Commentary on “The General Movements Motor Optimality Score in High-Risk Infants: A Systematic Scoping Review” : Pediatric Physical Therapy

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Commentary on “The General Movements Motor Optimality Score in High-Risk Infants: A Systematic Scoping Review”

McCarty, Dana PT, DPT; Cunningham, Catherine PT, DPT

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Pediatric Physical Therapy 35(1):p 27, January 2023. | DOI: 10.1097/PEP.0000000000000984
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“How could I apply this information?”

By using the General Movements Assessment (GMA), pediatric physical therapists have the opportunity to identify and diagnose cerebral palsy (CP) as early as 3 months of age. Specifically, when administered between 3 and 5 months of age, the absence of “fidgety” movements during this time period has high sensitivity and specificity for predicting CP. The Motor Optimality Score (MOS) and its newly revised version (MOS-R) are more detailed movement assessments that standardize scoring in 4 domains of movement quality: movement patterns, movement repertoire, postural patterns, and movement character. Evidence suggests that specific domains and assessment items have been associated with later development of CP and minor neurological dysfunction. The authors of this systematic review reported that the MOS is used both as a descriptive and predictive tool, as well as an outcome measure.

“What should I be mindful about when applying this information?”

The MOS is a relatively new tool that is not widely used in clinical practice but demonstrates promising predictive value in the early identification of CP. While the MOS-R (revised version) provides more clarity for scoring items than the original MOS, only the MOS has adequate to high interrater reliability in previous studies. To more widely incorporate the MOS-R into research, more evidence to support interrater reliability and validity of the MOS-R is needed. The MOS-R should only be administered by practitioners who have completed advanced GMA training; however, this training is not easily accessible to all practitioners. To support the widespread use of the GMA and MOS-R into clinical practice, a larger number of practitioners familiar with and trained in these metrics are necessary.

Dana McCarty, PT, DPT
Board Certified Pediatric Clinical Specialist
Assistant Professor
University of North Carolina
Chapel Hill, North Carolina
Catherine Cunningham, PT, DPT
Neonatal Physical Therapy Fellow
UNC Health
Chapel Hill, North Carolina

© 2023 Academy of Pediatric Physical Therapy of the American Physical Therapy Association