Home-based telehealth Movement-to-Music increases physical activity participation among adolescents with cerebral palsy: pilot RCT

Research Objectives: Aim 1 was to determine the preliminary efficacy of the early adoption phase of an adult Movement-to-Music (M2M) program with behavioral telecoaching for increasing Leisure-time Physical Activity (LTPA) and activity participation compared with a waitlist control group in adolescents with cerebral palsy (CP). Aim 2 was to qualitatively evaluate factors that influenced engagement and develop a theory that would inform the development of a more targeted M2M telehealth program.

Design: Randomized controlled trial piloting a 4-week M2M program. Participants were recruited randomized into one of two groups: a) M2M or b) waitlist control, which maintained their daily activities before receiving M2M.

Setting: Recruited from the Children's Hospital of Alabama.

Participants: Recruitment of 58 adolescents (10-19 years of age) with cerebral palsy (GMFCS I-V) occurred from September 2020 to September 2021.

Interventions: M2M incorporated music-oriented routines to improve cardiovascular capacity, muscular strength and endurance, range of motion, and general physical function.M2M videos were organized into weekly playlists. Participants were instructed to complete their playlist 3x/week.

Main Outcome Measures: Changes in activity and LTPA participation were measured pre to post intervention via the Children’s Assessment of Participation and Enjoyment (CAPE) total domain scores and active physical recreation domain scores (CAPE-APR), respectively. Changes in scores were compared between groups using analysis of covariance (ANCOVA). A grounded theory approach was used to analyze one-on-one interviews, coaching notes, and feedback surveys.

Results: ANCOVA revealed statistically significant between group differences in pre to post change score for CAPE-Intensity (F (1, 47)=5.63, p = 0.022, effect size=0.11) (a.k.a. volume of activity) and CAPE-APR-Intensity (F (1, 47)=8.76, p = 0.0048, effect size=0.17; a.k.a. volume of LTPA). Estimated marginal means revealed that changes were small, in favor of the intervention group. We developed a theory based on 6 factors that affected engagement.

Conclusions: The project established the preliminary efficacy of a scalable telehealth M2M program for increasing LTPA behavior among adolescents with CP and provides a theory for making additional CP-specific modifications before implementation in a larger trial.

Author(s) Disclosures: None to declare.