Effectiveness of home-delivered action observation therapy by means of Tele-UPCAT system

Introduction: Action Observation Therapy (AOT) is a new rehabilitative approach for children with cerebral palsy. A new platform called Tele‐UPper Limb Children Action Observation Training (Tele‐UPCAT) has been provided to deliver AOT in a home setting and an RCT study protocol has been already published (Sgandurra et al, BMJ Open, 2018) and registered (NCT03094455). Moreover, Tele‐UPCAT demonstrated to be feasible as a home‐based AOT for children and adolescents with UCP (Beani et al, Front Neurol, 2020). Patients and Methods: Twenty‐nine children aged 11.73 ± 3.65 years (range 6.00‐18.75) with a diagnosis of unilateral cerebral palsy were enrolled. Fifteen were immediately allocated to the experimental group of 3‐weeks Tele‐UPCAT training while 14 participants were firstly allocated to the waitlist group starting with a 3‐weeks of standard care followed by Tele‐UPCAT training. The assessment points were the week before (T0) and after (T1) the period of AOT/standard care. Further assessments were at T1 plus, the week after the AOT period for the waitlist group and at 8 weeks (T2) and 24 weeks (T3) after AOT training. The primary outcome measure was the Assisting Hand Assessment (AHA). Linear mixed models has been fitted, with fixed effects TIMING and GROUP (along with their interaction) and random effects. Results: A significative timing∗group effect was found both considering the short term effects (T1 vs T0, p = 0.021) and long term effects (p = 0.024) at the AHA. Conclusion: These results highlight the evidence of AOT effectiveness also when delivered at home by means of new technological approaches, such as Tele‐UPCAT platform.