Blended Care in the mCIMT-BiT Pirate Group in Children with Unilateral Cerebral Palsy: A Feasibility Study

Intensive upper limb rehabilitation is essential for children with unilateral cerebral palsy (uCP). Home-based training may extend practice opportunities and reduce logistical barriers. This study examined the feasibility of a blended care approach in the mCIMT-BiT Pirate group, adapted from the fully on-site program.

Seventeen children with uCP (mean age 4 y 4 m, SD 1 y 5 m), including eight boys, participated in an eight-week program combining two three-hour weekly on-site sessions with a recommended three hours of weekly home training. Feasibility was evaluated through adherence and acceptability (questionnaires and interviews) of the home training, and limited-efficacy testing of affected arm use.

Mean home training adherence was 43% (77 min/week), highest in week one (63%) declining to 24% by week eight. Qualitative analyses yielded three themes: (1) support, strong support from therapists and environment; (2) motivation, high but decreasing over time; and (3) logistics, scheduling home sessions proved difficult. Questionnaire results were consistent with interview findings. Children showed improvements in affected arm use in standardized tests and daily activities.

Feasibility of home-training in blended care in the mCIMT-BiT Pirate group was limited, yet meaningful functional improvements were observed. Parents expressed intent to continue home practice, suggesting potential long-term benefits.