Feasibility of motor capability training at home in children with acquired brain injury

Objectives: Acquired brain injury (ABI) requires an extended recovery time and residual signs may be observed years after discharge. Supervised home-based motor training may present a viable option for continuing treatment of adult patients, but little information is available on home-based treatment in children. This study assessed the feasibility of home practice in children with ABI (1 or more years post-trauma). The efficacy of the programme was also evaluated. Design: A non-randomised, self-control study with control and intervention periods. Setting: Home-based exercise programme. Participants: Nineteen children (mean age 12.5 ± 3.1 years). Interventions: A 4-week daily training programme of step-up and sit-stand-sit exercises. Main outcome measures: Feasibility was assessed by the number of participants who completed the programme. Efficacy was evaluated at different stages using 10-metre walking and 2-minute walking tests, and the balance subitems of the Bruininks-Oseretsky Test of Motor Proficiency. An energy expenditure index was calculated for walking. Performance scores were used to assess balance. Results: Nine participants completed the study. The mean number of training sessions was 22 ± 8 of the 30 sessions originally scheduled. Major differences were noted between the experimental stages. Walking speed, endurance and balance improved significantly during the intervention period. Conclusions: Continuing exercising at home may be a feasible and efficient option for a considerable proportion of ABI children who are compliant with a simple but challenging exercise programme. A randomised controlled trial with a larger sample is now required.