Including a Lower-Extremity Component during Hand-Arm Bimanual Intensive Training does not Attenuate Improvements of the Upper Extremities: A Retrospective Study of Randomized Trials

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dc.creatorGeoffroy Saussez
dc.creatorMarina de Brito Brandao
dc.creatorAndrew M. Gordon
dc.creatorYannick Bleyenheuft
dc.date.accessioned2024-03-01T16:20:50Z
dc.date.accessioned2025-09-09T00:16:12Z
dc.date.available2024-03-01T16:20:50Z
dc.date.issued2017-09-25
dc.format.mimetypepdf
dc.identifier.doihttps://doi.org/10.3389/fneur.2017.00495
dc.identifier.issn1664-2295
dc.identifier.urihttps://hdl.handle.net/1843/65086
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofFrontiers in Neurology
dc.rightsAcesso Aberto
dc.subjectHemiplegia
dc.subjectExtremidades
dc.subjectEnfermagem
dc.subject.otherCerebral palsy
dc.subject.otherHemiplegia
dc.subject.otherIntensive intervention
dc.subject.otherUpper extremity
dc.subject.otherLower extremity
dc.subject.otherBimanual training
dc.subject.otherMotor function
dc.subject.otherInterlimb coordination
dc.titleIncluding a Lower-Extremity Component during Hand-Arm Bimanual Intensive Training does not Attenuate Improvements of the Upper Extremities: A Retrospective Study of Randomized Trials
dc.typeArtigo de periódico
local.citation.epage10
local.citation.spage495
local.citation.volume8
local.description.resumoHand-Arm Bimanual Intensive Therapy (HABIT) promotes hand function using intensive practice of bimanual functional and play tasks. This intervention has shown to be efficacious to improve upper-extremity (UE) function in children with unilateral spastic cerebral palsy (USCP). In addition to UE function deficits, lower-extremity (LE) function and UE–LE coordination are also impaired in children with USCP. Recently, a new intervention has been introduced in which the LE is simultaneously engaged during HABIT (Hand-Arm Bimanual Intensive Therapy Including Lower Extremities; HABIT-ILE). Positive effects of this therapy have been demonstrated for both the UE and LE function in children with USCP. However, it is unknown whether the addition of this constant LE component during a bimanual intensive therapy attenuates UE improvements observed in children with USCP. This retrospective study, based on multiple randomized protocols, aims to compare the UE function improvements in children with USCP after HABIT or HABIT-ILE. This study included 86 children with USCP who received 90 h of either HABIT (n = 42) or HABIT-ILE (n = 44) as participants in previous studies. Children were assessed before, after, and 4–6 months after intervention. Primary outcomes were the ABILHAND-Kids and the Assisting Hand Assessment. Secondary measures included the Jebsen-Taylor Test of Hand Function, the Pediatric Evaluation of Disability Inventory [(PEDI); only the self-care functional ability domain] and the Canadian Occupational Performance Measure (COPM). Data analysis was performed using two-way repeated-measures analysis of variance with repeated measures on test sessions. Both groups showed similar, significant improvements for all tests (test session effect p < 0.001; group × test session interaction p > 0.05) except the PEDI and COPM. Larger improvements on these tests were found for the HABIT-ILE group (test session effect p < 0.001; group × test session interaction p < 0.05). These larger improvements may be explained by the constant simultaneous UE–LE engagement observed during the HABIT-ILE intervention since many daily living activities included in the PEDI and the COPM goals involve the LE and, more specifically, UE–LE coordination. We conclude that UE improvements in children with USCP are not attenuated by simultaneous UE–LE engagement during intensive intervention. In addition, systematic LE engagement during bimanual intensive intervention (HABIT-ILE) leads to larger functional improvements in activities of daily living involving the LE.
local.identifier.orcidhttps://orcid.org/0000-0001-5192-0868
local.publisher.countryBrasil
local.publisher.departmentEEF - DEPARTAMENTO DE TERAPIA OCUPACIONAL
local.publisher.departmentEEFFTO - ESCOLA DE EDUCAÇÃO FISICA, FISIOTERAPIA E TERAPIA OCUPACIONAL
local.publisher.initialsUFMG
local.url.externahttps://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00495/full

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