A pilot single-blind multicentre randomised controlled trial to evaluate the potential benefits of computer-assisted arm rehabilitation gaming technology on arm function of children with spastic cerebral palsy. Run-on subtitle: Computer-assisted arm rehabilitation Authors:

Objective: To evaluate the potential benefits of computer-assisted arm rehabilitation gaming technology on arm function of children with spastic cerebral palsy. Design: a single-blind randomised controlled trial design. Power calculations indicated that 58 children would be required to demonstrate a clinically important difference. Setting: Intervention was home-based; recruitment took place in regional spasticity clinics. Participants: Fifteen children with cerebral palsy aged five to twelve years were recruited; eight to the device group. Interventions: Both study groups ヴWIWキ┗WS け┌ゲ┌;ノ aラノノラ┘ ┌ヮ デヴW;デマWミデげ aラノノラ┘キミェ spasticity treatment with botulinum toxin; the intervention group also received a rehabilitation gaming device. Main measures: ABILHAND-kids and Canadian Occupational Performance Measure were performed by blinded assessors at baseline, six and twelve weeks. Results: An ANCOVA showed no group differences in mean ABILHAND-kids scores between time points. A non-parametric ANOVA on Canadian Occupational Performance Measure scores showed a statistically significant improvement across time points (x 2 (2,15)=6.778, p=0.031) but this improvement did not reach minimal clinically important difference. Mean daily device use was seven minutes. Recruitment did not reach target due to unanticipated staff shortages in clinical services. Feedback from children and their families indicated that the games were not sufficiently engaging to promote sufficient use that was likely to result in functional benefits. Conclusion: This study suggests that computer-assisted arm rehabilitation gaming does not benefit arm function but a Type II error cannot be ruled out. Clinical messages:  The use of assistive gaming technology for less than eight minutes per day in non-collaborative and non-competitive game play does not benefit upper limb activity limitation of children with cerebral palsy.