Montgomery C, Johansen K, Lucas S, Strömberg B, Persson K. The Structured Observation of Motor Performance in Infants can detect cerebral palsy early in neonatal intensive care recipients.
Early Hum Dev 2017;
113:31-39. [PMID:
28728014 DOI:
10.1016/j.earlhumdev.2017.07.009]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/23/2017] [Accepted: 07/02/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND
The detection of motor problems in infancy requires a detailed assessment method that measures both the infants' level of motor development and movement quality.
AIMS
To evaluate the ability of the Structured Observation of Motor Performance in Infants (SOMP-I) to detect cerebral palsy (CP) in neonatal intensive care recipients.
STUDY DESIGN
Prospective cohort study analyzed retrospectively.
SUBJECTS
212 (girls: 96) neonatal intensive care recipients (mean gestational age 34weeks, range: 23-43). Twenty infants were diagnosed with CP.
OUTCOME MEASURES
The infants were assessed using SOMP-I at 2, 4, 6 and 10months' corrected age. Accuracy measures were calculated for level of motor development, quality of motor performance and a combination of the two to detect CP at single and repeated assessments.
RESULTS
At 2months, 17 of 20 infants with CP were detected, giving a sensitivity of 85% (95% CI 62-97%) and a specificity of 48% (95% CI 40-55%), while the negative likelihood ratio was 0.3 (95% CI 0.1-0.9) and the positive likelihood ratio was 1.6 (95% CI 1.3-2.0). At 6months all infants with CP were detected using SOMP-I, and all infants had repeatedly been assessed outside the cut-offs. Specificity was generally lower for all assessment ages, however, for repeated assessments sensitivity reached 90% (95% CI 68-99%) and specificity 85% (95% CI 79-90%).
CONCLUSIONS
SOMP-I is sensitive for detecting CP early, but using the chosen cut-off can lead to false positives for CP. Assessing level and quality in combination and at repeated assessments improved predictive ability.
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