A pilot single-blind multicentre randomized controlled trial to evaluate the potential benefits of computer-assisted arm rehabilitation gaming technology on the arm function of children with spastic cerebral palsy

Abstract

Objective:

To evaluate the potential benefits of computer-assisted arm rehabilitation gaming technology on arm function of children with spastic cerebral palsy.

Design:

A single-blind randomized controlled trial design. Power calculations indicated that 58 children would be required to demonstrate a clinically important difference.

Setting:

Intervention was home-based; recruitment took place in regional spasticity clinics.

Participants:

A total of 15 children with cerebral palsy aged five to 12 years were recruited; eight to the device group.

Interventions:

Both study groups received ‘usual follow-up treatment’ following spasticity treatment with botulinum toxin; the intervention group also received a rehabilitation gaming device.

Main measures:

ABILHAND-kids and Canadian Occupational Performance Measure were performed by blinded assessors at baseline, six and 12 weeks.

Results:

An analysis of covariance showed no group differences in mean ABILHAND-kids scores between time points. A non-parametric analysis of variance on Canadian Occupational Performance Measure scores showed a statistically significant improvement across time points (χ² (2,15) = 6.778, p = 0.031), but this improvement did not reach minimal clinically important difference. Mean daily device use was seven minutes. Recruitment did not reach target owing to unanticipated staff shortages in clinical services. Feedback from children and their families indicated that the games were not sufficiently engaging to promote sufficient use that was likely to result in functional benefits.

Conclusion:

This study suggests that computer-assisted arm rehabilitation gaming does not benefit arm function, but a Type II error cannot be ruled out.