Intensive upper‐ and lower‐extremity training for children with bilateral cerebral palsy: a quasi‐randomized trial. (30th January 2017)

• Record Type: Journal Article
• Authors: Bleyenheuft, Yannick; Ebner‐Karestinos, Daniela; Surana, Bhavini; Paradis, Julie; Sidiropoulos, Alexis; Renders, Anne; Friel, Kathleen M; Brandao, Marina; Rameckers, Eugene; Gordon, Andrew M
• Is Part Of: Developmental medicine & child neurology. Volume 59:Number 6(2017)
• Page Start: 625
• Page End: 633
• Publication Date: 2017-01-30
• Subjects: Child development -- Periodicals; Pediatric neurology -- Periodicals; 616.8
• DOI: 10.1111/dmcn.13379
• Languages: English
• ISSNs: 0012-1622

Abstract

Abstract : Aim: An approach that simultaneously engages both the upper and lower extremities, hand–arm bimanual intensive therapy including lower extremity (HABIT‐ILE), has recently demonstrated improvements in upper and lower extremities in children with unilateral cerebral palsy (CP). It is not known whether children with bilateral CP would benefit from this approach. The aim of this study was to examine the efficacy of HABIT‐ILE in children with bilateral CP. Method: A quasi‐randomized trial design was used, whereby 20 participants (age 6–15y, Gross Motor Function Classification System levels II–IV, Manual Ability Classification System levels I–III) were assigned to a treatment (HABIT‐ILE) or a comparison group in the order in which they were enrolled. Children in the HABIT‐ILE group were assessed before and after 84 hours of intervention over 13 days, as well as at 3 months' follow‐up. Children in the comparison group were assessed at the same time points. Children in both groups were assessed using the Gross Motor Function Measure (GMFM‐66) and ABILHAND‐Kids (primary measures), and six secondary measures. Results: A group×test session interaction indicated significant improvements in the HABIT‐ILE group as assessed by the GMFM‐66, lower‐extremity performance (6‐Minute Walk Test; Pediatric Balance Scale), functional upper‐extremity abilities (ABILHAND‐Kids/Pediatric Evaluation of Disability Inventory), and the dexterity of the less affected upper extremity. Conclusion: HABIT‐ILE is efficacious for improving both upper‐ and lower‐extremity function in children with bilateral CP. What this paper adds: Hand–arm bimanual intensive therapy including lower extremity can be adapted for children with bilateral cerebral palsy (CP). Children demonstrate improvements in upper extremities, gross motor function, walking, and balance. They also demonstrate improvements in goal performance. Therapies based on motor skill learning are adaptable and efficient for children with bilateral CP. This article is commented on by Charles on page569 of this issue. Video Podcast:https://youtu.be/nfM1OIeJMU8