Randomized controlled trial of a web-based multi-modal therapy program for executive functioning in children and adolescents with unilateral cerebral palsy

Randomized controlled trial of a web-based multi-modal therapy program for executive functioning in children and adolescents with unilateral cerebral palsy

Purpose state: Determine the efficacy of Move-it-to-improve-it (Mitii™), a multi-modal web-based program, in improving Executive Function (EF) in children with unilateral cerebral palsy (UCP).

Method: Participants (n=102) were matched in pairs then randomised to: intervention (Mitii™ for 20 weeks; n=51; 26 males; mean age=11 years 8 months (SD=2y4m); Full Scale IQ=84.65 (SD=15.19); 28 left UCP; GMFCS-E&R (I=20, II=31) or waitlist control (n=50; 25 males; mean age=11y10m (SD=2y5m); Full Scale IQ=80.75 (SD=19.81); 20 left UCP; GMFCS-E&R (I=25, II=25). Mitii™ targeted working memory (WM), visual processing (VP), upper limb co-ordination and physical activity. EF capacity was assessed: attentional control (DSB; WISC-IV); cognitive flexibility (inhibition and number-letter sequencing DKEFS); goal setting (D-KEFs Tower Test); and information processing (WISC-IV Symbol Search and Coding). EF performance was assessed via parent report (BRIEF). Groups were compared at 20 weeks using linear regression (SPSS 21).

Results: There were no significant between group differences in attentional control (DSB; p=0.20;CI=-0.40,1.87); cognitive flexibility (Inhibition, p=0.34;CI=-0.73,2.11; number/letter sequencing, p=0.17; CI=-0.55,2.94); problem solving (Tower; p=0.28; CI=-0.61,2.09), information processing (Symbol; p=0.08; CI=-0.16, 2.75; Coding; p=0.07; CI=-0.12,2.52) or EF performance (p=0.13; CI=-10.04,1.38).

Conclusion: In a large RCT, Mitii TM did not lead to significant improvements on measures of EF or parent ratings of EF performance in children with UCP.

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