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Bootle Blast: A pilot randomized control trial

Cerebral palsy (CP) is a lifelong condition that affects movement and function. Movement therapies benefit children with CP but can be unexciting, costly and hard to access. Children, parents, and clinicians want video games that motivate home practice for hand and arm therapy. Yet, few home-based video games for therapy have proven effective. Our interdisciplinary team worked with children to co-create Bootle Blast. Bootle Blast is a motivating, adaptable video game that tracks movement and interaction with real-life objects. Early findings show that children with CP can improve in function by playing Bootle Blast at home. A randomized controlled trial (RCT) is needed to establish the effectiveness of Bootle Blast. Large-scale RCTs are costly. Pilot RCTs are used to increase the chances that large-scale RCTs lead to clinically meaningful results.

Objective. We will answer the question: Is it feasible and acceptable to carry out a RCT to determine if 12 weeks of home practice with Bootle Blast improves upper limb function, activity, and participation?

Approach. A 24-week pilot RCT with 46 children with CP, aged 6-17 years who have difficulty handling objects. The intervention group will play Bootle Blast at home for 12 weeks. The control group will receive usual care for the first 12 weeks and then will play Bootle Blast. Feasibility will be measured by rates of recruitment and adherence. Children/caregivers will be asked about the positive and negative parts of Bootle Blast. We will report how many children make clinically important gains. We will also look at factors influencing outcomes (e.g. age, dose) and engagement.

Impact. Study results will inform future work to establish Bootle Blast as an effective, motivating option for home-based hand/arm therapy. We will create new knowledge that will be shared widely.

Principal Investigator

Elaine Biddiss, MASc, PhD

Darcy Fehlings, MD

Co-Investigators and Research Team

Hana Alazem, MD, MSc PT, FRCPC

Daniela Chan-Viquez, MSc, PT, PhD Candidate 

Carolyn Hunt, MD

Shannon Knights, MD

Anna McCormick, MD, FRCPC

Fiona Moola, PhD

Simar Moussaoui, BSc, MA Candidate

Sarah Munce, MSc, PhD

Joanne Wincentak, MSc(OT), OT Reg. (Ont.)

Virginia Wright, PhD