical University of Graz , Graz , Austria.
Phys Occup Ther Pediatr. 2018 Aug;38(3):269-279. doi: 10.1080/01942638.2017.1395380. Epub 2017 Nov 16.
To pilot the practicality of administering the Prechtl General Movements Assessment of infants (GMA) in the Neonatal Intensive Care Unit (NICU) setting and at home to infants at risk for developing cerebral palsy (CP). Additional aims included assessing inter-rater reliability and comparing GMA predictions to AIMS motor assessment at 12 months.
12 "at risk" infants were recruited by convenience sample. Video recordings were obtained in the NICU and provided by parents after discharge. These recordings were analyzed by two trained examiners to assess infants in the writhing and fidgety movement periods (birth to 16 weeks). Infants were assessed at 12 months corrected age using the Alberta Infant Motor Scale (AIMS) with scores lower than 5th centile considered a motor delay.
33 of 42 videos (79%) were of sufficient quality to permit interpretation and there was 97% inter-examiner subcategory agreement and 100% overall developmental trajectory (abnormal/normal) agreement. The GMA demonstrated a sensitivity of 60% and a specificity of 100% in predicting AIMS score (age appropriate or delayed).
Clinical feasibility of GMA obtained in the NICU was demonstrated however feasibility of parents providing video samples after discharge was not demonstrated, indicating a need for a parent-friendly method.
在新生儿重症监护病房（NICU）环境及家中，对有患脑瘫（CP）风险的婴儿进行普雷茨尔婴儿全身运动评估（GMA），以试行其实用性。其他目的包括评估评分者间信度，并将GMA预测结果与12个月时的AIMS运动评估结果进行比较。
通过便利抽样招募了12名“有风险”的婴儿。在NICU获取视频记录，并在婴儿出院后由家长提供。由两名经过培训的检查人员对这些记录进行分析，以评估处于扭动和不安运动期（出生至16周）的婴儿。使用艾伯塔婴儿运动量表（AIMS）对婴儿进行12个月矫正年龄评估，得分低于第5百分位数被视为运动发育迟缓。
42段视频中有33段（79%）质量足以进行解读，检查人员间亚类一致性为97%，总体发育轨迹（异常/正常）一致性为100%。GMA在预测AIMS评分（年龄适宜或延迟）方面的敏感性为60%，特异性为100%。
已证明在NICU进行GMA的临床可行性，但未证明家长在婴儿出院后提供视频样本的可行性，这表明需要一种对家长友好的方法。
