AIM: To determine the efficacy of web-based training on activity capacity and performance in children with unilateral cerebral palsy (CP). METHOD: In a matched-pairs randomized waitlist controlled trial, independently ambulant children and adolescents with unilateral CP were allocated to receive 30 minutes of training (intervention) 6 days per week, or usual care (waitlist control) for 20 weeks. Activity capacity was assessed using maximal repetitions of functional strength tasks and 6-minute walk test (6MWT); performance using 4-day ActiGraph GT3X+ accelerometer records at baseline and 20 weeks. Data were analysed by intention to treat comparing between groups using hierarchical linear modelling. RESULTS: Participants were n = 101, 52 males, mean age 11 years 3 months (SD 2 y 4 mo). Intervention participants completed a mean 32.4 hours (SD 17.2) of training, associated with significant improvements in functional strength (mean difference 19.3 repetitions; 95% confidence interval (CI) 10.8 to 27.7; p < 0.001) and 6MWT distance (mean difference 38.9m; 95% CI 12.3 to 51.9; p < 0.001) compared with the control group at 20 weeks, although not activity performance (p > 0.05). INTERPRETATION: Training was effective at increasing functional strength and walking endurance in independently ambulant children with unilateral CP. This did not translate into improvements in activity performance.

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