Short-Term Powered Mobility Intervention Is Associated With Improvements in Development and Participation for Young Children With Cerebral Palsy: A Randomized Clinical Trial

Abstract

OBJECTIVE: The objective of this study was to evaluate the effects of 2 short-term powered mobility interventions across developmental domains, participation, and perceptions of intervention implementation for young children with cerebral palsy and their families. METHODS: This randomized, crossover clinical trial compared 2 powered mobility interventions: the Explorer Mini (Permobil AB, Timra, Sweden) and an adapted ride-on toy car. Analyses included 24 children aged 12 to 36 months, recruited from 3 sites. Each device was trialed in the home for an 8-week period for a total of 16 weeks. Three in-person study visits took place at baseline, crossover, and study completion, and 2 additional virtual check-ins were conducted for each device trial period. Outcome measures included all domains of the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4); Child Engagement in Daily Life (CEDL) participation questionnaire; and t3 perceptual implementation measures: Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure. Analyses included descriptive statistics, 2 by 3 group × time analysis of variance, and post hoc t tests as warranted. RESULTS: Statistically significant mean improvements were observed in all domains of the Bayley-4 and in the self-care subscale of the CEDL regardless of device order. Caregivers ranked both devices as acceptable and feasible to implement, although the Explorer Mini was ranked slightly more favorably than the adapted ride-on toy car, with a device order effect being observed. CONCLUSION: Short-term powered mobility intervention may advance multiple domains of development and participation for young children with cerebral palsy. Caregivers rated 2 different powered mobility devices favorably as part of their child's early intervention strategies. IMPACT: This study enhances the quality of evidence available to clinicians and families to support decision-making about powered mobility intervention for young children with motor disabilities, especially those who may be reluctant to begin powered mobility due to stigma or concern for motor skill development. LAY SUMMARY: In this study, children with cerebral palsy used 2 different powered mobility devices over 16 weeks. The goal of the study was to understand how powered mobility device use affected the children's movement, communication, learning, and social interactions. The goal was also to understand how caregivers felt about the intervention and device options.