title: A randomized controlled trial of web-based training to increase activity in children with cerebral palsy.
abstract: OBJECTIVE
  To determine the efficacy of web-based training on activity capacity and performance in children with unilateral cerebral palsy (CP).
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland, Brisbane, Qld, Australia.
authors.forename: Louise E
authors.initials: LE
authors.lastname: Mitchell
authors.affiliation: Children's Health Queensland, Brisbane, Qld, Australia.|School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Qld, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Ziviani
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland, Brisbane, Qld, Australia.
authors.forename: Roslyn N
authors.initials: RN
authors.lastname: Boyd
mesh_terms: D061725:Accelerometry; D000293:Adolescent; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009426:Netherlands; D009862:Online Systems; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome