Intensive upper‐ and lower‐extremity training for children with bilateral cerebral palsy: a quasi‐randomized trial

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 .