Randomized controlled trial of web-based multimodal therapy for unilateral cerebral palsy to improve occupational performance

Abstract

Aim: The study aimed to investigate the effectiveness of a web-based therapy programme, 'Move it to improve it' (Mitii(™)), in children with unilateral cerebral palsy (UCP) on occupational performance, upper limb function, and visual perception.

Method: Participants (n=102) were matched in pairs and randomized to intervention (Mitii for 20wks; 26 males, mean age 11y 8mo [2y 4mo], Manual Ability Classification System level I=11, II=39, III=1) or control (standard care; 25 males, mean age 11y 10mo [2y 5mo], Manual Ability Classification System level I=13, II=37). Outcomes were the Assessment of Motor and Process Skills (AMPS), Assisting Hand Assessment, Jebsen-Taylor Test of Hand Function (JTTHF), Melbourne Assessment of Unilateral Upper Limb Function (MUUL), Canadian Occupational Performance Measure (COPM), and Test of Visual Perceptual Skills (TVPS-3).

Results: Participants completed on average 32.4 hours of Mitii (range 3.7-74.7h). The Mitii group demonstrated significantly greater post-intervention scores than the comparison group on the AMPS, JTTHF dominant upper limb, COPM, and TVPS-3. The differences between groups were not clinically significant. There were no differences between groups on measures of impaired upper limb function.

Interpretation: Mitii delivers individualized, web-based therapy at home and has potential to increase therapy dose. Mitii can be considered as an option to enhance occupational performance and visual perception for children with UCP.