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Prechtl's Assessment of General Movements
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Prec htl’s Assessment of General Movements
Classification
Supplemental – Highly Recommended: Cerebral Palsy (CP)
Short Description of Instrument
Construct measured: Infant gross motor development
Generic vs. disease specific: Generic
Means of administration: Examiner observation
Intended respondent: Administrator.
Background: Prechtl’s Assessment of General Movements or General Movements Assessment (GMs) was developed to primarily distinguish between infants with and without motor dysfunction and predict which infants may have future motor delays with secondary aims of being used to evaluate infants overtime. Its validated in preterm birth to 4 months age term equivalent. Components of the evaluation include spontaneous infant movement and neurologic integrity.
Comments/Special Instructions
Infants spontaneous movements are recorded. The infant is not handled. The video is then watched by the examiner with scoring performed from movements observed on the video. Training is required with a certified organization. This generally requires a multi-day course.
Scoring
Scoring: Scoring depends on infant’s age. From preterm up to 6 weeks, movements are classified as normal or abnormal (poor repertoire, cramp synchronized, or chaotic). Nine to 20 weeks is considered the fidgety priod with movement classified as present, abnormal, or absent. This is interpreted using an individual trajectory score as there are no norms.
Administration Time: 10–30 minutes
Rationale/Justification
Strengths/Weaknesses: This measure does not have norms. Videotaped observation provides greater ease of reviewing scoring or having more than one examiner score. Videoing can be done by families in the infant’s home with appropriate instruction. One of only a few measures that can be used in the preterm period.
Psychometric Properties:Construct validty supported in studies of infants with and without cerebral lesions or abnormal ultrasound studies. It can discriminate between normal and abnormal movement in preterm and term infants. Intrarater and interrater reliability are excellent. Of motor outcomes tools, this has one of the greatet combinations of sensitivity and specificity for detecting atypical motor development and/or predicting cerebral palsy in early infancy.
References
Key Reference(s):
Einspieler C, Prechtl HF, Bos AF, Ferrari F, Cioni G. Prechtl’s Method on the Qualitative Assessment of General Movements in Preterm, Term and Young Infants. Clin Dev Med. No. 167. London: Mac Keith Press; 2004. 104 p.
Einspieler C, Prechtl HF. Prechtl's assessment of general movements: a diagnostic tool for the functional assessment of the young nervous system. Ment Retard Dev Disabil Res Rev. 2005;11(1):61–67.
Additional References:
Cioni G, Prechtl HF, Ferrari F, Paolicelli PB, Einspieler C, Roversi MF. Which better predicts later outcome in full-term infants: quality of general movements or neurological examination? Early Human Dev. 1997;50(1):71–85.
Cioni G, Ferrari F, Einspieler C, Paolicelli PB, Barbani MT, Prechtl HF. Comparison between observation of spontaneous movements and neurologic examination in preterm infants. J Pediatr. 1997;130(5):704–711.
Guzzetta A, Mercuri E, Rapisardi G, Ferrari F, Roversi MF, Cowan F, Rutherford M, Paolicelli PB, Einspieler C, Boldrini A, Dubowitz L, Prechtl HF, Cioni G. General movements detect early signs of hemiplegia in term infants with neonatal cerebral infarction. Neuropediatr. 2003;34(2):61–66.
Prechtl HF, Einspieler C, Cioni G, Bos AF, Ferrari F, Sontheimer D. An early marker for neurological deficits after perinatal brain lesions. Lancet. 1997;349(9062):1361–1363.
Prechtl HF, Fargel JW, Weinmann HM, Bakker HH. Postures, motility and respiration of low-risk pre-term infants. Dev Med Child Neurol. 1979;21(1):3–27.
Spittle AJ, Doyle LW, Boyd RN. A systematic review of the clinimetric properties of neuromotor assessments for preterm infants during the first year of life. Dev Med Child Neurol. 2008;50(4):254–266.
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