Cluster RCT to improve translation of intensive UL rehabilitation for children with Unilateral CP

Chief Investigators: AI Sakzewski, CIs Novak, Boyd, Ziviani.

Funding: NHMRC ECR (2015-2019)

Rationale: Based on meta-analysis of 36 RCTs of intensive upper limb (UL) training6 and a pilot implementation project, a cluster RCT has commenced.

Aims: Evaluate effectiveness of a Multifaceted Implementation program (MI) to increase the quality/dose of UL rehabilitation compared to Single faceted Implementation program (SI).

Methodology: Clusters (based on location) are randomised to either a tailored MI implementation program (audit/feedback, barrier identification, interactive education targeting identified barriers), compared to a single faceted implementation program (audit/feedback alone).

Primary outcomes: processes of care, evidence practice behaviours including:

  • (i) collaborative goals;
  • (ii) use of evidence-based motor learning approach;
  • (iii) adequate dose; and
  • (iv)objective reliable outcomes.

A sample of 36 therapists is required to detect a difference in number of rehabilitation hours (MD6, SD3.5).

Update: Pilot complete, a new RCT has commenced.

New knowledge: Effective, implementation programs that increase adoption of research evidence into practice are required to improve patient outcomes. Implementation can be time consuming, so cost effectiveness will be examined.