Effectiveness Comparison of Kinect-Based and Therapist-Based Bimanual Intensive Training in Children With Unilateral Cerebral Palsy: A Randomized Controlled Trial.

Abstract

To compare the effectiveness of Kinect-based bimanual intensive training (K-BIT) and therapist-based bimanual intensive training (T-BIT) in children with unilateral cerebral palsy (UCP) in upper limb motor function. Single-blind, randomized controlled trial. The K-BIT and T-BIT were conducted in the child's natural environment, such as their home or school classroom. Thirty-one children with UCP were randomly allocated to the K-BIT (mean age 8 y 1 mo [SD= 2 y 1 mo], 9 males, 7 females) or T-BIT (mean age 8 y 7 mo [SD=1 y 5 mo], 5 males, 10 females). Both the K-BIT and T-BIT groups received two 2.25-hour intervention sessions per week, for 8 weeks (total=36 h). The more-affected upper extremity's (UE) motor control and bimanual coordination were assessed by unimanual and bimanual reaching-to-grasp (RTG) tasks. Daily motor functions were assessed by the Pediatric Motor Activity Log-Revised and ABILHAND-Kids. K-BIT and T-BIT were generally comparable in the more-affected UE's motor control, bimanual coordination, and daily motor functions. In addition, K-BIT had a faster reaction time in RTG tasks (P=.03, η_p²=.17), whereas T-BIT had smoother movement in bimanual RTG tasks (P=.02, η_p²=.21). K-BIT may serve as an effective alternative to T-BIT, reducing therapists' workload and improving the clinical utility of BIT. Time constraints in K-BIT's exergames may prompt faster reactions and more efficient movement preparation. In addition, incorporating tangible objects that provide haptic feedback in K-BIT might further improve the movement smoothness.