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Randomized controlled trial of web-based multimodal therapy for children with acquired brain injury to improve gross motor capacity and performance

BAQUE E; BARBER L; SAKZEWSKI L; BOYD RN
CLIN REHABIL , 2017, vol. 31, n° 6, p. 722-732
Doc n°: 183460
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1177/0269215516651980
Descripteurs : AJ33 - SEQUELLES DE TRAUMATISME CRANIEN - NEUROLOGIE INFANTILE

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.
DESIGN: Randomized
waitlist controlled trial.
SETTING: Home environment. PARTICIPANTS: 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 MitiiTM training (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). INTERVENTION: The MitiiTM program comprised of gross
motor, upper limb and visual perception/cognitive activities. MAIN MEASURES: 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 MitiiTM group 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. CONCLUSION:
Although the MitiiTM programme 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. CLINICAL TRIAL REGISTRATION:
Australian New Zealand Clinical Trials Registration Number, ANZCTR12613000403730.

Langue : ANGLAIS

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