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. 2024 Mar 1;14(3):e080063.
doi: 10.1136/bmjopen-2023-080063.

NeuroMotion smartphone application for remote General Movements Assessment: a feasibility study in Nepal

Antti Juhani Kukka  1   2 , Heléne E K Sundelin  3   4 , Omkar Basnet  5 , Prajwal Paudel  6 , Kalpana Upadhyay Subedi  6 , Katarina Svensson  7 , Nick Brown  8   2 , Helena Litorp  8   9 , Rejina Gurung  8   5 , Pratiksha Bhattarai  5 , Johan Wrammert  8 , Ashish Kc  8   10
Affiliations

NeuroMotion smartphone application for remote General Movements Assessment: a feasibility study in Nepal

Antti Juhani Kukka et al. BMJ Open. .

Abstract

Objectives: To evaluate the feasibility of using the NeuroMotion smartphone application for remote General Movements Assessment for screening infants for cerebral palsy in Kathmandu, Nepal.

Method: Thirty-one term-born infants at risk of cerebral palsy due to birth asphyxia or neonatal seizures were recruited for the follow-up at Paropakar Maternity and Women's Hospital, 1 October 2021 to 7 January 2022. Parents filmed their children at home using the application at 3 months' age and the videos were assessed for technical quality using a standardised form and for fidgety movements by Prechtl's General Movements Assessment. The usability of the application was evaluated through a parental survey.

Results: Twenty families sent in altogether 46 videos out of which 35 had approved technical quality. Sixteen children had at least one video with approved technical quality. Three infants lacked fidgety movements. The level of agreement between assessors was acceptable (Krippendorf alpha 0.781). Parental answers to the usability survey were in general positive.

Interpretation: Engaging parents in screening of cerebral palsy with the help of a smartphone-aided remote General Movements Assessment is possible in the urban area of a South Asian lower middle-income country.

Keywords: Developmental neurology & neurodisability; Feasibility Studies; Follow-Up Studies; NEONATOLOGY; Nepal; eHealth.

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Conflict of interest statement

Competing interests: KS and HEKS developed the application NeuroMotion with financial support from a private donation through Knut och Alice Wallenbergs Stiftelse. For the purpose of further research and later implementation of NeuroMotion, the company NeuroMotion AB was founded and is the owner of the application. NeuroMotion AB is owned by KS and HEKS and has the purpose of research and to be non-profitable.

Figures

Figure 1
Figure 1
Screenshots of the Nepali version of the NeuroMotion application including (A) introduction, (B–D) instructions about filming and (E) a view of the filming interface. Corresponding sections in the English version read: (A) this application is designed in order to record and send short clips in a simple and secure way from a smartphone to a secure server only available to healthcare personnel. The clips can be used as support in medical research and diagnostics. (B) Hello! With this application you can record your child. The film can be uploaded and analysed by healthcare personnel. (C) Remember! Keep the camera as still as possible, same distance and direction. Head, hands and feet are visible in the screen. Background as neutral as possible. (D) A baby: should be on its back, be active and satisfied. Only wear a one-coloured t-shirt/one piece and diaper, no pacifier. Film from above, so that the whole child can be seen on the screen. The recording should be 2-3 minutes.
Figure 2
Figure 2
Participant flow diagram. FM, fidgety movements; SNCU/NICU, sick newborn care unit/neonatal intensive care unit.
Figure 3
Figure 3
Stacked bar graph of parental answers to smartphone application usability survey.
See this image and copyright information in PMC

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