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Hand–arm bimanual intensive therapy and daily functioning of children with bilateral cerebral palsy: a randomized controlled trial
Author(s) -
Figueiredo Priscilla R P,
Mancini Marisa C,
Feitosa Aline M,
Teixeira Claudia M M F,
Guerzoni Vanessa P D,
Elvrum AnnKristin G,
Ferre Claudio L,
Gordon Andrew M,
BrandÃo Marina B
Publication year - 2020
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.14630
Subject(s) - cerebral palsy , physical therapy , activities of daily living , randomized controlled trial , medicine , physical medicine and rehabilitation , psychology , occupational therapy , analysis of variance , gross motor function classification system , surgery
Aim To examine the efficacy of Hand–Arm Bimanual Intensive Therapy (HABIT) on daily functioning, unimanual dexterity, and bimanual performance of children with bilateral cerebral palsy (CP) compared with customary care. Method Forty‐one children with bilateral CP, aged 4 to 16 years, classified in levels I to III of the Manual Ability Classification System, were randomly assigned to HABIT (90h) ( n =21) or to customary care (4.5h) ( n =20). Participants’ daily functioning (Pediatric Evaluation of Disability Inventory [PEDI], Canadian Occupational Performance Measure [COPM]), unimanual dexterity (Jebsen–Taylor Test of Hand Function, Box and Blocks Test [BBT]), and bimanual performance (Both Hands Assessment) were assessed pre‐, post‐, and 6 months after the intervention. Linear mixed‐effects models were used for inferential analysis. Results Children participating in HABIT showed greater improvements in daily functioning (COPM performance : χ 1 2 =9.50, p <0.01; COPM satisfaction : χ 1 2 =5.07, p <0.05; PEDI functional skills : χ 1 2 =6.81, p <0.01; PEDI caregiver assistance : χ 1 2 =6.23, p <0.05) and in the dexterity of the dominant hand (BBT: χ 1 2 =3.99, p <0.05) compared with children maintaining customary care. Group or time effects did not explain any variance in bimanual performance or in the dexterity of the non‐dominant hand. Interpretation HABIT may be beneficial for children with bilateral CP, with benefits evidenced for daily functioning outcomes. What this paper adds Hand–Arm Bimanual Intensive Therapy (HABIT) improved daily functioning of children with bilateral cerebral palsy (CP). Bimanual performance, measured by the Both Hands Assessment, did not change after HABIT in children with bilateral CP. Children with asymmetric and symmetric hand use exhibited similar improvements after HABIT.