Andrew Weightman, Nick Preston, Martin Levesley, Raymond Holt, Mark Mon-Williams, Mike Clarke, Alastair J. Cozens, Bipin Bhakta
DOI: 10.2340/16501977-0679

Objective: We developed a home-based rehabilitation exercise system incorporating a powered joystick linked to a computer game, to enable children with arm paresis to participate in independent home exercise. We investigated the feasibility and impact of using the system in the home setting.
Methods: Eighteen children with cerebral palsy (median age 7. 5 years, age range 5–16 years) were recruited from local National Health Service and the exercise system was installed in their home for approximately 4 weeks. Baseline and post-intervention assessments were taken: Canadian Occupational Performance Measure (COPM); kinematic measurement of movement quality (indexed by duration and smoothness) measured using a motion tracking system when performing a standardized computer task.
Results: The system was used for a median time of 75 min (interquartile range (IQR) 17–271), equating to 606 outward and 734 inward movements. Pre-COPM, (median 4. 2); post-COPM (median 6. 0); obs = 34; z = 3. 62, p < 0. 01). Kinematic analysis of pre- and post-intervention movements on the standardized task showed decreased duration and increased smoothness.
Conclusion: Some improvements in self-reported function and quality of movement are observed. This pilot study suggests that the system could be used to augment home-based arm exercise in an engaging way for children with cerebral palsy, although a controlled clinical trial is required to establish clinical efficacy. The feasibility of this technology has been demonstrated.