# A "motor learning based intervention for lower extremities (MOBILE)" to target walking performance in ambulant children with cerebral palsy: A feasibility study

## TL;DR

This study tests a new motor learning-based therapy to improve walking in children with cerebral palsy, focusing on activity and participation rather than just physical structure.

## Contribution

The study introduces a novel motor learning-based intervention (MOBILE) targeting walking performance in children with CP.

## Key findings

- The MOBILE intervention will be tested for feasibility and acceptability in ambulant children with CP.
- The study will assess recruitment, adherence, and retention rates for the intervention.
- Clinical outcomes like gait and mobility will be measured to evaluate the intervention's impact.

## Abstract

Cerebral Palsy (CP) is the largest contributor to childhood physical disability with abnormal gait pattern such as toe walking commonly reported. The International Classification of Functioning (ICF) in disabilities framework outlines three domains to consider when looking at impact of a disability on a child; body/structure, activity and participation. Interventions to target body/structure have been widely studied but the focus is now shifting towards activity and participation. Activity and participation targeted interventions using Motor Learning Theory (MLT) have shown positive results on walking performance, gross motor skills and upper limb rehabilitation in CP. This study aims to determine feasibility and acceptability of a motor learning-based intervention for lower extremities (MOBILE) targeting walking performance in ambulant children with CP to inform a future randomized controlled trial (RCT).

Fourteen ambulant children with CP, aged 6–17, with a walking goal will be recruited from community disability services. They will undergo a tailored intensive MOBILE intervention to target walking goals amounting to 30 hours practice in 6 weeks or less. Outcomes will include feasibility of recruitment, adherence, retention and outcome measures, and acceptability of the intervention. Clinical outcome measures will include the Gait Outcomes Assessment List, Six Minute Walk Test, modified Timed Up and Go, Ten metre walk test, Range of Motion and the Child Health Utility instrument. Feasibility outcomes will be reported using descriptive statistics such as percentages and confidence intervals.

Long-term retention of walking improvements in CP following interventions targeting the body/structure domain of the ICF are reportedly poor. The MOBILE intervention based on its theoretical framework could lead to improvements in walking performance with a possibility of long-term retention and impact on activity and participation. The feasibility of the study design and acceptability of the intervention needs to be investigated to inform a future definitive trial.