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Intensive upper‐ and lower‐extremity training for children with bilateral cerebral palsy: a quasi‐randomized trial
Author(s) -
Bleyenheuft Yannick,
EbnerKarestinos Daniela,
Surana Bhavini,
Paradis Julie,
Sidiropoulos Alexis,
Renders Anne,
Friel Kathleen M,
Brandao Marina,
Rameckers Eugene,
Gordon Andrew M
Publication year - 2017
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13379
Subject(s) - cerebral palsy , randomized controlled trial , physical therapy , gross motor function classification system , medicine , upper limb , physical medicine and rehabilitation , balance (ability) , habit , rehabilitation , psychology , surgery , psychotherapist
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 .