Assessment of Motor Development With a Wearable in Rural and Low-income Settings (MaMa)

Assessment of Motor Development With a Wearable in Rural and Low-income Settings: Feasibility and Validity of MAIJU Jumpsuit in Malawi

The MaMa study aims to assess feasibility and validity of an infant wearable in a rural settings. Altogether N~100 infants will be recruited and measured multiple times at homes from age 6 months to age 18 months. Neurodevelopment of the infants is assessed at 18-24 months of age to compare motor development trajectories with the later neurodevelopmental outcome.

Study Overview

• Status: Active, not recruiting
• Conditions: Infant Development
• Intervention / Treatment: Device: wearable MAIJU for motor assessment

Detailed Description

The MaMa study aims to assess the feasibility and validity of an infant wearable method to study young infants' neuromotor development in a low income setting. In this method, infants' motor abilities (e.g. variety of different postures and movement types) are measured using a playsuit equipped with movement sensors while the infant is freely playing in his/her native environment, such as home. The data recorded with the wearable sensors is analysed afterwards using an algorithm that quantifies individual movement and posture components as well as delivers holistic interpretations of infant's motor maturity. This method is developed in University of Helsinki, and it is already successfully used in clinical research projects in Finland, Denmark, Italy and USA. Use of movement sensors is common in other wellness and health applications, however wearables of this kind have not been used before for infant's neuromotor assessment. The solution has the advantage that it provides a fully objective and quantified representation of infant's motor activity in his/her native environment; which is not achievable with any of the currently used clinical assessment methods that are typically performed in the outpatient clinic environment.

The study will be conducted in rural Malawi, is East Africa. The investigators will assess the feasibility of the wearable method in a resource poor setting by running a pilot study on approximately five-to-seven-month-old infants. In the first phase, the investigators will assess technical suitability of wearable methods in 20 typically developing infants in the rural settings, and compare the results to those obtained from infants of the same age in Finland. In the second phase, the study will continue as a longitudinal follow-up of these infants and recruit a larger study group of Malawian infants (up to a total N~100), all of whom will undergo repeated assessment with the wearable method, every 6 weeks until the age of 18 months, or until they walk fluently. The results will support constructing motor growth charts for the Malawian infant population. At the age of 24 months, children's neuropsychological performance will be assessed using an assessment battery that was recently adapted for Malawian context; this will allow us to study how early motor development associates with later neurocognitive developmental profile.

There are three potential benefits from performing the study. First, to establish the practical feasibility and utility of a novel method for out-of-hospital neurological assessment in infants. Second, the project will establish functional motor growth charts for Malawian population to serve as a benchmark in any future intervention trial in comparable environments; these can be also compared to data from Finland. Finally, the project will allow assessing links between early motor and later cognitive development, a question with significant global health implications in all cultures.

• Study Type: Observational
• Enrollment (Estimated): 100

Contacts and Locations

Study Locations

• Finland
  • Helsinki, Finland, 00250
    • University of Helsinki
  • Helsinki, Finland
    • BABA, Clinical Trial Unit, New Children's Hospital
• Malawi
  • Blantyre, Malawi, 3
    • Kamuzu University of Health Sciences
  • Mangochi district
    • Mangochi, Mangochi district, Malawi
      • Lungwena Health Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 4 months to 2 years (Child)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

All infants born in the catchment area of Lungwena health center are screened, and the infants are contacted if they fullfil the eligibility criteria.

Description

Inclusion Criteria:

• A documented birth date
• Birth at about term age, i.e. between 35 and 42 gestation weeks
• Mother's ability to speak fluently Chi-Chewa, Chi-Yao or English
• Permanent resident of Lungwena Health Centre catchment area
• Availability and willingness of the mother and infant during the period of the study
• Signed or thumb-printed informed consent by the caregiver of the infant

Exclusion Criteria:

• Very early birth (at 7th month or earlier) based on mother's information
• Infant's congenital malformation or severe illness as judged clinically by a study nurse

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Motor maturation level (BIMS)	BIMS (Baba Infant Motility Score) is a score that combines all recorded postures and movement activities to a holistic estimate of infant's motor maturation. BIMS has a scale from 0 to 100, with higher number being better.	The primary outcome BIMS is the level reached by 18 months of age

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Kilifi Developmental Inventory (KDI) score	KDI is a questionnaire based assessment of infants' neurocognitive development at 12-24 months of age. It is validated in the Malawi context. The scale is 0-70, with higher number being better.	24 months of age

Collaborators and Investigators

• Sponsor: Helsinki University Central Hospital
• Collaborators: University of Helsinki; Tampere University; Kamuzu University of Health Sciences
• Investigators: Principal Investigator: Sampsa Vanhatalo, MD PhD, professor in physiology, consultant in clinical neurophysiology

Publications and helpful links

General Publications

• Airaksinen M, Gallen A, Kivi A, Vijayakrishnan P, Hayrinen T, Ilen E, Rasanen O, Haataja LM, Vanhatalo S. Intelligent wearable allows out-of-the-lab tracking of developing motor abilities in infants. Commun Med (Lond). 2022 Jun 15;2:69. doi: 10.1038/s43856-022-00131-6. eCollection 2022.
• Airaksinen M, Rasanen O, Ilen E, Hayrinen T, Kivi A, Marchi V, Gallen A, Blom S, Varhe A, Kaartinen N, Haataja L, Vanhatalo S. Automatic Posture and Movement Tracking of Infants with Wearable Movement Sensors. Sci Rep. 2020 Jan 13;10(1):169. doi: 10.1038/s41598-019-56862-5.

Helpful Links

• link to presentation of the MAIJU wearable

Study record dates

Study Major Dates

• Study Start (Actual): May 15, 2023
• Primary Completion (Estimated): October 30, 2025
• Study Completion (Estimated): December 31, 2025

Study Registration Dates

• First Submitted: March 11, 2023
• First Submitted That Met QC Criteria: March 11, 2023
• First Posted (Actual): March 23, 2023

Study Record Updates

• Last Update Posted (Estimated): September 18, 2025
• Last Update Submitted That Met QC Criteria: September 14, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: wearable; motor development; neurodevelopment; neurophysiology; activity tracking; child neurology; developmental assessment; neurological assessment
• Other Study ID Numbers: MaMa2022

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: data will contain sensitive information that is not allowed to share without additional permission and contracts between relevant insitutions

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No