Efficacy of a technology-based client-centred training system in neurological rehabilitation: a randomised controlled trial.
Els Knippenberg, Annick Timmermans, Jolijn Coolen and 4 others
PMID 34961531WHAT IT FOUND
Adding i-ACT to usual therapy gave no clear added functional benefit in 45 people with central nervous system deficits.
Both groups improved. The self-reported ability score favoured i-ACT during training, then usual therapy later.
Key findings
01The only significant between-group difference in primary outcomes was on self-reported manual ability: it favoured i-ACT during training and favoured conventional care at follow-up.
02Both groups improved over time on the main function and self-reported performance measures.
03Personal goals were more often trained with i-ACT: 87.50% of goals in the i-ACT group versus 45.71% in the control group.
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
The study was probably too small to detect real differences between groups. Follow-up conclusions are weaker because not everyone completed the full protocol; only 37 people completed all time points. The training dose was low: 3 sessions of 45 minutes per week for 6 weeks, and the authors say this may have been too little to create a between-group effect. Baseline scores differed between groups on MAM-36 and COPM satisfaction, which can make between-group comparison less clean. Most participants had stroke (36 of 45), so the findings are less certain for other central nervous system conditions. The intervention was added to conventional care, so this does not test i-ACT as a replacement for usual therapy.
Declared interests
Funded by interreg v-a euregio meuse-rhine, provincie limburg (be), and agentschap innoveren en ondernemen.
The easy way to misread this
Do not conclude that i-ACT is an effective add-on because participants adhered well or liked it. Adherence was high (97.92%), but the main functional outcomes improved in both groups and did not clearly favour i-ACT. The study was probably too small to detect real differences, and the primary outcome difference reversed at follow-up.