Feedback on the Speed Track: Feasibility of Clinician-Delivered Ride-On-Toy Navigation Training for Children With Unilateral Cerebral Palsy

Importance: Technology-based adjuncts have been used to incentivize and boost upper extremity (UE) motor rehabilitation among children with unilateral cerebral palsy (UCP). Objective: To evaluate the feasibility and perceived benefit of a clinician-delivered ride-on-toy navigation training (RNT) program. Design: Single-group pretest–posttest design. Setting: Three-week task-oriented UE training camp. Participants: Children with UCP (N = 13) ages 4 to 11 yr. Intervention: Children received 5 hours of unimanual practice and 1 hour of bimanual practice 5 days/wk for 3 wk. As part of daily camp programming, they received 15 to 30 min of RNT delivered by clinicians (two occupational therapists and two physical therapists). Ride-on toys were operated with a single joystick on the child’s affected side. Outcomes and Measures: Feasibility and acceptance of RNT were assessed by tracking session adherence and in-session affected UE use and through a clinician-rated exit questionnaire. Clinicians’ satisfaction with the program was assessed using an exit questionnaire and the ABILHAND-Kids questionnaire. Results: The high degree of session adherence indicated that the RNT program was feasible for clinicians to deliver. Children showed high levels of in-session affected UE use and improved scores on the ABILHAND-Kids questionnaire from pretest to posttest. Clinicians rated program-related satisfaction as high and indicated they had noted benefits from incorporating RNT into camp programming. Conclusions and Relevance: These pilot data suggest that RNT can be successfully delivered by clinicians within an intensive camp and may be used as an engaging technology-based intervention to promote UE motor function in children with UCP. Plain-Language Summary: This pilot study provides evidence that a training program, in which single-joystick–operated ride-on toys are used as therapy adjuncts, can be incorporated into an intensive three-week upper extremity training camp for children with unilateral cerebral palsy. Clinicians were able to successfully deliver the ride-on-toy navigation training program with children with unilateral cerebral palsy as part of a modified constraint-induced movement therapy camp. Children demonstrated high levels of session adherence, the ride-on-toy navigation training program promoted high levels of affected upper extremity use across three weeks, and children improved their bimanual upper extremity use during daily activities after the training program. Clinicians indicated that they were satisfied with the ride-on-toy navigation training program and found it feasible to deliver. Modified ride-on toys can be used in conventional rehabilitation settings, such as intensive camps, as a child-friendly way to promote upper extremity motor function in children with unilateral cerebral palsy.