title: Effect of parent-delivered action observation therapy on upper limb function in unilateral cerebral palsy: a randomized controlled trial.
abstract: OBJECTIVE
  To determine whether home-based, parent-delivered therapy comprising action observation (AO) and repeated practice (RP) improves upper limb function more than RP alone in children with unilateral cerebral palsy (UCP).
  
  
  METHODS
  
  
  
  METHODS
  single-blinded parallel-group randomized controlled trial with 1:1 allocation comparing AO+RP (intervention) with RP alone (control).
  
  
  METHODS
  computer-generated, with allocation concealment by opaque sequentially-numbered envelopes.
  
  
  METHODS
  northern England, August 2011 to September 2013.
  
  
  METHODS
  70 children with UCP; mean age 5.6 years (SD 2.1), 31 female.
  
  
  METHODS
  home-based activities were provided, tailored to interests and abilities.
  
  
  METHODS
  15 minutes/day, 5 days/week for 3 months.
  
  
  METHODS
  Assisting Hand Assessment (AHA; primary outcome measure), Melbourne Assessment 2 (MA2), and ABILHAND-Kids at baseline, 3 months, and 6 months.
  
  
  RESULTS
  Outcome data was available at 3 months for 28 children in the AO+RP group and 31 controls, and at 6 months for 26 and 28 children respectively. There were no between-group differences in AHA, MA2, or ABILHAND-Kids at 3 or 6 months versus baseline (all p>0.05). Combined-group improvements (p<0.001), observed in AHA and MA2 at 3 months, were maintained at 6 months. ABILHAND-Kids also showed improvement at 3 months (p=0.003), maintained at 6 months.
  
  
  CONCLUSIONS
  Parent-delivered RP (with or without AO) improves upper limb function and could supplement therapist input.
authors.affiliation: Southampton Clinical Trials Unit, University of Southampton, Southampton, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Kirkpatrick
authors.affiliation: Paediatric Occupational Therapy Services, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors.forename: Janice
authors.initials: J
authors.lastname: Pearse
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: James
authors.affiliation: Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Basu
mesh_terms: D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D000066530:Neurological Rehabilitation / Q000379:methods*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010290:Parents; D016037:Single-Blind Method; D034941:Upper Extremity / Q000503:physiopathology*