【Objective】 To study the predictive value of a single qualitive assessment of general movements(GMs) in fidgety period(fidgety movements) for high risk infants’ abnormal motor developmental outcome. 【Methods】 183...【Objective】 To study the predictive value of a single qualitive assessment of general movements(GMs) in fidgety period(fidgety movements) for high risk infants’ abnormal motor developmental outcome. 【Methods】 183 high risk infants were accepted a single or multiple GMs assessment in fidgety movements period.Motor developmental outcome was defined by clinical diagnosis and Peabody Motor Develoment Scale assessment after 12-month-age(corrected age of premature infants).The predictive validities were compared between the single assessment group and the multiple assessment group. 【Results】 In the single assessment group,the predictive validity of cerebral palsy was as follows: sensitivity 100%,specificity 93.8%,positive predictive value 87.8%,and negative predictive value 100%;while the predictive validity of abormal motor developmental outcome(cerebral palsy and motor retardation) was as follows: sensitivity 74.0%,specificity 93.9%,positive predictive value 90.2%,and negative predictive value 82.7%.In the multiple assessment group,the predictive validity of cerebral palsy was as follows: sensitivity 85.0%,specificity 89.4%,positive predictive value 77.3%,and negative predictive value 93.3%;while the predictive validity of abormal motor developmental outcome was as follows: sensitivity 77.8%,specificity 97.5%,positive predictive value 95.5%,and negative predictive value 86.7%. 【Conclusions】 The study found a high relationship between a single fidgety movements assessment and the infants’ motor developmental outcome(especially cerebral palsy).Further studies need to be done in general population.展开更多
目的比较全身运动质量评估(General movements assessment,GMs)不安运动阶段和Gesell发育量表(Gesell Developmental Test Scales,GDS)对早产儿运动发育结局的预测效度,及对两种评估方法和发育结局的一致性检测。方法对2011年6月-2013年...目的比较全身运动质量评估(General movements assessment,GMs)不安运动阶段和Gesell发育量表(Gesell Developmental Test Scales,GDS)对早产儿运动发育结局的预测效度,及对两种评估方法和发育结局的一致性检测。方法对2011年6月-2013年6月共226例在本院儿童保健科随访的早产儿,在纠正5个月内采用GMs和GDS进行评估,在纠正12个月时临床诊断是否为脑瘫,并使用Peabody运动发育量表(Peabody Development Motor Scale 2,PDMS-2)确定其运动发育结局。对比分析两种评估方法的预测效度(包括敏感度、特异度、阳性预测值和阴性预测值),及与发育结局的相关性。结果 226例早产儿发育结局中运动发育正常176例,运动发育迟缓22例,脑瘫28例。不安运动阶段评估结果为正常者168例,异常为58例;GDS评估结果为正常者140例,异常为86例。不安运动及GDS预测脑瘫敏感度92.9%、71.4%,特异度83.8%、66.7%,阳性预测值44.8%、23.3%,阴性预测值98.8%、94.3%。不安运动及GDS预测运动发育结局敏感度88.0%、68.0%,特异度92.0%、70.4%,阳性预测值75.9%、39.5%,阴性预测值96.4%、88.6%。GDS和PDMS-2的一致性检验Kappa值0.306,P<0.05,GMs和PDMS-2评估的一致性检验Kappa值0.757,P<0.05,提示GMs、GDS对运动发育预测与发育结局均具有良好的一致性,GMs中不安运动阶段的预测与发育结局的一致性更高。结论 GMs的不安运动阶段能够超早期预测脑瘫等不良运动发育结局,在预测预后方面要优于GDS,能更早期的做出预测。展开更多
文摘【Objective】 To study the predictive value of a single qualitive assessment of general movements(GMs) in fidgety period(fidgety movements) for high risk infants’ abnormal motor developmental outcome. 【Methods】 183 high risk infants were accepted a single or multiple GMs assessment in fidgety movements period.Motor developmental outcome was defined by clinical diagnosis and Peabody Motor Develoment Scale assessment after 12-month-age(corrected age of premature infants).The predictive validities were compared between the single assessment group and the multiple assessment group. 【Results】 In the single assessment group,the predictive validity of cerebral palsy was as follows: sensitivity 100%,specificity 93.8%,positive predictive value 87.8%,and negative predictive value 100%;while the predictive validity of abormal motor developmental outcome(cerebral palsy and motor retardation) was as follows: sensitivity 74.0%,specificity 93.9%,positive predictive value 90.2%,and negative predictive value 82.7%.In the multiple assessment group,the predictive validity of cerebral palsy was as follows: sensitivity 85.0%,specificity 89.4%,positive predictive value 77.3%,and negative predictive value 93.3%;while the predictive validity of abormal motor developmental outcome was as follows: sensitivity 77.8%,specificity 97.5%,positive predictive value 95.5%,and negative predictive value 86.7%. 【Conclusions】 The study found a high relationship between a single fidgety movements assessment and the infants’ motor developmental outcome(especially cerebral palsy).Further studies need to be done in general population.
文摘目的比较全身运动质量评估(General movements assessment,GMs)不安运动阶段和Gesell发育量表(Gesell Developmental Test Scales,GDS)对早产儿运动发育结局的预测效度,及对两种评估方法和发育结局的一致性检测。方法对2011年6月-2013年6月共226例在本院儿童保健科随访的早产儿,在纠正5个月内采用GMs和GDS进行评估,在纠正12个月时临床诊断是否为脑瘫,并使用Peabody运动发育量表(Peabody Development Motor Scale 2,PDMS-2)确定其运动发育结局。对比分析两种评估方法的预测效度(包括敏感度、特异度、阳性预测值和阴性预测值),及与发育结局的相关性。结果 226例早产儿发育结局中运动发育正常176例,运动发育迟缓22例,脑瘫28例。不安运动阶段评估结果为正常者168例,异常为58例;GDS评估结果为正常者140例,异常为86例。不安运动及GDS预测脑瘫敏感度92.9%、71.4%,特异度83.8%、66.7%,阳性预测值44.8%、23.3%,阴性预测值98.8%、94.3%。不安运动及GDS预测运动发育结局敏感度88.0%、68.0%,特异度92.0%、70.4%,阳性预测值75.9%、39.5%,阴性预测值96.4%、88.6%。GDS和PDMS-2的一致性检验Kappa值0.306,P<0.05,GMs和PDMS-2评估的一致性检验Kappa值0.757,P<0.05,提示GMs、GDS对运动发育预测与发育结局均具有良好的一致性,GMs中不安运动阶段的预测与发育结局的一致性更高。结论 GMs的不安运动阶段能够超早期预测脑瘫等不良运动发育结局,在预测预后方面要优于GDS,能更早期的做出预测。
