Implementation of remote General Movement Assessment using the In-motion instructions in a high-risk Norwegian cohort.

Lars Adde, Toril Fjørtoft, Gunfrid Vinje Størvold, Per Gunnar Sandstrøm, Frank Piegsa, Randi Lade, Kristine Hermansen Grunewaldt, Ragnhild Støen, Beate Horsberg Eriksen, Kristin Bjørnstad Åberg, Siril Osland
Purpose:

The aim of this study was to implement home- and local hospital-based filming of GMs for remote expertbased General Movement Assessment (GMA) in follow-up programs in the Central Norway Regional Health Authority. Secondary objectives was to evaluate the proportion of hospital films and family films performed in a Norwegian high-risk infant cohort that complied with standards for GMA, as well as parents’ experiences in filming at home. 

We hypothesized that more than 80% of families returned home videos that correctly complied with GMA standards and that parents were not more stressed performing home videos.

Methods:

This knowledge translational study used a prospective cohort design including participants referred to neurodevelopmental follow-up across three sites in the Central Norway Regional Health Authority. Two home films of the fidgety type of general movements were collected between 12+1–14+6 and 15+1–17+6 weeks after term by parents. An additional film was collected at the hospital between 12+1 and 17+6 weeks after term. The instructional guide for all filming was the In-Motion App standards. Videos were transferred to a remote GMA team and classified as either“GMA scorable” or “GMA not scorable” based on Prechtl’s GMA standards. Parents responded to an online survey using a 5-point Likert scale to collect information about their perspectives, experiences, and possible worries by filming at home.

Results:

One-hundred-and-two infants from 95 families participated. Ninety-two (96.8%) families transferred 177 home-based videos. Eighty-four (92%) of these had 95 videos taken in their local hospital. All 177 home-videos were “GMA scorable” and three (3,1%) out of 95 hospital-based videos were classifed as“GMA not scorable”. Eight families did not respond to the survey and two families did not receive the survey due to a technical error. Seventy-eight (91.7%) respondents agreed or strongly agreed that it was easy to perform home filming and five (5.9%) agreed that they were more worried about their child`s development after filming at home. Almost 80% of respondents agreed that a video for GMA can be taken at home instead of in hospital.

Conclusion(s):

This study strengthens the clinical implementation of home filming by parents and remote GMA for early detection of CP in high-risk follow-up programs. The implementation of remote GMA has the potential to facilitate early intervention to improve function in children with CP in line with international recommendations.

Implications:

These results contributes to equal access to GMA independent of travel distances and local GMA competence. The promising findings from this study implies that similar remote GMA might be possible to implement also in other hospital based settings.

Funding acknowledgements:
The Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology (SO-ID: 24239).
Keywords:
Cerebral palsy
Early detection
General movement assessment
Primary topic:
Paediatrics: cerebral palsy
Second topic:
Research methodology, knowledge translation and implementation science
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Regional committee for medical and health research ethics in Norway. Study registration in ClinicalTrials.gov Protocol Record ID: NCT04287166.
Provide the ethics approval number:
62240
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
Yes

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