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The concurrent validity of assessment of general movements with traditional neonatal neurobehavioral examination in preterm period
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WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS633–eS832
which supports the clinical use of TC for COPD. Further RCTs are needed until we can establish whether TC is more effective than other exercise in patients with COPD. Future trials should be reported following the CONSORT guidelines, and data should be analyzed according to intention to treat principles. Moreover, systematic data collection at short, mid, and long-term follow-up is essential. Keywords: Tai Chi; Chronic obstructive pulmonary disease; Systematic review Funding acknowledgements: State Administration of Traditional Chinese Medicine of the People’s Republic of China (ZYYXXX-06). Ethics approval: Ethics approval was not required, but we have registered. (PROSPERO International prospective register of systematic reviews, number 2013:CRD42013005142). http://dx.doi.org/10.1016/j.physio.2015.03.3525 Research Report Poster Presentation Number: RR-PO-16-16-Sun Sunday 3 May 2015 13:00 Exhibit halls 401–403 THE CONCURRENT VALIDITY OF ASSESSMENT OF GENERAL MOVEMENTS WITH TRADITIONAL NEONATAL NEUROBEHAVIORAL EXAMINATION IN PRETERM PERIOD P.J. Jian, B.J. Hsue, M.P. Rau, Y.C. Ko National Cheng Kung University, Physical Therapy, Tainan, Taiwan Background: General movements are spontaneous movements emerging at 9 to 10 weeks postmenstrual age and possibly generated endogenously by spinal cord and brainstem. The infants born with prematurity, low birth weight or other medical problems such as hypoxic, brain injury and so on have higher risk to develop delay. The assessment of general movements (GMsA) proposed by Prechtl provides the advantages of being non-invasive, and requiring minimal handling and video-recording, so it has been widely used in many countries. However, the findings of previous studies on concurrent validity during preterm period were inconsistent. Purpose: To determine the concurrent validity of GMsA by determining its relationship with Morgan Neonatal Neurobehavioral examination (MNNE) on premature infants with high risk for developmental delay in preterm period. Methods: A total of 29 premature infants who were possibly associated with low birth weight, Apgar score less than 7 at first 1 or 5 minutes after birth, abnormal findings of brain images, or other medical problems, were recruited. Before gestational age (GA) of 37 weeks, the infant’s MNNE was administered and the spontaneous movements were collected for 1 hour using two digital camcorders. The quality of GMsA was scored with categorical (normal, poor repertoire,
chaotic, and cramped-synchronized) and dichotomous (normal, abnormal) first, and then consensus scores were reached via open-discussion by the raters. Percentage of agreement and Cramer’s V correlation coefficients were used to determine the correlation between GMsA and MNNEs. Statistical significance level was p < 0.05. Results: A total of 29 recordings were used to determine the relationship between GMsA scores and MNNE. The GA of the infants was 35.00 ± 1.08 weeks. The scores of MNNE were 50.43 ± 7.47, and 17 of 29 participants were diagnosed with normal and 12 of them with either poor repertoire or chaotic by GMsA. The percentage of agreement between GMsA and MNNE was 51.7%; low but no significant correlation was found between the GMsA and MNNE (Cramer’s V = 0.16; p = 0.654). Conclusion(s): The low correlation between GMsA with MNNE found in this study was probably because of the differences in the content of the two assessments. MNNE examined the tone and motor pattern, reflexes and behavioral responses, so the results could be affected by the instable performance and behavioral state of the infants. This may be also one of the reasons why the previous studies on MNNE were limited. As compared to MNNE, GMsA is non-invasive and requires no physical contact, which is more suitable for the fragile and sensitive premature infants. However, the low correlation between MNNE and GMsA suggests that they are not able to replace each other. Implications: GMsA has also been proved to be able to reflect the condition of the brain by observing the quality of GMs, but the predictive validity is lower in preterm period than fidgety period. It may be more appropriate to use GMsA in conjunction with other examinations (e.g. MNNE) in preterm period to detect the possible developmental problems in high risk infants. Keywords: General movements; Concurrent validity; Premature Funding acknowledgements: Partial support from National Health Research Institute and Ministry of Science and Technology of Taiwan. Ethics approval: Institutional Review Board for Human Experiment and Ethics of National Cheng Kung University Hospital in Taiwan. http://dx.doi.org/10.1016/j.physio.2015.03.3526
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS633–eS832
which supports the clinical use of TC for COPD. Further RCTs are needed until we can establish whether TC is more effective than other exercise in patients with COPD. Future trials should be reported following the CONSORT guidelines, and data should be analyzed according to intention to treat principles. Moreover, systematic data collection at short, mid, and long-term follow-up is essential. Keywords: Tai Chi; Chronic obstructive pulmonary disease; Systematic review Funding acknowledgements: State Administration of Traditional Chinese Medicine of the People’s Republic of China (ZYYXXX-06). Ethics approval: Ethics approval was not required, but we have registered. (PROSPERO International prospective register of systematic reviews, number 2013:CRD42013005142). http://dx.doi.org/10.1016/j.physio.2015.03.3525 Research Report Poster Presentation Number: RR-PO-16-16-Sun Sunday 3 May 2015 13:00 Exhibit halls 401–403 THE CONCURRENT VALIDITY OF ASSESSMENT OF GENERAL MOVEMENTS WITH TRADITIONAL NEONATAL NEUROBEHAVIORAL EXAMINATION IN PRETERM PERIOD P.J. Jian, B.J. Hsue, M.P. Rau, Y.C. Ko National Cheng Kung University, Physical Therapy, Tainan, Taiwan Background: General movements are spontaneous movements emerging at 9 to 10 weeks postmenstrual age and possibly generated endogenously by spinal cord and brainstem. The infants born with prematurity, low birth weight or other medical problems such as hypoxic, brain injury and so on have higher risk to develop delay. The assessment of general movements (GMsA) proposed by Prechtl provides the advantages of being non-invasive, and requiring minimal handling and video-recording, so it has been widely used in many countries. However, the findings of previous studies on concurrent validity during preterm period were inconsistent. Purpose: To determine the concurrent validity of GMsA by determining its relationship with Morgan Neonatal Neurobehavioral examination (MNNE) on premature infants with high risk for developmental delay in preterm period. Methods: A total of 29 premature infants who were possibly associated with low birth weight, Apgar score less than 7 at first 1 or 5 minutes after birth, abnormal findings of brain images, or other medical problems, were recruited. Before gestational age (GA) of 37 weeks, the infant’s MNNE was administered and the spontaneous movements were collected for 1 hour using two digital camcorders. The quality of GMsA was scored with categorical (normal, poor repertoire,
chaotic, and cramped-synchronized) and dichotomous (normal, abnormal) first, and then consensus scores were reached via open-discussion by the raters. Percentage of agreement and Cramer’s V correlation coefficients were used to determine the correlation between GMsA and MNNEs. Statistical significance level was p < 0.05. Results: A total of 29 recordings were used to determine the relationship between GMsA scores and MNNE. The GA of the infants was 35.00 ± 1.08 weeks. The scores of MNNE were 50.43 ± 7.47, and 17 of 29 participants were diagnosed with normal and 12 of them with either poor repertoire or chaotic by GMsA. The percentage of agreement between GMsA and MNNE was 51.7%; low but no significant correlation was found between the GMsA and MNNE (Cramer’s V = 0.16; p = 0.654). Conclusion(s): The low correlation between GMsA with MNNE found in this study was probably because of the differences in the content of the two assessments. MNNE examined the tone and motor pattern, reflexes and behavioral responses, so the results could be affected by the instable performance and behavioral state of the infants. This may be also one of the reasons why the previous studies on MNNE were limited. As compared to MNNE, GMsA is non-invasive and requires no physical contact, which is more suitable for the fragile and sensitive premature infants. However, the low correlation between MNNE and GMsA suggests that they are not able to replace each other. Implications: GMsA has also been proved to be able to reflect the condition of the brain by observing the quality of GMs, but the predictive validity is lower in preterm period than fidgety period. It may be more appropriate to use GMsA in conjunction with other examinations (e.g. MNNE) in preterm period to detect the possible developmental problems in high risk infants. Keywords: General movements; Concurrent validity; Premature Funding acknowledgements: Partial support from National Health Research Institute and Ministry of Science and Technology of Taiwan. Ethics approval: Institutional Review Board for Human Experiment and Ethics of National Cheng Kung University Hospital in Taiwan. http://dx.doi.org/10.1016/j.physio.2015.03.3526