Does the assessment of general movements without video observation reliably predict neurological outcome?
OBJECTIVE
To assess the clinical value of a modified version, not employing video recording, of Precthl's method on the qualitative assessment of general movements (GMs) in preterm, term and young infants at neurological risk.


METHODS
One-hundred and fifteen infants consecutively enrolled in our follow-up program were selected for the study (103 preterm and 12 term infants). While being video recorded, each infant's spontaneous motor activity was directly observed and documented using a written proforma. An evaluation of the video was later performed by a different assessor blind to the infant's clinical history.


RESULTS
The correlation between the two techniques was significant both at writhing age (birth to 6 weeks post-term age) and at fidgety age (9-15 weeks post-term age). Both methods showed a very high sensitivity for the prediction of cerebral palsy, as no false negatives were observed. The direct assessment showed a lower specificity, particularly during the writhing period.


CONCLUSIONS
These results support the use of the direct assessment of GMs when the full application of the standard video observation cannot be routinely applied, restraining the use of video recordings to the abnormal or doubtful cases. This may facilitate the wished integration of the assessment of spontaneous motility into more general protocols of neurological examination and into clinical follow-up programs.
Guzzetta
Andrea
A
Department of Developmental Neuroscience, Stella Maris Scientific Institute, Via dei Giacinti, 2, I 56018 Calambrone, Pisa, Italy. a.guzzetta@inpe.unipi.it
Belmonti
Vittorio
V
Battini
Roberta
R
Boldrini
Antonio
A
Paolicelli
Paola Bruna
PB
Cioni
Giovanni
G
D005069:Evaluation Studies as Topic; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D008297:Male; D009068:Movement / Q000502:physiology*; D009460:Neurologic Examination / Q000379:methods*; D019370:Observation; D017063:Outcome Assessment, Health Care / Q000592:standards*; D011237:Predictive Value of Tests; D011247:Pregnancy; D012680:Sensitivity and Specificity; D014741:Video Recording