Article

AIMS: To determine whether the multi-modal web-based rehabilitation 'Move it to
improve it' (Mitii) is more effective than wait list control (usual care) to
improve occupational performance, upper limb function, and visual perception in
children with acquired brain injury (ABI). METHOD:
Fifty-eight randomly allocated
children (53% males; mean age 11y 11mo, SD 2y 6mo; Manual Abilities Classification Scale equivalent I=32, II=24, III=2; mean Full-scale IQ 75.8, SD
16.2) received either 20 weeks of Mitii (n=29) or usual care (n=29). Mitii
comprised upper limb, cognitive, visual perception, and gross motor tasks,
recommended for 30 minutes per day, 6 days per week, over 20 weeks. Outcomes were
the Assessment of Motor and Process Skills (AMPS), Melbourne Assessment of
Unilateral Upper Limb Function, Jebsen-Taylor Test of Hand Function, Test of
Visual Perceptual Skills, Assisting Hand Assessment (AHA), and Canadian
Occupational Performance Measure. The primary comparison at 20 weeks between
groups on the AMPS process and motor measures used generalized estimating
equations. RESULTS: Groups were equivalent at baseline. Participants completed on
average 17.6 hours (range 0-46h) of Mitii. There were no differences between
groups on the primary outcome (AMPS process: estimated mean difference -0.1, 95%
CI -0.3 to 0.2, p=0.589; and AMPS motor: estimated mean difference 0.2, 95% CI
-0.1 to 0.5, p=0.192). There were no differences between groups on overall visual
perception, upper limb, and occupational performance outcomes. INTERPRETATION:
Mitii led to negligible changes on all primary and secondary outcomes compared
with usual care. This likely reflects the small dose achieved and poses questions
around the acceptability and feasibility of home-delivered Mitii in this population of children with ABI.
CI - (c) 2016 Mac Keith Press.

Langue : ANGLAIS