Blended Care in the mCIMT-BiT Pirate Group in Children with Unilateral Cerebral Palsy: A Feasibility Study

AIMS: Intensive upper limb rehabilitation is essential for children with unilateral cerebral palsy (uCP). Home-based training may extend practice opportunities and reduce logistical barriers. This study examined the feasibility of a blended care approach in the mCIMT-BiT Pirate group, adapted from the fully on-site program. METHODS: Seventeen children with uCP (mean age 4 y 4 m, SD 1 y 5 m), including eight boys, participated in an eight-week program combining two three-hour weekly on-site sessions with a recommended three hours of weekly home training. Feasibility was evaluated through adherence and acceptability (questionnaires and interviews) of the home training, and limited-efficacy testing of affected arm use. RESULTS: Mean home training adherence was 43% (77 min/week), highest in week one (63%) declining to 24% by week eight. Qualitative analyses yielded three themes: (1) support, strong support from therapists and environment; (2) motivation, high but decreasing over time; and (3) logistics, scheduling home sessions proved difficult. Questionnaire results were consistent with interview findings. Children showed improvements in affected arm use in standardized tests and daily activities. CONCLUSIONS: Feasibility of home-training in blended care in the mCIMT-BiT Pirate group was limited, yet meaningful functional improvements were observed. Parents expressed intent to continue home practice, suggesting potential long-term benefits.