Effectiveness of the home-based training program Tele-UPCAT (Tele-monitored UPper Limb Children Action Observation Training) in unilateral cerebral palsy: a randomized controlled trial.
Elena Beani, Valentina Menici, Elisa Sicola and 7 others
PMID 37462399WHAT IT FOUND
Children with unilateral cerebral palsy who did a 3-week home action observation program had greater improvement in hand use than children receiving usual care, and the improvement was retained at later follow-up.
Key findings
01The primary outcome, the Assisting Hand Assessment score, improved more with the home training than with usual care immediately after training and remained improved at later follow-up.
02The Box and Block Test improved significantly for the less affected hand, but not for the affected hand, and the Melbourne Assessment did not show immediate differences.
03All children completed the training sessions and assessments, with no missed sessions and no adverse events.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 30 children were studied, although the planned minimum was 24 participants. The control group crossed over to the home training after 3 weeks, so later between-group comparisons were not possible. The study compared home training with usual care, not with clinic-delivered action observation training, so it does not show that home delivery is better than clinic delivery. The training was not customized to individual interests or progress, and it was carried out at home without online supervision. The paper did not report cost-effectiveness. Sensor data from the toy and wearable devices were collected but not analyzed in this paper.
Declared interests
The authors declared no financial conflicts of interest. The study was partially funded by the Italian Ministry of Health grants GR-2011-02350053, RCR-2017, and RC2019, and by 5 X 1000 Health Research 2017.
The easy way to misread this
Do not conclude that this program makes the affected hand more dexterous. The affected-hand Box and Block Test did not show a significant immediate difference, and the Melbourne Assessment did not show immediate differences versus usual care.