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A randomized controlled trial of web-based training to increase activity in children with cerebral palsy
Louise E Mitchell1, Jenny Ziviani2,3, Roslyn N Boyd1
1Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland, Brisbane, Qld, Australia.
Insights
Web-based training improved functional strength and walking endurance in children with unilateral cerebral palsy (CP). However, it did not enhance overall activity performance in this group.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Physical Therapy
Background:
- Unilateral cerebral palsy (CP) affects motor function in children.
- Activity capacity and performance are key outcomes in CP management.
- Web-based interventions offer accessible rehabilitation options.
Purpose of the Study:
- To evaluate the effectiveness of a web-based training program.
- To assess impacts on activity capacity and performance in children with unilateral CP.
Main Methods:
- Matched-pairs randomized waitlist controlled trial.
- 101 independently ambulant children with unilateral CP participated.
- Intervention group received 20 weeks of web-based training; control group received usual care.
Main Results:
- Significant improvements in functional strength (19.3 repetitions) and 6-minute walk test (38.9m) in the intervention group.
- No significant changes in activity performance (accelerometer data) were observed.
- Training adherence averaged 32.4 hours over 20 weeks.
Conclusions:
- Web-based training effectively enhanced functional strength and walking endurance.
- The intervention did not lead to measurable improvements in overall activity performance.
- Further research may explore optimizing web-based programs for broader functional gains in unilateral CP.
Aim:
To determine the efficacy of web-based training on activity capacity and performance in children with unilateral cerebral palsy (CP).
Method:
In a matched-pairs randomized waitlist controlled trial, independently ambulant children and adolescents with unilateral CP were allocated to receive 30 minutes of training (intervention) 6 days per week, or usual care (waitlist control) for 20 weeks. Activity capacity was assessed using maximal repetitions of functional strength tasks and 6-minute walk test (6MWT); performance using 4-day ActiGraph GT3X+ accelerometer records at baseline and 20 weeks. Data were analysed by intention to treat comparing between groups using hierarchical linear modelling.
Results:
Participants were n=101, 52 males, mean age 11 years 3 months (SD 2y 4mo). Intervention participants completed a mean 32.4 hours (SD 17.2) of training, associated with significant improvements in functional strength (mean difference 19.3 repetitions; 95% confidence interval [CI] 10.8-27.7; p<0.001) and 6MWT distance (mean difference 38.9m; 95% CI 12.3-51.9; p<0.001) compared with the control group at 20 weeks, although not activity performance (p>0.05).
Interpretation:
Training was effective at increasing functional strength and walking endurance in independently ambulant children with unilateral CP. This did not translate into improvements in activity performance.
