title: 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.
  
  
  METHODS
  A single-blind randomized controlled trial design. Power calculations indicated that 58 children would be required to demonstrate a clinically important difference.
  
  
  METHODS
  Intervention was home-based; recruitment took place in regional spasticity clinics.
  
  
  METHODS
  A total of 15 children with cerebral palsy aged five to 12 years were recruited; eight to the device group.
  
  
  METHODS
  Both study groups received 'usual follow-up treatment' following spasticity treatment with botulinum toxin; the intervention group also received a rehabilitation gaming device.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  This study suggests that computer-assisted arm rehabilitation gaming does not benefit arm function, but a Type II error cannot be ruled out.
authors.affiliation: Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, UK N.Preston@leeds.ac.uk.
authors.forename: Nick
authors.initials: N
authors.lastname: Preston
authors.affiliation: School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Weightman
authors.affiliation: School of Mechanical Engineering, University of Leeds, Leeds, UK.
authors.forename: Justin
authors.initials: J
authors.lastname: Gallagher
authors.affiliation: School of Mechanical Engineering, University of Leeds, Leeds, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Levesley
authors.affiliation: Institute of Psychological Sciences, University of Leeds, Leeds, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Mon-Williams
authors.affiliation: Department of Paediatrics, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Clarke
authors.affiliation: Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, UK National Demonstration Centre in Rehabilitation, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: Rory J
authors.initials: RJ
authors.lastname: O'Connor
mesh_terms: D001132:Arm; D002547:Cerebral Palsy / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D010865:Pilot Projects; D012656:Self-Help Devices; D016037:Single-Blind Method; D016896:Treatment Outcome; D018910:Video Games
keywords: Cerebral palsy; activity limitation; assistive technology; rehabilitation gaming technology; upper limb