Prediction of Cerebral Palsy and Other Motor Developmental Trajectories in High-Risk Neonate Using the Rapid Neurodevelopmental Assessment (RNDA) and Prechtl’s Method of Qualitative Assessment of General Movement (GMsA)

Abstract

Background: The integration of the RNDA and Prechtl's Method offers a promising approach to identify high-risk neonates and predict their motor developmental trajectories. This early identification can guide clinicians in providing timely interventions, improving the long-term outcomes and quality of life for infants affected by CP and other motor disorders. Objective: The study investigates the predictive potential of the Rapid Neurodevelopmental Assessment (RNDA) and Prechtl’s Method of Qualitative Assessment of General Movement (GMsA) in high-risk neonates. Method: This longitudinal cohort study at Dhaka Shishu Hospital (January 2016-December 2017) enrolled 16 high-risk neonates. GMsA and RNDA were conducted from birth to 20 weeks post-term age. Muscle tone, primitive reflexes, gross and fine motor skills were evaluated. Impending CP diagnosis was at 1 year. Statistical analysis was performed using SPSS 23.0. Results: The study investigates the association between various developmental markers and the risk of cerebral palsy (CP) in infants. Results reveal a higher prevalence of muscle tone impairment in impending CP cases across preterm, term, and post term ages. Sensitivity, specificity, and predictive values for CP prediction based on muscle tone are presented, showing significant associations. Primitive reflexes also demonstrate higher impairment rates in impending CP cases across different age points, with corresponding sensitivity, specificity, and predictive values. Gross motor and fine motor impairments exhibit significant associations with impending CP, along with predictive values. The distribution of categorical scores for GMsA and RNDA across various age points emphasizes the prevalence of impairments in impending CP cases. Findings indicate a strong association between GMsA scores and CP risk, with significant predictive capabilities across different visits. Overall, the study highlights the utility of these developmental markers in predicting CP ....