Article

Intensive bimanual training results in more improvement in hand
function in children with unilateral spastic cerebral palsy (USCP) than lower
intensity conventional interventions. However, it is not known whether combined
upper and lower extremity training in an intensive protocol is more efficacious
for upper and lower functional abilities than conventional therapies provided in
usual customary care. OBJECTIVE: To determine the efficacy of Hand and Arm
Bimanual Intensive Therapy Including Lower Extremity
(HABIT-ILE) for children
with USCP. METHODS: Twenty-four children with USCP were randomized into 2 groups:
an immediate HABIT-ILE group (IHG, initially receiving HABIT-ILE, 10 days = 90
hours), and a delayed HABIT-ILE group (DHG), which continued their
conventional/ongoing treatment for an intended total duration of 90 hours. In
phase 2, children in the DHG were crossed over to receive HABIT-ILE and children
of the IHG were followed in their ongoing conventional therapy. Children were
assessed using the Assisting Hand Assessment (AHA, primary outcome), the
ABILHAND-Kids, and the Pediatric Evaluation of Disability Inventory. Dexterity
(Box and Blocks Test [BBT]) and pinch strength were also measured. Locomotor
abilities were assessed with Six-Minute Walk Test (6MWT, primary outcome) and
ABILOCO-kids. Social participation was measured with the Assessment of
Life-HABITs. RESULTS: A 2 (groups) x 3 (test sessions) analysis of variance
indicated significant improvements for primary outcomes (AHA, P < .001; 6MWT, P = .002) and all secondary assessments except BBT, step length and bodyweight
distribution following HABIT-ILE, but not conventional therapy. CONCLUSION: The
findings suggest that combined upper and lower extremity in an intensive training
protocol may be efficacious for improving both upper and lower extremity function
in children with USCP.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS