Kwong Amanda K-L, Boyd Roslyn N, Chatfield Mark D, Ware Robert S, Colditz Paul B, George Joanne M
Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4101, Australia.
Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia.
J Clin Med. 2022 Mar 25;11(7):1833. doi: 10.3390/jcm11071833.
The Motor Optimality Score, revised (MOS-R) is an extension of the Prechtl General Movements Assessment. This study aims to determine the relationship between MOS-R and 2-year neurodevelopmental outcomes in a cohort of 169 infants born very preterm (<31 weeks’ gestational age), and to examine the predictive validity of the MOS-R at 3−4 months’ corrected age (CA) above perinatal variables associated with poor outcomes, including Prechtl fidgety movements. Development at 2 years’ CA was assessed using Bayley Scales of Infant and Toddler Development, Third edition (Bayley-III) (motor/cognitive impairment: Bayley-III ≤ 85) and Neurological, Sensory, Motor, Developmental Assessment (NSMDA) (neurosensory motor impairment: NSMDA ≥ 12). Cerebral palsy (CP) was classified at 2 years as definite or clinical. The MOS-R was related to 2-year outcomes: Bayley-III motor (BMOS-R = 1.24 95% confidence interval (0.78, 1.70)), cognitive (BMOS-R = 0.91 (0.48, 1.35)), NSMDA scores (BMOS-R = −0.34 (−0.42, −0.25)), definite CP (odds ratio [OR] 0.67 (0.53, 0.86)), clinical CP (OR 0.74 (0.66, 0.83)) for each 1-point increase in MOS-R. MOS-R ≤ 23 predicted motor (sensitivity 78% (60−91%); specificity 63% (54−72%)) and neurosensory motor impairment (sensitivity 86% (64−97%); specificity 59% (51−68%)). The MOS-R is strongly related to CP and motor and cognitive delay at 2 years and is a good predictor of motor and neurosensory motor impairment.
修订后的运动最优性评分（MOS-R）是普雷赫特一般运动评估的扩展。本研究旨在确定169例极早产儿（胎龄<31周）队列中MOS-R与2岁神经发育结局之间的关系，并检验校正年龄（CA）为3 - 4个月时MOS-R相对于与不良结局相关的围产期变量（包括普雷赫特不安运动）的预测效度。使用贝利婴幼儿发展量表第三版（贝利-III）（运动/认知障碍：贝利-III≤85）和神经、感觉、运动、发育评估（NSMDA）（神经感觉运动障碍：NSMDA≥12）评估2岁校正年龄时的发育情况。2岁时将脑瘫（CP）分类为确诊或临床诊断。MOS-R与2岁结局相关：MOS-R每增加1分，贝利-III运动评分（BMOS-R = 1.24，95%置信区间（0.78，1.70））、认知评分（BMOS-R = 0.91（0.48，1.35））、NSMDA评分（BMOS-R = -0.34（-0.42，-0.25））、确诊CP（优势比[OR] 0.67（0.53，0.86））、临床CP（OR 0.74（0.66，0.83））。MOS-R≤23预测运动障碍（敏感性78%（60 - 91%）；特异性63%（54 - 72%））和神经感觉运动障碍（敏感性86%（64 - 97%）；特异性59%（51 - 68%））。MOS-R与2岁时的CP以及运动和认知延迟密切相关，是运动和神经感觉运动障碍的良好预测指标。
