Tele-treatments
Cerebral palsy
Evidence reviewed as of before 20-05-2021
Author(s): Ogourtsova, T. (PhD OT), Osman, G. (MSc OT student), & Dunn, T. (MSc student)
Introduction
For cerebral palsy, we found 11 studies on tele-treatments. Seven of them are high quality randomized clinical trials (RCTs) and 4 are non-RCTs.These tele-treatments were provided by multidisciplinary teams, occupational therapists, physiotherapists, and speech-language pathologists. All tele-treatments (100% of studies) targeted to improve child-related outcomes. For instance, interventions focused on child’s upper and lower extremity motor functions, visual perception, dexterity, strength, coordination and speech function. Interventions were mainly provided through videoconferencing (in 72.7% of studies) and clinicians were mainly actively involved in all sessions (72.7% of studies).
Thirty-nine (n=39) different outcomes were studied, and 66.7% of them emerged from RCTs. Telerehabilitation was found to be more effective (vs. no treatment) in improving 54.5% of outcomes; more effective (vs. another intervention) in improving 30.7% of outcomes; and more effective (vs. a face-to-face usual care intervention) in improving 50% of outcomes.
Proceed to the Clinician information section to find out more.
Clinician information
In this section, you will find a list of outcomes that were examined in the selected studies; whether telerehabilitation was more or as effective (for RCTs) or effective/not effective (for non-RCTs); the comparison intervention (e.g., usual care, if present); and the level of evidence. Find out more about the levels of evidence here.Health education
Results TableFor cerebral palsy, one study focused on interventions without specifying the professional. This study was a high quality RCT.
The focus of these tele-interventions was to improve child’s physical activity.
Six (n=6) different outcomes were studied.
Expand on the outcomes below to find out more.
Exercise attitudesAs effective vs. Usual care 1b
One high quality RCT (Maher et al., 2010) investigated the effect of telerehabilitation on exercise attitudes among adolescents with cerebral palsy (CP). This high quality RCT randomized participants (youth alone) to receive telerehabilitation (Get Set Internet-intervention targeting physical activity for 20 weeks) vs. usual care. Exercise attitudes were measured by the Lifestyle Education for Activity Program II scale (LEAP II) at mid-treatment (10 weeks) and post-treatment (20 weeks). No significant between-group differences were found.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Get Set Internet-intervention targeting physical activity) is as effective as the comparison intervention (usual care) in improving exercise attitudes among adolescents with CP.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Get Set Internet-intervention targeting physical activity) is as effective as the comparison intervention (usual care) in improving exercise attitudes among adolescents with CP.
Exercise knowledgeAs effective vs. Usual care 1b
One high quality RCT (Maher et al., 2010) investigated the effect of telerehabilitation on exercise knowledge among adolescents with cerebral palsy (CP). This high quality RCT randomized participants (youth alone) to receive telerehabilitation (Get Set Internet-intervention targeting physical activity for 20 weeks) vs. usual care. Exercise knowledge was measured by the purpose-designed scale at mid-treatment (10 weeks) and post-treatment (20 weeks). No significant between-group differences were found.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Get Set Internet-intervention targeting physical activity) is as effective as the comparison intervention (usual care) in improving exercise knowledge among adolescents with CP.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Get Set Internet-intervention targeting physical activity) is as effective as the comparison intervention (usual care) in improving exercise knowledge among adolescents with CP.
Exercise self-efficacyAs effective vs. Usual care 1b
One high quality RCT (Maher et al., 2010) investigated the effect of telerehabilitation on exercise self-efficacy among adolescents with cerebral palsy (CP). This high quality RCT randomized participants (youth alone) to receive telerehabilitation (Get Set Internet-intervention targeting physical activity for 20 weeks) vs. usual care. Exercise self-efficacy was measured by the Lifestyle Education for Activity Program II scale (LEAP II) at mid-treatment (10 weeks) and post-treatment (20 weeks). No significant between-group difference was found.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Get Set Internet-intervention targeting physical activity) is as effective as the comparison intervention (usual care) in improving exercise self-efficacy among adolescents with CP.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Get Set Internet-intervention targeting physical activity) is as effective as the comparison intervention (usual care) in improving exercise self-efficacy among adolescents with CP.
Physical activityAs effective vs. Usual care 1b
One high quality RCT (Maher et al., 2010) investigated the effect of telerehabilitation on physical activity among adolescents with cerebral palsy (CP). This high quality RCT randomized participants (youth alone) to receive telerehabilitation (Get Set Internet-intervention targeting physical activity for 20 weeks) vs. usual care. Physical activity was measured by recording daily step counts and daily distance for up to 7 days at mid-treatment (10 weeks) and post-treatment (20 weeks). No significant between-group difference was found.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Get Set Internet-intervention targeting physical activity) is as effective as the comparison intervention (usual care) in improving physical activity among adolescents with CP.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Get Set Internet-intervention targeting physical activity) is as effective as the comparison intervention (usual care) in improving physical activity among adolescents with CP.
Self-reported physical activity behaviourAs effective vs. Usual care 1b
One high quality RCT (Maher et al., 2010) investigated the effect of telerehabilitation on self-reported physical activity behaviour among adolescents with cerebral palsy (CP). This high quality RCT randomized participants (youth alone) to receive telerehabilitation (Get Set Internet-intervention targeting physical activity for 20 weeks) vs. usual care. Self-reported physical activity behaviour was measured by the Multimedia Activity Recall for Children and Adolescents at mid-treatment (10 weeks) and post-treatment (20 weeks). No significant between-group difference was found.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Get Set Internet-intervention targeting physical activity) is as effective as the comparison intervention (usual care) in improving self-reported physical activity behaviour among adolescents with CP.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Get Set Internet-intervention targeting physical activity) is as effective as the comparison intervention (usual care) in improving self-reported physical activity behaviour among adolescents with CP.
Multidisciplinary team
Results TableFor cerebral palsy, we found 4 studies on tele-treatments provided by a multidisciplinary team. Of these studies, 3 are high-quality randomized clinical trials (RCTs) and 1 is a non-RCT.
The focus of the tele-interventions provided by the multidisciplinary team was to improve child’s upper extremity motor functions and visual perception.
Fifteen (n=15) different outcomes were studied, and 73.3% of them emerge from RCTs.
Expand on the outcomes below to find out more.
Activity capacityMore effective vs. Waitlist1b
One high quality RCT (Mitchell et al., 2016) investigated the effect of telerehabilitation on activity capacity in children with unilateral cerebral palsy (CP). This high quality RCT randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30 minute sessions, 6 sessions a week for 20 weeks) vs. waitlist. Activity capacity was measured by the maximal repetitions of sit-to-stand, lateral step up using a 20-cm step, and half-kneel to standing from dominant and non-dominant legs over a 30-sec period, at post-treatment (20 weeks). A significant between-group difference was found, favouring Mitii vs. waitlist.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting upper extremity motor function and visual perception) is more effective than the comparison intervention (waitlist) in improving activity capacity among children with unilateral CP.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting upper extremity motor function and visual perception) is more effective than the comparison intervention (waitlist) in improving activity capacity among children with unilateral CP.
Cost-effectivenessMore effective vs. Waitlist1b
Two high quality RCTs from one project (James et al., 2015; Comans et al., 2017) investigated the effect of telerehabilitation on cost-effectiveness among children with spastic unilateral cerebral palsy (CP). These high quality RCTs randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting upper extremity function and visual perception for 20-30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Cost-effectiveness was measured by the incremental cost-effectiveness ratio at post-treatment (20 weeks). A significant between-group difference was found, favouring Mitii vs. waitlist.
Conclusion: There is moderate level of evidence (Level 1b) from two high quality RCTs from one project that telerehabilitation (Mitii targeting upper extremity function and visual perception) is more effective than the comparison intervention (waitlist) in improving cost-effectiveness among children with spastic unilateral CP.
Conclusion: There is moderate level of evidence (Level 1b) from two high quality RCTs from one project that telerehabilitation (Mitii targeting upper extremity function and visual perception) is more effective than the comparison intervention (waitlist) in improving cost-effectiveness among children with spastic unilateral CP.
Functional and occupational performanceMore effective vs. Waitlist1b
Two high quality RCTs from one project (James et al., 2015; Comans et al., 2017) investigated the effect of telerehabilitation on functional and occupational performance in children with unilateral spastic cerebral palsy (CP). These high quality RCTs randomized children (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting upper extremity function and visual perception for 20-30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Functional and occupational performance were measured by the Assessment of Motor and Process Skills, the Canadian Occupational Performance Measure (COPM), and Performance Satisfaction at post-treatment (20 weeks). A significant between-group difference was found on all measures, favouring Mitii vs. waitlist.
Conclusion: There is moderate level of evidence (Level 1b) from two high quality RCTs from one project that telerehabilitation (Mitii targeting upper extremity function and visual perception) is more effective than the comparison intervention (waitlist) in improving functional and occupational performance in children with unilateral spastic CP.
Conclusion: There is moderate level of evidence (Level 1b) from two high quality RCTs from one project that telerehabilitation (Mitii targeting upper extremity function and visual perception) is more effective than the comparison intervention (waitlist) in improving functional and occupational performance in children with unilateral spastic CP.
Hand functionMore effective vs. Waitlist1b
Two high quality RCTs from one project (James et al., 2015; Comans et al., 2017) investigated the effect of telerehabilitation on hand function among children with unilateral spastic cerebral palsy (CP). These high quality RCTs randomized participants (child/youth alone) to receive telerehabilitation (Move it To Improve it [Mitii] targeting the upper extremity motor function and visual perception for 20-30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Hand function was measured by the Jebsen-Taylor Test of Hand Function at post-treatment (20 weeks). A significant between-group difference was found, favouring Mitii vs. waitlist.
Conclusion: There is moderate level of evidence (Level 1b) from two high quality RCTs from one project that telerehabilitation (Mitii targeting upper extremity function and visual perception) is more effective than the comparison intervention (waitlist) in improving hand function among children with unilateral spastic CP.
Conclusion: There is moderate level of evidence (Level 1b) from two high quality RCTs from one project that telerehabilitation (Mitii targeting upper extremity function and visual perception) is more effective than the comparison intervention (waitlist) in improving hand function among children with unilateral spastic CP.
Visual perceptionMore effective vs. Waitlist1b
Two high quality RCTs from one project (James et al., 2015; Comans et al., 2017) and one non-RCT study (Bilde et al., 2011) investigated the effect of telerehabilitation on visual perception among children with unilateral spastic cerebral palsy (CP).
The high quality RCTs form one project (James et al., 2015; Comans et al., 2017) randomized participants (child/youth alone) to receive telerehabilitation (Move it To Improve it [Mitii] targeting upper extremity function and visual perception for 20-30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Visual perception was measured by the Test of Visual Perceptual Skills at post-treatment (20 weeks). A significant between-group difference was found, favouring Mitii vs. waitlist.
One non-RCT study (Bilde et al., 2011) assigned participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30-minute sessions, 7 sessions a week for 20 weeks). Visual perception was measured by the Test of Visual Perceptual Skills post-treatment (20 weeks). A significant improvement was found.
Conclusion: There is moderate level of evidence (Level 1b) from two high quality RCTs from one project and one non-RCT study that telerehabilitation (Mitii targeting upper extremity function and visual perception) is more effective than the comparison intervention (waitlist) in improving visual perception among children with unilateral spastic CP.
The high quality RCTs form one project (James et al., 2015; Comans et al., 2017) randomized participants (child/youth alone) to receive telerehabilitation (Move it To Improve it [Mitii] targeting upper extremity function and visual perception for 20-30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Visual perception was measured by the Test of Visual Perceptual Skills at post-treatment (20 weeks). A significant between-group difference was found, favouring Mitii vs. waitlist.
One non-RCT study (Bilde et al., 2011) assigned participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30-minute sessions, 7 sessions a week for 20 weeks). Visual perception was measured by the Test of Visual Perceptual Skills post-treatment (20 weeks). A significant improvement was found.
Conclusion: There is moderate level of evidence (Level 1b) from two high quality RCTs from one project and one non-RCT study that telerehabilitation (Mitii targeting upper extremity function and visual perception) is more effective than the comparison intervention (waitlist) in improving visual perception among children with unilateral spastic CP.
Walking enduranceMore effective vs. Waitlist1b
One high quality RCT (Mitchell et al., 2016) and one non-RCT study (Bilde et al., 2011) investigated the effect of telerehabilitation on walking endurance in children with unilateral cerebral palsy (CP).
The high quality RCT (Mitchell et al., 2016) randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30-minute sessions, 6 sessions a week for 20 weeks) vs. waitlist. Walking endurance was measured by the 6 Minute Walk Test at post-treatment (20 weeks). A significant between-group difference was found, favouring Mitii vs. waitlist.
The non-RCT study (Bilde et al., 2011) assigned participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30-minute sessions, 7 sessions a week for 20 weeks). Walking endurance was measured by the 6 Minute Walk Test at post-treatment (20 weeks). A significant improvement was found.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT and one non-RCT study that telerehabilitation (Mitii targeting upper extremity motor function and visual perception) is more effective than the comparison intervention (waitlist) in improving walking endurance among children with unilateral CP.
The high quality RCT (Mitchell et al., 2016) randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30-minute sessions, 6 sessions a week for 20 weeks) vs. waitlist. Walking endurance was measured by the 6 Minute Walk Test at post-treatment (20 weeks). A significant between-group difference was found, favouring Mitii vs. waitlist.
The non-RCT study (Bilde et al., 2011) assigned participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30-minute sessions, 7 sessions a week for 20 weeks). Walking endurance was measured by the 6 Minute Walk Test at post-treatment (20 weeks). A significant improvement was found.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT and one non-RCT study that telerehabilitation (Mitii targeting upper extremity motor function and visual perception) is more effective than the comparison intervention (waitlist) in improving walking endurance among children with unilateral CP.
Activity performanceAs effective vs. Waitlist1b
One high quality RCT (Mitchell et al., 2016) investigated the effect of telerehabilitation on activity performance in children with unilateral cerebral palsy (CP). This high quality RCT randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30-minute sessions, 6 sessions a week for 20 weeks) vs. waitlist. Activity performance was measured by sedentary, light, and moderate-vigorous activity; activity counts, and steps at post-treatment (20 weeks). No significant between-group differences were found.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting the upper extremity function and visual perception) is as effective as the comparison intervention (waitlist) in improving activity performance among children with unilateral CP.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting the upper extremity function and visual perception) is as effective as the comparison intervention (waitlist) in improving activity performance among children with unilateral CP.
Bimanual hand functionAs effective vs. Waitlist1b
Two high quality RCTs from one project (James et al., 2015; Comans et al., 2017) and one non-RCT study (Bilde et al., 2011) investigated the effect of telerehabilitation on bimanual hand function among children with unilateral spastic cerebral palsy (CP).
The high quality RCTs from one project (James et al., 2015; Comans et al., 2017) randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting upper extremity function and visual perception for 20-30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Bimanual hand function was measured by the Assisting Hand Assessment (AHA) at post-treatment (20 weeks). No significant between-group differences were found.
The non-RCT study (Bilde et al., 2011) assigned participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30 minute sessions, 7 sessions a week for 20 weeks). Bimanual hand function was measured by the AHA at post-treatment (20 weeks). No significant improvement was found.
Conclusion: There is moderate level of evidence (Level 1b) from two high quality RCTs from one project and one non-RCT study that telerehabilitation (Mitii targeting upper extremity function and visual perception) is as effective as the comparison intervention (waitlist) in improving bimanual hand function in children with unilateral spastic CP.
The high quality RCTs from one project (James et al., 2015; Comans et al., 2017) randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting upper extremity function and visual perception for 20-30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Bimanual hand function was measured by the Assisting Hand Assessment (AHA) at post-treatment (20 weeks). No significant between-group differences were found.
The non-RCT study (Bilde et al., 2011) assigned participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30 minute sessions, 7 sessions a week for 20 weeks). Bimanual hand function was measured by the AHA at post-treatment (20 weeks). No significant improvement was found.
Conclusion: There is moderate level of evidence (Level 1b) from two high quality RCTs from one project and one non-RCT study that telerehabilitation (Mitii targeting upper extremity function and visual perception) is as effective as the comparison intervention (waitlist) in improving bimanual hand function in children with unilateral spastic CP.
MobilityAs effective vs. Waitlist1b
One high quality RCT (Mitchell et al., 2016) investigated the effect of telerehabilitation on mobility in children with unilateral cerebral palsy (CP). This high quality RCT randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30-minute sessions, 6 sessions a week for 20 weeks) vs. waitlist. Mobility was measured by the Mobility Questionnaire 28 at post-treatment (20 weeks). No significant between-group difference was found.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting upper extremity function and visual perception) is as effective as the comparison intervention (waitlist) in improving mobility among children with unilateral CP.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting upper extremity function and visual perception) is as effective as the comparison intervention (waitlist) in improving mobility among children with unilateral CP.
Recreational participationAs effective vs. Waitlist1b
One high quality RCT (Mitchell et al., 2016) investigated the effect of telerehabilitation on recreational participation in children with unilateral cerebral palsy (CP). This high quality RCT randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30-minute sessions, 6 sessions a week for 20 weeks) vs. waitlist. Recreational participation was measured by the Assessment of Life Habits (ALH: Recreational domain) at post-treatment (20 weeks). No significant between-group difference was found.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting upper extremity function and visual perception) is as effective as the comparison intervention (waitlist) in improving recreational participation among children with CP.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Mitii targeting upper extremity function and visual perception) is as effective as the comparison intervention (waitlist) in improving recreational participation among children with CP.
Upper extremity functionAs effective vs. Waitlist1b
Two high quality RCTs from one project (James et al., 2015; Comans et al., 2017) investigated the effect of telerehabilitation on upper extremity function in children with unilateral spastic cerebral palsy (CP). These high quality RCTs randomized participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting upper extremity function and visual perception for 20-30 minutes a day, 6 days a week for 20 weeks) vs. waitlist. Upper extremity function was measured by the Melbourne Assessment of Unilateral Upper Limb Function at post-treatment (20 weeks). No significant between-group difference was found.
Conclusion: There is moderate level of evidence (Level 1b) from two high quality RCTs from one project that telerehabilitation (Mitii targeting upper extremity function and visual perception) is as effective as the comparison intervention (waitlist) in improving upper extremity function in children with unilateral spastic CP.
Conclusion: There is moderate level of evidence (Level 1b) from two high quality RCTs from one project that telerehabilitation (Mitii targeting upper extremity function and visual perception) is as effective as the comparison intervention (waitlist) in improving upper extremity function in children with unilateral spastic CP.
EnduranceEffective5
One non-RCT study (Bilde et al., 2011) investigated the effect of telerehabilitation on endurance in children with cerebral palsy (CP). This non-RCT study assigned participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30-minute sessions, 7 sessions a week for 20 weeks). Endurance was measured by the Bruce Test at post-treatment (20 weeks). A significant improvement was found.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (Mitii targeting the upper extremity motor functions and visual perception) on endurance among children with CP. However, one non-RCT study found improvements following telerehabilitation.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (Mitii targeting the upper extremity motor functions and visual perception) on endurance among children with CP. However, one non-RCT study found improvements following telerehabilitation.
Motor functionEffective5
One non-RCT study (Bilde et al., 2011) investigated the effect of telerehabilitation on motor function in children with cerebral palsy (CP). This non-RCT study assigned participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30-minute sessions, 7 sessions a week for 20 weeks). Motor function was measured by the Assessment of Motor and Process Skills at post-treatment (20 weeks). A significant improvement was found.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (Mitii targeting the upper extremity motor functions and visual perception) on motor function among children with CP. However, one non-RCT study found improvements following telerehabilitation.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (Mitii targeting the upper extremity motor functions and visual perception) on motor function among children with CP. However, one non-RCT study found improvements following telerehabilitation.
BalanceNot effective 5
One non-RCT study (Bilde et al., 2011) investigated the effect of telerehabilitation on balance in children with cerebral palsy (CP). This non-RCT study assigned participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30-minute sessions, 7 sessions a week for 20 weeks). Balance was measured by the Romberg test, the frontal and lateral step-up tests, and sit-to-stand test at post-treatment (20 weeks). A significant improvement was found only in 1 measure of balance (Romberg Test).
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (Mitii targeting the upper extremity motor functions and visual perception) on balance among children with CP.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (Mitii targeting the upper extremity motor functions and visual perception) on balance among children with CP.
Muscle strengthNot effective 5
One non-RCT study (Bilde et al., 2011) investigated the effect of telerehabilitation on muscle strength in children with cerebral palsy (CP). This non-RCT study assigned participants (child/youth alone) to receive telerehabilitation (Move It To Improve It [Mitii] targeting the upper extremity motor functions and visual perception in 30-minute sessions, 7 sessions a week for 20 weeks). Muscle strength was measured by isometric muscle strength in knee flexors, while extensors were evaluated by iso-dynamometer at post-treatment (20 weeks). No significant improvement was found.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (Mitii targeting the upper extremity motor functions and visual perception) on muscle strength among children with CP.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (Mitii targeting the upper extremity motor functions and visual perception) on muscle strength among children with CP.
Occupational therapy
Results TableFor cerebral palsy, there were 3 studies on tele-treatments provided by occupational therapists. Out of those studies, 1 is a high quality randomized clinical trials (RCTs) and 2 are non-RCTs.
The focus of the tele-interventions provided by occupational therapists was sensory dexterity, bimannual hand function, upper extremity motor function, strength, bilateral coordination, and reaction speed.
Eleven (n=11) different outcomes were studied, and 36.3% of them emerge from the RCTs.
Expand on the outcomes below to find out more.
DexterityMore effective vs. LIFT-control1b
One high quality RCT (Ferre et al., 2017) investigated the effect of telerehabilitation on dexterity in children with unilateral spastic cerebral palsy (CP). This high quality RCT randomized participants (children/youth and parent) to receive telerehabilitation (Home-based hand-arm bimanual intensive therapy [H-HABIT], targeting dexterity and bilateral hand function in 2 hour sessions, 5 times a week for 9 weeks) vs. a comparison intervention (Lower functional intensive training [LIFT-control]). Dexterity was measured by the Box and Block Test at post-treatment (9 weeks). A significant between-group difference was found, favouring H-HABIT vs. LIFT-control.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (H-HABIT targeting dexterity and bimanual hand function) is more effective than the comparison intervention (LIFT-control) in improving dexterity among children with CP.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (H-HABIT targeting dexterity and bimanual hand function) is more effective than the comparison intervention (LIFT-control) in improving dexterity among children with CP.
Occupational performanceMore effective vs. LIFT-control1b
One high quality RCT (Ferre et al., 2017) investigated the effect of telerehabilitation on occupational performance in children with unilateral spastic cerebral palsy (CP). This high quality RCT randomized participants (children/youth and parent) to receive telerehabilitation (Home-based hand-arm bimanual intensive therapy [H-HABIT], targeting dexterity and bilateral hand function in 2 hour sessions, 5 times a week for 9 weeks) vs. a comparison intervention (Lower functional intensive training [LIFT-control]). Occupational performance was measured by the Canadian Occupational Performance Measure (COPM: Performance) at post-treatment (9 weeks). A significant between-group difference was found, favouring H-HABIT vs. LIFT-control.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (H-HABIT targeting dexterity and bimanual hand function) is more effective than the comparison intervention (LIFT-control) in improving occupational performance among children with CP.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (H-HABIT targeting dexterity and bimanual hand function) is more effective than the comparison intervention (LIFT-control) in improving occupational performance among children with CP.
Bimanual hand functionAs effective vs. LIFT-control1b
One high quality RCT (Ferre et al., 2017) and one non-RCT study (Reinfenberg et al., 2017) investigated the effect of telerehabilitation on bimanual hand function in children with unilateral spastic cerebral palsy (CP).
The high quality RCT (Ferre et al., 2017) randomized participants (children/youth and parents) to receive telerehabilitation (Home-based hand-arm bimanual intensive therapy [H-HABIT], targeting dexterity and bilateral hand function in 2 hour sessions, 5 times a week for 9 weeks) vs. a comparison intervention (Lower functional intensive training [LIFT-control]). Bimanual hand function was measured by the Assisting Hand Assessment (AHA) at post-treatment (9 weeks). No significant between-group difference was found.
The non-RCT study (Reifenberg et al., 2017) assigned participants (child and parent) to receive telerehabilitation (Game-Based Neurorehabilitation + Telehealth Technologies [GbN+TT] targeting upper extremity motor functions, strength, bilateral coordination, and reaction speed for 7 hours a week for 8 weeks), vs. no training. Bimanual hand function was measured by the AHA at post-treatment (12 weeks; 8 weeks with a 4-week washout period). A significant improvement was found.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (H-HABIT targeting dexterity and bimanual hand function) is as effective as the comparison intervention (LIFT-control) in improving bimanual hand function among children with CP. One non-RCT study found improvements following tele-rehabilitation.
The high quality RCT (Ferre et al., 2017) randomized participants (children/youth and parents) to receive telerehabilitation (Home-based hand-arm bimanual intensive therapy [H-HABIT], targeting dexterity and bilateral hand function in 2 hour sessions, 5 times a week for 9 weeks) vs. a comparison intervention (Lower functional intensive training [LIFT-control]). Bimanual hand function was measured by the Assisting Hand Assessment (AHA) at post-treatment (9 weeks). No significant between-group difference was found.
The non-RCT study (Reifenberg et al., 2017) assigned participants (child and parent) to receive telerehabilitation (Game-Based Neurorehabilitation + Telehealth Technologies [GbN+TT] targeting upper extremity motor functions, strength, bilateral coordination, and reaction speed for 7 hours a week for 8 weeks), vs. no training. Bimanual hand function was measured by the AHA at post-treatment (12 weeks; 8 weeks with a 4-week washout period). A significant improvement was found.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (H-HABIT targeting dexterity and bimanual hand function) is as effective as the comparison intervention (LIFT-control) in improving bimanual hand function among children with CP. One non-RCT study found improvements following tele-rehabilitation.
Occupational performance satisfactionAs effective vs. LIFT-control1b
One high quality RCT (Ferre et al., 2017) investigated the effect of telerehabilitation on occupational performance satisfaction in children with unilateral spastic cerebral palsy (CP). This high quality RCT randomized participants (children/youth and parents) to receive telerehabilitation (Home-based hand-arm bimanual intensive therapy [H-HABIT], targeting dexterity and bilateral hand function in 2 hour sessions, 5 times a week for 9 weeks) vs. a standardized intervention (Lower functional intensive training [LIFT-control]). Occupational performance satisfaction was measured by the Canadian Occupational Performance Measure (COPM: Satisfaction Performance) at post treatment (9 weeks). No significant between-group difference was found.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (H-HABIT targeting dexterity and bimanual hand function) is as effective as the comparison intervention (LIFT-control) in improving occupational performance satisfaction among children with unilateral spastic CP.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (H-HABIT targeting dexterity and bimanual hand function) is as effective as the comparison intervention (LIFT-control) in improving occupational performance satisfaction among children with unilateral spastic CP.
Fine and gross motor functionEffective5
One non-RCT study (Reifenberg et al., 2017) investigated the effectiveness of telerehabilitation intervention on fine and gross motor function in one child with spastic hemiparetic cerebral palsy (CP). This non-RCT study assigned participants (child and parent) to receive telerehabilitation (Game-Based Neurorehabilitation + Telehealth Technologies [GbN+TT] targeting upper extremity motor functions, strength, bilateral coordination, reaction speed for 7 hours a week for 8 weeks) vs. no training. Fine and gross motor functions were measured by the Bruininks-Oseretsky Test of Motor Proficiency (2nd edition) at post-treatment (12 weeks; 8 weeks with a 4-week washout period). A significant improvement was found.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (GbN+TT targeting upper extremity motor functions, strength, bilateral coordination, and reaction speed) on fine and gross motor function among one child with CP. However, one non-RCT study found improvements following telerehabilitation.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (GbN+TT targeting upper extremity motor functions, strength, bilateral coordination, and reaction speed) on fine and gross motor function among one child with CP. However, one non-RCT study found improvements following telerehabilitation.
Functional performanceEffective5
One non-RCT study (Reiferberg et al., 2017) investigated the effect of telerehabilitation intervention functional performance in one child with spastic hemiparetic cerebral palsy (CP). This non-RCT study assigned participants (child and parent) to receive telerehabilitation (Game-Based Neurorehabilitation + Telehealth Technologies [GbN+TT] targeting upper extremity motor functions, strength, bilateral coordination, reaction speed for 7 hours a week for 8 weeks) vs. no training. Functional performance was measured by the Pediatric Evaluation of Disability Inventory computer-adapted version (PEDI-CAT) at post-treatment (12 weeks; 8 weeks with a 4-week washout period). A significant improvement was found.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (GbN+TT targeting upper extremity motor functions, strength, bilateral coordination, and reaction speed) on functional performance in one child with CP. However, one non-RCT study found improvements following telerehabilitation.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (GbN+TT targeting upper extremity motor functions, strength, bilateral coordination, and reaction speed) on functional performance in one child with CP. However, one non-RCT study found improvements following telerehabilitation.
Functional upper-extremity use Effective5
One non-RCT study (Reiferberg et al., 2017) investigated the effect of telerehabilitation intervention on functional upper extremity use in one child with spastic hemiparetic cerebral palsy (CP). This non-RCT study assigned participants (child and parent) to receive telerehabilitation (Game-Based Neurorehabilitation + Telehealth Technologies [GbN+TT] targeting upper extremity motor functions, strength, bilateral coordination, reaction speed for 7 hours a week for 8 weeks) vs. no training. Functional upper-extremity use was measured by the Pediatric Motor Activity Log at post-treatment (12 weeks; 8 weeks with a 4-week washout period). A significant improvement was found.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (GbN+TT targeting upper extremity motor functions, strength, bilateral coordination, and reaction speed) on functional upper-extremity use in one child with CP. However, one non-RCT study found improvements following telerehabilitation.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (GbN+TT targeting upper extremity motor functions, strength, bilateral coordination, and reaction speed) on functional upper-extremity use in one child with CP. However, one non-RCT study found improvements following telerehabilitation.
Grip strengthEffective5
One non-RCT study (Golomb et al., 2010) investigated the effect of telerehabilitation on grip strength in adolescents with severe hemiplegic cerebral palsy (CP). This non-RCT study assigned participants (youth alone) to receive telerehabilitation (virtual reality [VR] video game intervention targeting upper extremity function for 30 minutes a day, 5 days a week for 3 months) vs. no treatment. Grip strength was tested using the Jebsen Test at post-treatment (3 months). A significant improvement was found.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (VR video game intervention targeting upper extremity function) on grip strength among adolescents with CP. However, one non-RCT study found improvements following telerehabilitation.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (VR video game intervention targeting upper extremity function) on grip strength among adolescents with CP. However, one non-RCT study found improvements following telerehabilitation.
Hand range of motionEffective5
One non-RCT study (Golomb et al., 2010) investigated the effect of telerehabilitation on hand range of motion in adolescents with severe hemiplegic Cerebral Palsy (CP). This case series study assigned participants (youth alone) to receive telerehabilitation (virtual reality [VR] video game intervention targeting upper extremity function for 30 minutes a day, 5 days a week for 3 months). Hand range of motion was measured using a goniometer at post-treatment (3 months). A significant improvement was found.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (VR video game intervention targeting upper extremity function) on hand range of motion among adolescents with severe hemiplegic CP. However, one non-RCT study found improvements following telerehabilitation.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (VR video game intervention targeting upper extremity function) on hand range of motion among adolescents with severe hemiplegic CP. However, one non-RCT study found improvements following telerehabilitation.
Parental stress levelEffective5
One non-RCT study (Reiferberg et al., 2017) investigated the effect of telerehabilitation on parental stress level among caregivers of children with spastic hemiparetic cerebral palsy (CP). This non-RCT study assigned participants (parent alone) to a telerehabilitation program for their children (Game-Based Neurorehabilitation + Telehealth Technologies [GbN+TT] targeting upper extremity motor functions, strength, bilateral coordination, reaction speed for 7 hours a week for 8 weeks). Parental stress level was measured by the Perceived Stress Scale (PSS-14) at post-treatment (12 weeks; 8 weeks with a 4-week washout period). A significant improvement was found.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (GbN+TT targeting upper extremity motor functions, strength, bilateral coordination, and reaction speed) on parental stress level in caregivers of children with CP. However, one non-RCT study found improvements following telerehabilitation.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (GbN+TT targeting upper extremity motor functions, strength, bilateral coordination, and reaction speed) on parental stress level in caregivers of children with CP. However, one non-RCT study found improvements following telerehabilitation.
Upper extremity movement patternsNot effective 5
One non-RCT study (Reiferberg et al., 2017) investigated the effect of telerehabilitation on upper extremity movement patterns and hand function in one child with spastic hemiparetic cerebral palsy (CP). This non-RCT study assigned participants (child and parent) to receive telerehabilitation (Game-Based Neurorehabilitation + Telehealth Technologies [GbN+TT] targeting upper extremity motor functions, strength, bilateral coordination, reaction speed for 7 hours a week for 8 weeks) vs. no training. Upper extremity movement patterns and hand function was measured by the Quality of Upper Extremity Skills Test at post-treatment (12 weeks; 8 weeks with a 4-week washout period). No significant improvement was found.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (GbN+TT targeting upper extremity motor functions, strength, bilateral coordination, and reaction speed) on upper extremity movement patterns and hand function in children with CP.
Conclusion: There is insufficient evidence (Level 5) from one non-RCT study regarding the effect of telerehabilitation (GbN+TT targeting upper extremity motor functions, strength, bilateral coordination, and reaction speed) on upper extremity movement patterns and hand function in children with CP.
Physical therapy
Results TableFor cerebral palsy, there were 2 studies on tele-treatments provided by physical therapists. Out of those studies, 1 is a high quality randomized clinical trials (RCTs) and 1 is a non-RCT.
The focus of the tele-interventions provided by physical therapists was upper and lower extremity motor functions and mobility.
Six (n=6) different outcomes were studied, and 66.6% of them emerge from RCTs.
Expand on the outcomes below to find out more.
MobilityMore effective vs. H-HABIT1b
One high quality RCT (Surana et al., 2019) investigated the effect of telerehabilitation on mobility in children with unilateral spastic cerebral palsy (CP). This high quality RCT randomized participants (children and parents) to receive telerehabilitation (Lower functional intensive training [LIFT-control] targeting upper and lower extremity motor functions; 2 hours a day, 5 days a week for 9 weeks) vs. a comparison intervention (Home-based hand-arm bimanual intensive therapy [H-HABIT]). Mobility was measured by the parent-reported ABILOCO-Kids at post-treatment (9 weeks). A significant between-group difference was found, favouring LIFT-control vs. H-HABIT.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (LIFT-control targeting upper and lower extremity motor functions) is more effective than a comparison intervention (H-HABIT) in improving mobility among children with CP.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (LIFT-control targeting upper and lower extremity motor functions) is more effective than a comparison intervention (H-HABIT) in improving mobility among children with CP.
Walking capacityMore effective vs. H-HABIT1b
One high quality RCT (Surana et al., 2019) investigated the effect of telerehabilitation on walking capacity in children with unilateral spastic cerebral palsy (CP). This high quality RCT randomized participants (children and parents) to receive telerehabilitation (Lower functional intensive training [LIFT-control] targeting upper and lower extremity motor functions; 2 hours a day, 5 days a week for 9 weeks) vs. a comparison intervention (Home-based hand-arm bimanual intensive therapy [H-HABIT]). Walking capacity was measured by the 1 Minute Walk Test and 10 Meter Walk Test at post-treatment (9 weeks). A significant between-group difference was found, favouring LIFT-control vs. H-HABIT.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (LIFT-control targeting upper and lower extremity motor functions) is more effective than a comparison intervention (H-HABIT) in improving walking capacity among children with CP.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (LIFT-control targeting upper and lower extremity motor functions) is more effective than a comparison intervention (H-HABIT) in improving walking capacity among children with CP.
EnduranceAs effective vs. H-HABIT1b
One high quality RCT (Surana et al., 2019) investigated the effect of telerehabilitation on endurance in children with unilateral spastic cerebral palsy (CP). This high quality RCT randomized participants (children and parents) to receive telerehabilitation (Lower functional intensive training [LIFT-control] targeting upper and lower extremity motor functions; 2 hours a day, 5 days a week for 9 weeks) vs. a comparison intervention (Home-based hand-arm bimanual intensive therapy [H-HABIT]). Endurance was measured by the 30-s chair rise at post-treatment (9 weeks). No significant between-group difference was found.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (LIFT-control targeting upper and lower extremity motor functions) is as effective as a comparison intervention (H-HABIT) in improving endurance among children with CP.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (LIFT-control targeting upper and lower extremity motor functions) is as effective as a comparison intervention (H-HABIT) in improving endurance among children with CP.
Standing balanceAs effective vs. H-HABIT1b
One high quality RCT (Surana et al., 2019) investigated the effect of telerehabilitation on standing balance in children with unilateral spastic cerebral palsy (CP). This high quality RCT randomized participants (children and parents) to receive telerehabilitation (Lower functional intensive training [LIFT-control] targeting upper and lower extremity motor functions; 2 hours a day, 5 days a week for 9 weeks) vs. a comparison intervention (Home-based hand-arm bimanual intensive therapy [H-HABIT]). Standing balance was measured by the Single-leg stance on the affected side at post treatment (9 weeks). No significant between-group difference was found.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (LIFT-control targeting upper and lower extremity motor functions) is as effective as a comparison intervention (H-HABIT) in improving standing balance among children with CP.
Conclusion: There is a moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (LIFT-control targeting upper and lower extremity motor functions) is as effective as a comparison intervention (H-HABIT) in improving standing balance among children with CP.
Occupational performanceEffective5
One non-RCT study (Weightman et al., 2011) investigated the effect of telerehabilitation on occupational performance among children with cerebral palsy (CP). This non-RCT study assigned participants (child and parent) to receive telerehabilitation (Home-based rehabilitation exercise system [HB-RES] targeting the upper and lower extremity motor functions and mobility with 75-minute sessions for 4 weeks). Occupational performance was measured by the Canadian Occupational Performance Measure (COPM: Performance) at post-treatment (4 weeks). A significant improvement was found.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (HB-RES targeting the upper and lower extremity motor functions and mobility) on occupational performance among children with CP. However, one non-RCT study found improvements following telerehabilitation.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (HB-RES targeting the upper and lower extremity motor functions and mobility) on occupational performance among children with CP. However, one non-RCT study found improvements following telerehabilitation.
Upper extremity kinematicsNot effective5
One non-RCT study (Weightman et al., 2011) investigated the effect of telerehabilitation on upper extremity kinematics among children with cerebral palsy (CP). This non-RCT study assigned participants (child and parent) to receive telerehabilitation (Home-based rehabilitation exercise system [HB-RES] targeting the upper and lower extremity motor functions and mobility with 75 minute sessions for 4 weeks). Upper extremity kinematics were measured by range of elbow movement, movement time, peak speed and smoothness of movement (normalized average rectified jerk) at post-treatment (4 weeks). No significant improvements were found.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (Home-based rehabilitation exercise system [HB-RES] targeting the upper and lower extremity motor functions and mobility) on upper extremity kinematics among children with CP.
Conclusion: There is insufficient evidence (Level 5) regarding the effect of telerehabilitation (Home-based rehabilitation exercise system [HB-RES] targeting the upper and lower extremity motor functions and mobility) on upper extremity kinematics among children with CP.
Speech language pathology
Results TableFor cerebral palsy, there was one study on tele-treatments provided by speech-language pathologists. This study was a high quality RCT.
The focus of the tele-interventions provided by speech-language pathologists was primarily to improve speech functions.
Two (n=2) different outcomes were studied.
Expand on the outcomes below to find out more.
Communicative performance and participationMore effective vs. Usual care1b
One high quality RCT (Pennington et al., 2018) investigated the effect of telerehabilitation on communicative performance and participation among children with dysarthria and cerebral palsy (CP). This high quality RCT assigned participants (child/youth alone) to receive telerehabilitation (Skype dysarthria speech language pathology [SLP] targeting speech functions in 40-minute sessions, 3 sessions a week for 6 weeks) vs. usual care (face-to-face speech language pathology). Communicative performance and participation were measured by the Focus on the Outcomes of Communication Under Six (FOCUS) at post-treatment (6 weeks). A significant between-group difference was found, favouring SLP vs. usual care.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Skype dysarthria SLP targeting speech functions) is more effective than standard care in improving communicative performance and participation among children with dysarthria and CP.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Skype dysarthria SLP targeting speech functions) is more effective than standard care in improving communicative performance and participation among children with dysarthria and CP.
Speech intelligibilityAs effective vs. Usual care 1b
One high quality RCT (Pennington et al., 2018) investigated the effect of telerehabilitation on speech intelligibility among children with dysarthria and cerebral palsy (CP). This high quality RCT assigned participants (child/youth alone) to receive telerehabilitation (Skype dysarthria speech language pathology [SLP] targeting speech functions in 40-minute sessions, 3 sessions a week for 6 weeks) vs. usual care (face-to-face speech language pathology). Speech intelligibility was measured by the Children’s Speech Intelligibility Measure at post-treatment (6 weeks). No significant between-group difference was found.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Skype dysarthria SLP targeting speech functions) is as effective as the comparison intervention (usual care) in improving speech intelligibility among children with dysarthria and CP.
Conclusion: There is moderate level of evidence (Level 1b) from one high quality RCT that telerehabilitation (Skype dysarthria SLP targeting speech functions) is as effective as the comparison intervention (usual care) in improving speech intelligibility among children with dysarthria and CP.
References
Bilde, P.E., et al., Individualized, home-based interactive training of cerebral palsy children delivered through the Internet. BMC Neurol, 2011. 11: p. 32.
Comans, T., et al., The cost-effectiveness of a web-based multimodal therapy for unilateral cerebral palsy: the Mitii randomized controlled trial. Developmental Medicine and Child Neurology, 2017. 59(7): p. 756-761.
Ferre, C.L., et al., Caregiver-directed home-based intensive bimanual training in young children with unilateral spastic cerebral palsy: a randomized trial. Dev Med Child Neurol, 2017. 59(5): p. 497-504.
Golomb, M.R., et al., In-Home Virtual Reality Videogame Telerehabilitation in Adolescents With Hemiplegic Cerebral Palsy. Archives of Physical Medicine and Rehabilitation, 2010. 91(1): p. 1-8.e1.
James, S., et al., Randomized controlled trial of web-based multimodal therapy for unilateral cerebral palsy to improve occupational performance. Developmental Medicine and Child Neurology, 2015. 57(6): p. 530-538.
Maher, C., et al., An internet-based physical activity intervention for adolescents with cerebral palsy: a randomized controlled trial. Developmental Medicine and Child Neurology, 2010. 52(5): p. 448-55.
Mitchell, L.E., J. Ziviani, and R.N. Boyd, A randomized controlled trial of web-based training to increase activity in children with cerebral palsy. Developmental Medicine & Child Neurology, 2016. 58(7): p. 767-73.
Pennington, L., et al., Internet delivery of intensive speech and language therapy for children with cerebral palsy: a pilot randomised controlled trial. BMJ Open, 2019. 9(1): p. e024233.
Reifenberg, G., et al., Feasibility of pediatric game-based neurorehabilitation using telehealth technologies: A case report. American Journal of Occupational Therapy, 2017. 71(3): p. 7103190040 1-8.
Surana, B.K., et al., Effectiveness of Lower-Extremity Functional Training (LIFT) in Young Children With Unilateral Spastic Cerebral Palsy: A Randomized Controlled Trial. Neurorehabilitation and Neural Repair, 2019. 33(10): p. 862-872.
Weightman, A., et al., Home-based computer-assisted upper limb exercise for young children with cerebral palsy: A feasibility study investigating impact on motor control and functional outcome. Journal of Rehabilitation Medicine, 2011. 43(4): p. 359-63. 10.
Patient and family information
Summary for Patients/FamiliesWhat research is available?
There are 11 studies on different available telerehab-treatments.
How strong is the research behind these treatments?
How strong is the research behind these treatments?
Seven studies are of high research quality, while 4 studies are of low research quality.
Telerehabilitation is an emerging and a rapidly growing field. More high-quality research is on its way. We are dedicated to update the available information with the most recent findings.
Seven studies are of high research quality, while 4 studies are of low research quality.
Telerehabilitation is an emerging and a rapidly growing field. More high-quality research is on its way. We are dedicated to update the available information with the most recent findings.
Who provides these treatments?
These telerehab-treatments are provided by different specialists including:
• Occupational therapists (OT)
• Physiotherapists (PT)
• Speech-language pathologists (SLP)
• Multidisciplinary teams of different professionals (e.g., OT, SLP)
• Occupational therapists (OT)
• Physiotherapists (PT)
• Speech-language pathologists (SLP)
• Multidisciplinary teams of different professionals (e.g., OT, SLP)
What is the involvement of the clinician in these treatments?
Clinicians are mainly actively involved in these telerehab-treatments. In other words, they are present and engaged with you and/or the child in every therapy session.
How are these treatments provided?
In most cases, telerehab-treatments are provided through videoconferencing by using different platforms (e.g., Skype, Zoom, or other video calls options).
Who receives these treatments?
Telerehab-treatments are provided mostly directly to the children with CP alone. Fewer treatments engaged both the child and their parent together in their approach. No treatments engaged the parents alone.
What are the goals of these treatments?
All of the telerehab-treatments focus on improving child-related outcomes including:
Child’s…
• Upper and lower extremity motor functions (e.g. ability to move arms and legs)
• Visual perception (e.g. ability to perceive different visual depths)
• Dexterity (e.g. ability to manipulate small objects such as coins, zipper, pencil)
• Bimanual hand function (e.g. ability to perform a task that requires the use of both hands)
• Strength
• Bilateral coordination
• Reaction speed
• Mobility
• Speech functions
• Physical activity
• Upper and lower extremity motor functions (e.g. ability to move arms and legs)
• Visual perception (e.g. ability to perceive different visual depths)
• Dexterity (e.g. ability to manipulate small objects such as coins, zipper, pencil)
• Bimanual hand function (e.g. ability to perform a task that requires the use of both hands)
• Strength
• Bilateral coordination
• Reaction speed
• Mobility
• Speech functions
• Physical activity
Does it work?
Yes! Telerehab-treatments are shown to work for children and youth with CP and their families.
For instance, telerehab delivered by occupational and physical therapists, a multidisciplinary team, and speech-language pathologists were shown to be more effective in improving numerous skills and abilities among parents and children than when family receives:
• No treatment
• Face-to-face comparable treatment
• Usual care
It is important to note that no studies showed that the telerehab-treatments were less effective (than other interventions) or detrimental.
For instance, telerehab delivered by occupational and physical therapists, a multidisciplinary team, and speech-language pathologists were shown to be more effective in improving numerous skills and abilities among parents and children than when family receives:
• No treatment
• Face-to-face comparable treatment
• Usual care
It is important to note that no studies showed that the telerehab-treatments were less effective (than other interventions) or detrimental.
Are there any side effects/risks?
If your medical and rehabilitation team have cleared you and/or your child to engage in telerehabilitation, there are no specific associated risks or side effects. Your rehabilitation professional will help you and your child to perform the therapy safely and effectively.
However, it is important to relay any concerns and/or questions to your rehabilitation professional because telerehabilitation is a relatively new approach and it is different from the traditional face-to-face method. For instance, sometimes, technical issues (e.g., access to suitable technology such as a computer or a smart phone, internet connection, the platform that is used) might come up.
We encourage you to discuss these and other issues with your rehabilitation specialist to promote best results and optimize your therapy sessions.
However, it is important to relay any concerns and/or questions to your rehabilitation professional because telerehabilitation is a relatively new approach and it is different from the traditional face-to-face method. For instance, sometimes, technical issues (e.g., access to suitable technology such as a computer or a smart phone, internet connection, the platform that is used) might come up.
We encourage you to discuss these and other issues with your rehabilitation specialist to promote best results and optimize your therapy sessions.
How many treatments are necessary to make progress?
On average, improvements were noted following telerehab-treatments that were provided for 30-60 minutes, 3-5 days per week, for about 10 weeks.
However, every child’s needs and progress journeys, as well as parents’ resources, preferences, and availabilities are different.
In collaboration with your rehabilitation professional, you can determine the duration and frequency of tele-treatments that are most optimal and suitable for you and your child.
However, every child’s needs and progress journeys, as well as parents’ resources, preferences, and availabilities are different.
In collaboration with your rehabilitation professional, you can determine the duration and frequency of tele-treatments that are most optimal and suitable for you and your child.
Is this appropriate for me and my child?
Telerehab could be a great option for certain interventions that are feasible to be delivered and received virtually.
Children with CP aged anywhere from about 2 to 18 years old, and their families, can benefit from telerehab. However, every child’s needs, family’s resources, and progress journeys are different. We encourage that you discuss the appropriateness of telerehabilitation with your health professional.
Children with CP aged anywhere from about 2 to 18 years old, and their families, can benefit from telerehab. However, every child’s needs, family’s resources, and progress journeys are different. We encourage that you discuss the appropriateness of telerehabilitation with your health professional.
Where can I access more detailed information (e.g., that I can share with my child’s health provider)?