Okan University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Neurology, Istanbul, Turkey.
Istinye University Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey.
Pediatr Neonatol. 2022 Sep;63(5):535-541. doi: 10.1016/j.pedneo.2022.06.002. Epub 2022 Jul 19.
We aimed to compare the General Movement Assessment (GMA) and the Alberta Infant Motor Scale (AIMS) in preterm infants for the prediction of cerebral palsy (CP) and neurodevelopmental delay (NDD). Additionally, we aimed to evaluate the diagnostic compatibility of the General Movement Optimality Score (GMOS), the Motor Optimality Score (MOS), and AIMS for detecting CP and NDD.
Seventy-five preterm infants with gestational age (GA) 24-37 weeks were enrolled. Group 1 was composed of infants with 24-28 GA (n = 22); groups 2 and 3 consisted of infants with 29-32 GA weeks (n = 23) and 33-37 GA (n = 30) weeks, respectively. The infants were assessed during the writhing period, the fidgety period, and at 6-12 months of corrected age with GMOS, MOS, and AIMS, respectively.
In the writhing period, a cramped-synchronized pattern was observed in 17 (22%) infants, whereas a poor repertoire pattern was observed in 34 (45%) infants. In the fidgety period of the 63 infants, 29 (46%) presented with fidgety movements absent. The MOS and AIMS scores of the infants in group 1 were significantly lower than the other groups, which were statistically significant (p = 0.004, p˂0.001). High and positive compatibility (Kappa coefficient: 0.709; p = 0.001) was found between AIMS and GMOS scores and between AIMS and MOS scores (Kappa coefficient: 0.804; p < 0.001). In all groups, a statistically significant association was found between total GMOS scores (p = 0.003) and the presence of fidgety movements (p = 0.003). GMOS, MOS, and AIMS were found to be associated with CP and NDD (p < 0.001).
GMA is an important tool for the prediction of CP and NDD. The combined use of GMOS, MOS, and AIMS may guide the clinical practice for the valid and reliable diagnosis of CP and NDD.
我们旨在比较通用运动评估（GMA）和阿尔伯塔婴儿运动量表（AIMS）在预测脑瘫（CP）和神经发育迟缓（NDD）方面的作用。此外，我们旨在评估通用运动优化评分（GMOS）、运动优化评分（MOS）和 AIMS 的诊断兼容性，以检测 CP 和 NDD。
本研究纳入了 75 名胎龄（GA）为 24-37 周的早产儿。第 1 组由 24-28 GA 的婴儿组成（n=22）；第 2 组和第 3 组分别由 29-32 GA 周（n=23）和 33-37 GA 周（n=30）的婴儿组成。在扭体期、不安宁期和矫正年龄 6-12 个月时，分别使用 GMOS、MOS 和 AIMS 对婴儿进行评估。
在扭体期，17 名（22%）婴儿表现为紧张同步模式，34 名（45%）婴儿表现为运动模式不佳。在 63 名婴儿的不安宁期，29 名（46%）婴儿表现为不安宁运动缺失。第 1 组婴儿的 MOS 和 AIMS 评分显著低于其他组，具有统计学意义（p=0.004，p˂0.001）。AIMS 和 GMOS 评分以及 AIMS 和 MOS 评分之间具有高度和正的兼容性（Kappa 系数：0.709；p=0.001）。在所有组中，总 GMOS 评分（p=0.003）与不安宁运动的存在（p=0.003）之间均存在显著关联。GMOS、MOS 和 AIMS 与 CP 和 NDD 相关（p<0.001）。
GMA 是预测 CP 和 NDD 的重要工具。GMOS、MOS 和 AIMS 的联合使用可能为 CP 和 NDD 的有效和可靠诊断提供指导。
