MiTii: A randomised trial of novel web-based upper limb intervention for congenital hemiplegia

MiTii (“Move it To improve it”) is an internet-based multimodal therapy which combines upper-limb training within the context of meaningful physical activity that can be accessed in children's homes. Inherent in this approach is the ability to scaffold visual perception skills and cognitive challenge, both important aspects of activity engagement and participation in a virtual training environment. The program is potentially cost effective as only three centre-based therapists (Physiotherapist, Occupation Therapist, and psychologist) are required to provide initial assessment, goal setting and training for families and participating children. Each therapist then spends 30 minutes each week to remotely modify the individualised program. This current application proposes to test the efficacy of MiTii in a wait list randomised controlled trial. We propose to provide MiTii at an intensity of 30 minutes per day, 6 days/week for 20 weeks (total dose 60 hours). All children will therefore receive the therapy within 10 months of being randomised either to commence MiTii immediately or waitlisted for 20 weeks before receiving the same Mitii therapy as the Immediate invention group. Retention of effects will be tested at 10 months. As current therapy programs are resource intensive and time consuming it is important to determine if gains from MiTii are sustained over a 10 month period as this could offer a cost effective model of care, particularly for rural, remote and isolated children with CP.