A pilot randomised controlled trial of ride-on cars and postural combinations of standing and sitting for mobility and social function in toddlers with motor delays

Abstract

Purpose

Locomotor experiences in upright postures are essential for developing toddlers’ mobility and social functions. This pilot randomised controlled trial aimed to examine the effectiveness of using a modified ride-on car (ROC) with postural combinations of standing and sitting on mobility and social function in toddlers with motor delays.

Materials and methods

Nineteen participants aged 1–3 years with mild, moderate or severe motor delays were randomly assigned to four ROC groups. The ROC groups had different combinations of standing and sitting, namely standing for 70 min (ROC-Stand₇₀, five participants), standing for 45 min (ROC-Stand₄₅, four participants), standing for 25 min (ROC-Stand₂₅, five participants) and sitting for 70 min (ROC-Sit₇₀, five participants). All participants participated in 2-h sessions twice a week for 12 weeks. The Pediatric Evaluation of Disability Inventory, Goal Attainment Scaling and Bayley-III tests were administered before and after the intervention, and after 12 weeks of follow-up. A mixed-model analysis of variance was used to compare inter- and intra-group differences. This trial was registered at ClinicalTrials.gov (NCT03707405).

Results

All groups showed significantly improved mobility, social function and goal achievement at the post-test (p < .001). However, no significant changes were observed in Bayley scores.

Conclusions

Combining physical and social environmental modifications with active exploration is crucial for early power mobility training in toddlers with motor delays. To enhance the robustness and generalisability of our findings, future studies should include larger sample sizes, consider variations in motor delays, and measure energy expenditure during the intervention.

Implications for rehabilitation

• Providing active exploratory experience using ride-on cars (ROCs) with various postural combinations can improve a child’s mobility.

• The ROC training with various postural combinations can improve social function, and the degree of improvement may depend on the severity of motor delays.

• Setting goals with caregivers and incorporating their roles in the training process can empower them to interact with children more frequently and actively.

Keywords:

• Ride-on car
• postural combination
• mobility
• social function
• goal achievements

Acknowledgements

We thank the children, parents and caregivers who contributed significantly to this study.

Author contributions

We would also like to thank Hsiang-Han Huang, ScD, OT, for applying for the grant funding, conceptualizing the study, analyzing data, writing and revising the manuscript; Yu-Wen Chu, MS, OT, for providing ride-on car training and contributing to the data analysis; Ai-Tzu Chan, MS, OT, for performing the assessments and providing discussions; and Chia-ling Chen, MD, PhD, for recruiting the study participants and writing the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Ministry of Science and Technology, Taiwan (Grant No. 107-2314-B-182-012) and the Chang Gung Memorial Hospital (Grant No. BMRPD28).

Notes on contributors

Hsiang-Han Huang

Hsiang-Han Huang is an associate professor in the occupational therapy department at Chang Gung University. Her research primarily focuses on modifying environmental factors to improve motor and psychosocial functions in young children with motor delays.

Yu-Wen Chu

Yu-Wen Chu, an occupational therapist at Hung Da Wei Rehabilitation Clinic, specializes in innovative approaches to enhance the development of children with disabilities.

Ai-Tzu Chan

Ai-Tzu Chan is a doctoral student at the University of Southern California. Her thesis is dedicated to developing a novel approach using assistive technology to facilitate motor development in infants.

Chia-ling Chen

Chia-ling Chen, the Dean and a full professor at the Graduate Institute of Early Intervention at Chang Gung University, conducts research on the effectiveness of medical interventions and the development of technological methods to enhance children’s development.