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. 2021 Aug 25:9:720502.
doi: 10.3389/fped.2021.720502. eCollection 2021.

An Automated Approach for General Movement Assessment: A Pilot Study

Camilla Fontana  1 , Valeria Ottaviani  2 , Chiara Veneroni  2 , Sofia E Sforza  3 , Nicola Pesenti  3   4 , Fabio Mosca  1   3 , Odoardo Picciolini  5 , Monica Fumagalli  1   3 , Raffaele L Dellacà  2
Affiliations

An Automated Approach for General Movement Assessment: A Pilot Study

Camilla Fontana et al. Front Pediatr. .

Abstract

Objective: The objective of the study was to develop an automatic quantitative approach to identify infants with abnormal movements of the limbs at term equivalent age (TEA) compared with general movement assessment (GMA). Methods: GMA was performed at TEA by a trained operator in neonates with neurological risk. GMs were classified as normal (N) or abnormal (Ab), which included poor repertoire and cramped synchronized movements. The signals from four micro-accelerometers placed on all limbs were recorded for 10 min simultaneously. A global index (KC_index), quantifying the characteristics of individual limb movements and the coordination among the limbs, was obtained by adding normalized kurtosis of the distribution of the first principal component of the acceleration signals to the cross-correlation of the jerk for the upper and lower limbs. Results: Sixty-eight infants were studied. A KC_index cut-off of 201.5 (95% CI: 199.9-205.0) provided specificity = 0.86 and sensitivity = 0.88 in identifying infants with Ab movements. Conclusions: KC_index provides an automatic and quantitative measure that may allow the identification of infants who require further neurological evaluation.

Keywords: accelerometer; general movement assessment; infant; neurodevelopment; newborn.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Schematic representation of the setup including the four accelerometers placed on the wrists and ankles of the infants and connected to the acquisition board that stores data on an SD memory card for offline analysis and the video recording device used for offline general movement assessment (GMA).
Figure 2
Figure 2
Distribution of the KC_Index for normal (N), abnormal (Ab = CS+PR), poor repertoire (PR), and cramped synchronized (CS) subjects. The identified KC_Index cutoff is indicated by the dashed line. Comparison between N, PR, and CS groups: p < 0.001. N vs. PR, p < 0.001; N vs. CS, p < 0.001; PR vs. CS, p = 0.095, ANOVA with Tukey's HSD post-hoc test.
Figure 3
Figure 3
Receiver operating characteristic (ROC) curve analysis of KC_index and clinical GMA (normal vs. abnormal).
See this image and copyright information in PMC

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