Applying Prechtl's Assessment of General Movements for Preterm Infants Through Telemedicine

Infant, Premature Clinical Trial

Official title:

Feasibility and Reliability of Applying Prechtl's Assessment of General Movements for Preterm Infants Through Telemedicine

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03742635
• Other study ID #: 1288981
• Status: Completed
• Phase: N/A
• Start date: January 9, 2019
• Est. completion date: February 28, 2023

Study information

• Verified date: July 2023
• Source: University of California, Davis
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The investigators will implement a study to evaluate the hypothesis that applying General Movements Assessments (GMA) in a telemedicine setting with real-time scoring is feasible and comparable to scoring video recordings.

Description:

The investigators hypothesize that using telemedicine to conduct the GMA will improve early identification of risk for cerebral palsy and facilitate earlier referral and access to neurodevelopmental intervention. Preterm birth results from complex interactions of biological and socioeconomic risk factors, all of which continue to influence neurodevelopmental trajectories beyond the prenatal and neonatal period. Unfortunately many of the socioeconomic factors that contribute to increased risk of prematurity are also associated with decreased likelihood to attend appointments at high risk infant follow-up (HRIF) clinics. Early intervention has been shown to be most beneficial to infants with highest social risk. Additionally, mothers living in more rural communities tend to have higher social risk. They are often younger, more likely to be a single parent, and have lower income. Helping make follow-up more accessible and convenient for families through telemedicine and at an earlier age using the GMA has the potential to improve early identification, minimize loss to follow-up and ensure prompt referral to optimize outcomes for the most vulnerable babies in this already high-risk population.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 67
• Est. completion date: February 28, 2023
• Est. primary completion date: January 24, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A to 32 Weeks

Eligibility

Inclusion Criteria:

• All preterm infants who meet the High-Risk Infant Follow Up (HRIF) Criteria (less than 32 weeks gestational age or birth weight less than 1500 grams) who are cared for at UC Davis Medical Center

Exclusion Criteria:

• Families who are non-English speakers requiring a translator

• Families who are unable to access data-capable wireless service to participate in telemedicine visits through Zoom.

Related Conditions & MeSH terms

• Infant, Premature

Intervention

Other:
• General Movements Assessment
Prechtl's Assessment of General Movements (GMA) is a tool used in early infancy to identify infants at high risk of cerebral palsy and neurodevelopmental impairment. General movements are complex motor patterns that involve the entire body, moving fluidly in different directions through the arms, legs, and trunk with variable speed, amplitude, force and intensity. During fetal development, spontaneously generated motor patterns, including general movements, can already be observed. The GMA is a functional assessment of the maturing nervous system that takes advantage of the fact that typically developing infants will have a progression in their general movements. This pattern is characterized by a writhing pattern in the early weeks post-term, followed by the emergence of fidgety movements at 3-5 months of age.

Locations

Country	Name	City	State
United States	University of California-Davis	Sacramento	California

Sponsors (2)

Lead Sponsor	Collaborator
University of California, Davis	Children's Miracle Network

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Real-time versus video recording reliability	Intra-rater reliability of GMA (real-time versus video recording) will be assessed using the Kappa statistic.	9 months gestational age
Secondary	Video recording reliability	Inter-rater reliability of the video recording will be assessed using the Kappa statistic.	9 months gestational age
Secondary	Early referral	Number of participants referred to targeted early intervention services, indicating early recognition of neurodevelopmental disability.	9 months gestational age