Aim
To determine whether homeâbased, parentâdelivered therapy comprising action observation (AO) and repeated practice (RP) improves upper limb function more than RP alone in children with unilateral cerebral palsy (UCP).
Method
Design: singleâblinded parallelâgroup randomized controlled trial with 1:1 allocation comparing AO+RP (intervention) with RP alone (control). Randomization: computerâgenerated, with allocation concealment by opaque sequentiallyânumbered envelopes. Setting: northern England, August 2011 to September 2013. Participants: 70 children with UCP; mean age 5.6 years (SD 2.1), 31 female. Intervention: homeâbased activities were provided, tailored to interests and abilities. Duration: 15 minutes/day, 5 days/week for 3 months. Assessments: Assisting Hand Assessment (AHA; primary outcome measure), Melbourne Assessment 2 (MA2), and ABILHANDâKids 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 betweenâgroup differences in AHA, MA2, or ABILHANDâKids at 3 or 6 months versus baseline (all p>0.05). Combinedâgroup improvements (p<0.001), observed in AHA and MA2 at 3 months, were maintained at 6 months. ABILHANDâKids also showed improvement at 3 months (p=0.003), maintained at 6 months.
Interpretation
Parentâdelivered RP (with or without AO) improves upper limb function and could supplement therapist input.