Technology-assisted quantification of movement to predict infants at high risk of motor disability: A systematic review.

Aim: To systematically review the scientific literature to determine the predictive validity of technology-assisted measures of observable infant movement in infants less than six months of corrected age (CA) to identify high-risk of motor disability.

Method: A comprehensive search for randomised and non-randomised controlled trials, cohort studies and cross-comparison trials was performed on five electronic databases up to Feb 2021. Studies were included if they quantified infant movement before 6 months CA using some method of technology-assistance and compared the instrumented measure to a diagnostic clinical measure of neurodevelopment. Studies were excluded if they did not report a technology-assisted measure of infant movement. Methodological quality of the included studies was assessed using the Downs and Black scale.

Results: 23 studies met the full inclusion and exclusion criteria. Methodological quality of the included papers ranged from 9 to 24 (out of 26) on the Downs and Black scale. Infant movement assessments included the General Movements Assessment (GMA) and domains of the Hammersmith Infant Neurological Assessment (HINE). Studies used 2D video recordings, RGB-Depth recordings, accelerometry, and electromagnetic motion tracking technologies to quantify movement. Analytical approaches and movement features of interest were individual and varied. Technology assisted quantitative assessments identified cases of later diagnosed CP with sensitivity 44-100 %, specificity 59-95 %, Area under the ROC Curve 82-93 %; and typical development with sensitivity range 30-46 %, specificity 88-95 %, Area under the ROC Curve 68 %.

Interpretation: Technology-assisted assessments of movement in infants less than 6 months CA using current technologies are feasible. Validation of measurement tools are limited. Although methods and results appear promising clinical uptake of technology-assisted assessments remains limited.