[PI-2-2] Ride-on car training with different dosages for toddlers with motor delays: a pilot randomized controlled trial
Modified ride-on cars (ROCs) have been viewed as one Maker Movement and become an innovative option to enhance mobility and socialization in toddlers with disabilities in the recent years. However, researchers found 69% of pediatric occupational therapists and physical therapists in Canada and the USA never or seldom provided ROC-related mobility experiences to children in their practice due to the limited resources and the concern of training time. This pilot randomized controlled trial aims to compare the effectiveness of different doses of ROC training in the community-based environment on enhancing mobility and socialization in toddlers with motor delays. The study was approved by the local Institutional Review Board. Thirteen toddlers with motor delays were recruited in the study, including the ROC training with a 48-hour group (ROC-48, 6 participants, mean age: 22.5 months), the ROC training with a 24-hour group (ROC-24, 3 participants, mean age: 18.7 months) and the regular therapy group (Control, 4 participants, mean age: 19.3 months). The 2 ROC training groups both received a 12-week program and 2 training sessions per week. However, the training intensity was different (ROC-48: 120 mins/per session; ROC-24: 60 mins/per session). The control group only had their regular therapy during intervention. Chinese Version of Pediatric Evaluation of Disability Inventory (PEDI-C) and Goal Attainment Scaling (GAS) were administrated before and after 12-week intervention and after a 12-week follow-up. A two-way repeated measures ANOVA was used to evaluate the effects of the outcomes among the three groups. There was no significant difference in demographic data, mobility, social function and goal achievements among the groups at pre-test. There was no significant time × group interaction for the mobility, social function, and goal achievements. However, a main effect of testing session was seen for the three groups for all measures (p<.001) and the post-hoc test all showed a significant difference between pretest and posttest scores (p<.001), and pretest to follow-up test (p<.001). Moreover, 3 of 6 participants (50%) in the ROC-48, 1 of 3 participants (33%) in the ROC-24 groups, and 1 of 4 participants (25%) had clinically meaningful improvements on mobility and social function. Different intensity and time parameters may be beneficial for enhancing mobility, social function and goal achievements in toddlers with motor delays. The effects may sustain for 3 months follow-up. The higher intensity and time dosage parameter tends to result in more clinically meaningful changes in toddlers with motor delays. The total amount of 48-hour training may provide an optimal, time dosage parameter for applying ROC training in toddlers with motor delays. Future studies should consider a comparative design to examine the effectiveness of single dosage parameter to offer clinicians a more concrete guideline on the ROC training and the long-term effects.