title: Formal training in general movement assessment is required to effectively evaluate infants with perinatal asphyxia in outpatient settings.
abstract: OBJECTIVE
  General movement assessment (GMA) can help to identify children with a high risk of developing neurological dysfunction, such as cerebral palsy, and certified training is provided in this specialism. The aim of this study was to investigate the feasibility and reliability of using video recordings to assess GMA, in a busy Danish outpatient clinic.
  
  
  METHODS
  The study comprised 30-term infants born with perinatal asphyxia, who were video recorded at three months. They were assessed by two certified GMA observers and re-assessed two weeks later. Interobserver and intra-observer agreements were analysed using proportional agreement, and nominal kappa statistics were used to calculate 95% confidence intervals (95% CI).
  
  
  RESULTS
  We found substantial and almost perfect interobserver and intra-observer reliability. Intra-observer agreement was 0.85 (95% CI: 0.65-1.00; p < 0.0001) and 0.85 (95% CI: 0.62-1.00; p < 0.0001), and interobserver agreement was 0.71 (95% CI: 0.45-0.96; p < 0.0001) at time point one and 0.85 (95% CI: 0.63-1.00; p < 0.0001) two weeks later. All video recordings were completed within our multidisciplinary outpatient clinic without delay.
  
  
  CONCLUSIONS
  This study demonstrated the reliability of the GMA method in a busy multidisciplinary Danish paediatric outpatient setting, when assessors had been formally trained in the method and used it regularly.
authors.affiliation: Department of Physiotherapy and Neurology, Nordsjaelland University Hospital, Hilleroed, Denmark.|Department of Children and Adolescence, Nordsjaelland University Hospital, Hilleroed, Denmark.
authors.forename: Annemette K
authors.initials: AK
authors.lastname: Brown
authors.affiliation: Department of Neonatalogy, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Gorm
authors.initials: G
authors.lastname: Greisen
authors.affiliation: Department of Occupational Therapy and Physiotherapy, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Ulla
authors.initials: U
authors.lastname: Haugsted
authors.affiliation: Department of Children and Adolescence, Nordsjaelland University Hospital, Hilleroed, Denmark.
authors.forename: Finn
authors.initials: F
authors.lastname: Jonsbo
mesh_terms: D000553:Ambulatory Care / Q000592:standards; D001238:Asphyxia Neonatorum / Q000150:complications*; D005240:Feasibility Studies; D006801:Humans; D007223:Infant; D009068:Movement; D009460:Neurologic Examination / Q000379:methods*; D026741:Physical Therapy Modalities / Q000193:education; D011446:Prospective Studies; D015203:Reproducibility of Results; D014741:Video Recording
keywords: General movement assessment; Infants; Perinatal asphyxia; Reliability; Spontaneous motility