The predictive validity of general movements - A systematic review

Background: The assessment of general movements (GMs), introduced by Professor Heinz Prechtl and his co-workers in the early 1990s, may offer the opportunity to identify infants with neurological deficits at a very early age. Aim: The aim of this review was to systematically assess available data in order to determine the evidence of general movements in early infancy to predict the neuro-developmental outcome in 12- and 24-month-old infants. Method: A systematic literature search was performed using the following computerised databases: Medline, CINAHL, Pedro, The Cochrane Library, Science Direct, ProQuest: Science Journals, Medical Library & Social Science journals, journals @ OVID and PsycINFO. The following key terms were used: general movements, spontaneous motor activity, nervous system diseases [MeSH] and developmental disabilities [MeSH]. A comprehensive author search was also conducted. The methodological quality of eligible studies was critically appraised by two reviewers using the Critical Review Form for Quantitative Studies of the McMaster University Occupational Therapy Evidence-Based Practice Research Group. Results: Seventeen studies were eligible for this review. The average score of the studies was 8.82 (73.5%) from a total of 12 (SD 0.73). Fifteen of the 17 studies found a high relationship (sensitivity >= 92%; specificity >= 82%; p<0.01) between the quality of general movements at 8-20 weeks postterm (fidgety movements' period) and the infants' neuro-developmental outcome. Conclusion: The results of this systematic review indicate that the qualitative assessment of general movements, especially during the fidgety movements' period, can be used as a prognostic tool to identify infants with neuro-developmental disabilities. (C) 2008 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.