Telemedicine in Early Childhood Constraint Therapy for Cerebral Palsy

This study is looking at different ways to help infants with cerebral palsy (a condition affecting movement and muscle tone) improve the use of their arms. It compares two active treatments delivered through telehealth: APPLES-tele, which involves wearing a soft-constraint on the less affected arm and therapist-guided tasks, and a Parent-centered Approach (PCA) Support Intervention, which focuses on positive parenting principles. There's also a group receiving standard care. Researchers will measure changes in arm movement and parenting styles to see which approach is most helpful. Infants between 4 and 13 months old who have or are at high risk for cerebral palsy, with specific arm asymmetry, may be able to join. The study plans to enroll 267 participants.

Study design
This is an interventional study comparing two active treatments and standard care in infants with cerebral palsy. The planned enrollment is 267 participants.
What's involved
Participants will receive 5 weekly telehealth sessions over a 6-week period for the APPLES-tele or PCA interventions. Measurements will be taken at baseline, after the first intervention (Week 6), and after the second intervention (Week 12).
Compensation
Not stated in the trial record.
Follow-up
Participants will be followed for at least 12 weeks, with measurements taken at Week 6 and Week 12 after the interventions begin.

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NCT04997109

Telemedicine in Early Childhood Constraint Therapy in Cerebral Palsy

Recruiting
NAAges 4–13InterventionalSupportive care
Emory University
~267 participants
Updated 2025-10-14 on ClinicalTrials.gov
What's tested:APPLES-teleParent-centered Approach (PCA) Support InterventionStandard of Care

At a glance

Recruiting sites
4 of 4 listed sites are recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Change in Bayley Scales of Infant and Toddler Development (Bayley-3) More Affected Arm Motor Function Score
Measured over Baseline, Week 6 (after the first intervention), Week 12 (after the second intervention)
+1 more outcome measured
Cerebral Palsy
4 sites across 4 states
Georgia1
Maryland1
Pennsylvania1
Utah1
  • Nathalie Maitre, MD, PhD · PRINCIPAL_INVESTIGATOR · Emory University

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Eligibility criteria

Inclusion

Aged 4 to 13 months, corrected age
Diagnosis of CP or classification of high-risk for CP as determined by published guidelines (\>95% risk of later CP)
Hammersmith Infant Neurological Exam (HINE) arm asymmetry score of greater than or equal to 2 and/or neuroimaging consistent with perinatal involvement
Hand Assessment for Infants (HAI) difference between hands ≥2, with an observable and relative difference in quality or amount of movement between hands, as determined by HAI-certified study therapists and/or a unimanual Bayley score difference between hands \>1
Parent/legal guardian is able to provide informed consent

Exclusion

Congenital malformation of the brain or musculoskeletal system (MSK)
Receipt of botulinum toxin to the affected extremity within 3 months of study entry
Any prior long-term hard constraint programs
  • Change in Bayley Scales of Infant and Toddler Development (Bayley-3) More Affected Arm Motor Function ScoreBaseline, Week 6 (after the first intervention), Week 12 (after the second intervention)

    The Bayley-3 instrument is a norm-referenced test assessing developmental delays in early childhood. The fine motor function of the more affected upper extremity is assessed using the 54 unimanual items of the Bayley-3 instrument. Responses are provided on a 3-point scale where 0 = the skill is not present, 1 = the skill is emerging, and 2 = the skill is mastered. Total unimanual fine motor raw scores for the more affected arm range from 0 to 108 where higher scores indicate greater fine motor function.

  • Change in Parenting Styles and Dimensions Questionnaire (PSDQ) Authoritative Scale ScoreBaseline, Week 6 (after the first intervention), Week 12 (after the second intervention)

    The Authoritative Parenting Style scale of the Parenting Styles and Dimensions Questionnaire (PSDQ) - short version, includes 15 items that are rated on a 5-point scale where 1 = never and 5 = always. The raw score ranges from 15 to 75 and higher scores indicate a more expression of the authoritative parenting style.