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

Abstract

ObjectivesTo evaluate the feasibility of using the NeuroMotion smartphone application for remote General Movements Assessment for screening infants for cerebral palsy in Kathmandu, Nepal.MethodThirty-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.ResultsTwenty 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.InterpretationEngaging 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.

‘We did everything by phone’: a qualitative study of mothers' experience of smartphone-aided screening of cerebral palsy in Kathmandu, Nepal

“…The Technology Acceptance Model suggests that the use of information systems is predicted by the interplay of design features and users’ attitudes towards the intervention [ 16 ]. Only half of the children recruited into this follow-up study were successfully filmed despite the overall positive affective attitude and acceptable ethicality [ 14 ]. The relatively low success rate might be explained by the fact that some of the design features of the app like automatic notifications were not as functional in Nepal as in our previous experience in Sweden [ 10 ].…”

“…Follow-up of the children and the remote GMA assessment are described in a separate paper [ 14 ]. In short, recruitment of children took place at Paropakar Maternity and Women’s Hospital (PMWH), the largest public tertiary maternity hospital in Kathmandu.…”

“…We conducted a pilot study testing the feasibility of smartphone-aided remote GMA for identifying children at high risk of CP in Kathmandu, Nepal. The NeuroMotion™ app developed by Linköping University, Sweden, [ 10 ] was translated into Nepali and provided to parents of infants at risk of CP due to birth asphyxia or neonatal seizures [ 14 ].…”

Implementation of remote general movement assessment using the in-motion instructions in a high-risk norwegian cohort

“…Smartphone apps like the Baby Moves, In-Motion and NeuroMotion, have been used successfully by parents for home-based filming of GMs [ 22 – 25 ]. The app solutions enable remote GMA by trained experts located at specialized hospital centers.…”