Randomized controlled trial of web-based multimodal therapy for children with acquired brain injury to improve gross motor capacity and performance.
OBJECTIVE
To compare efficacy of a web-based multimodal training programme, 'Move it to improve it' (MitiiTM), to usual care on gross motor capacity and performance for children with an acquired brain injury.


METHODS
Randomized waitlist controlled trial.


METHODS
Home environment.


METHODS
A total of 60 independently ambulant children (30 in each group), minimum 12 months post-acquired brain injury were recruited and randomly allocated to receive either 20 weeks of MitiiTMtraining (30 minutes/day, six days/week, total 60 hours) immediately, or waitlisted (usual care control group) for 20 weeks. A total of 58 children completed baseline assessments (32 males; age 11 years 11 months ± 2 years 6 months; Gross Motor Function Classification System equivalent I = 29, II = 29).


METHODS
The MitiiTMprogram comprised of gross motor, upper limb and visual perception/cognitive activities.


METHODS
The primary outcome was 30-second, repetition maximum functional strength tests for the lower limb (sit-to-stand, step-ups, half-kneel to stand). Secondary outcomes were the 6-minute walk test, High-level Mobility Assessment Tool, Timed Up and Go Test and habitual physical activity as captured by four-day accelerometry.


RESULTS
Groups were equivalent at baseline on demographic and clinical measures. The MitiiTMgroup demonstrated significantly greater improvements on combined score of functional strength tests (mean difference 10.19 repetitions; 95% confidence interval, 3.26-17.11; p = 0.006) compared with the control group. There were no other between-group differences on secondary outcomes.


CONCLUSIONS
Although the MitiiTMprogramme demonstrated statistically significant improvements in the functional strength tests of the lower limb, results did not exceed the minimum detectable change and cannot be considered clinically relevant for children with an acquired brain injury.


BACKGROUND
Australian New Zealand Clinical Trials Registration Number, ANZCTR12613000403730.
Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, QLD, Australia.
Emmah
E
Baque
Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, QLD, Australia.
Lee
L
Barber
Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, QLD, Australia.
Leanne
L
Sakzewski
Queensland Cerebral Palsy and Rehabilitation Research Centre, The University of Queensland, Brisbane, QLD, Australia.
Roslyn N
RN
Boyd
D000293:Adolescent; D001930:Brain Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D006801:Humans; D015601:Injury Severity Score; D020407:Internet / Q000706:statistics & numerical data*; D000066530:Neurological Rehabilitation / Q000295:instrumentation / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods; D011793:Queensland; D012016:Reference Values; D013647:Task Performance and Analysis; D000069350:Telerehabilitation / Q000379:methods*; D016896:Treatment Outcome
Randomized controlled trial; acquired brain injury; children; rehabilitation