Twenty weeks of computer-training improves sense of agency in children with spastic cerebral palsy

Children with cerebral palsy (CP) show alteration of perceptual and cognitive abilities in addition to motor and sensory deficits, which may include altered sense of agency. The aim of this study was to evaluate whether 20 weeks of internet-based motor, perceptual and cognitive training enhances the ability of CP children to determine whether they or a computer are responsible for the movement of a visually observed object. 40 CP children (8–16 years) were divided into a training (n:20) and control group (n:20). The training group trained 30 min each day for 20 weeks. The ability of the children to judge whether they themselves or a computer were responsible for moving an object on a computer screen was tested before and after the 20-week period. Furthermore, we included a healthy age-matched group to determine a normal functional level of performance. Our results showed a significantly larger increase in the number of correct subjective reporting for the training group (p < 0.001). In accordance with this, the training group was also less fooled by computer-induced movements given by a decreased curvature which indicated a compensatory motor strategy when drawing the line to hit the target following the training than the control group (p = 0.018). These findings suggest that sense of agency may be altered, and that training of sense of agency may help to increase the outcome of training programmes in children with CP.

► Strengthen sensorimotor integration by new Internet-based training.
► Improvement of sensorimotor integration in CP children.
► Enhanced awareness of self-generated movements (improved sense of agency).