General movement assessment: Predicting cerebral palsy in clinical practise

Adde, Lars; Rygg, Marite; Lossius, Kristin; Øberg, Gunn Kristin; Støen, Ragnhild

doi:10.1016/j.earlhumdev.2006.03.005

« Previous Next »Early Human Development
Volume 83, Issue 1 , Pages 13-18, January 2007

General movement assessment: Predicting cerebral palsy in clinical practise

Lars Adde
- Department of Laboratory Medicine, Children and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Norway
- Department of Physiotherapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Corresponding author. Olav Kyrres gt 11, 7491 Trondheim, Norway. Tel.: +47 72 57 46 54, +47 91897615; fax: +47 73 86 73 22.
Marite Rygg
- Department of Laboratory Medicine, Children and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Norway
- Department of Paediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
Kristin Lossius
- Health and Medical Department, Eastern Norway Regional Health Authority, Hamar, Norway
Gunn Kristin Øberg
- The Faculty of Medicine, Institute of Clinical Medicine, Department of Nursing and Health Sciences, University of Tromsø, Norway
- Department of Physiotherapy, University Hospital of North Norway, Tromsø, Norway
Ragnhild Støen
- Neonatal Intensive Care Unit, Department of Paediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Present address: Division of Neonatology, Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.

Accepted 16 March 2006.

Abstract

Objective

The general movement assessment (GMA) method is used to predict cerebral palsy (CP) in infants with high risk of developing neurological dysfunctions. Most of the work on GMA has been performed from the same group of researchers. The aim of this study was to demonstrate to what extent GMA predicted CP in our hands.

Method

A prospective study was performed using the Prechtl classification system for GMA in the fidgety period to predict later cerebral palsy. The study population consisted of 74 term and preterm infants at low and high risk of developing neurological dysfunction. The absence or presence of CP was reported at 23 months median-corrected age by the child's physician and the parents.

Results

The GMA identified all 10 infants that later were classified as having CP. GMA also identified all the infants that did not develop CP except for one infant with abnormal GMA and no CP. Three infants had uncertain CP status at follow-up. The sensitivity of GMA with regard to later CP was 100% with 95% CI (0.73, 1.00) and the specificity was 98% with 95% CI (0.91, 0.99) when the three uncertain cases were excluded.

Conclusion

Our study indicates that the GMA used in a clinical setting strongly predicts the development of CP. The work supports the results of previous studies and contributes to the validation of GMA. The qualitative nature of this method may be a problem for inexperienced observers. Larger clinical studies are needed.

Keywords: General movement assessment, Cerebral palsy, Motor development, Neurological examination