The Effects of Hand-Arm Bimanual Intensive Training (HABIT) in Children With Bilateral Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Paralysis; Cerebral Palsy
Study type: Interventional

Summary: 
      Hand-Arm Bimanual Intensive Training (HABIT) has been shown to result in improvements in hand
      function and daily functioning of children with unilateral cerebral palsy (CP). Children with
      bilateral CP may also present difficulties to coordinate their hands to perform activities.
      Thus, HABIT may be a potential intervention for these individuals. We intend to examine the
      effects of HABIT on hand function and daily functioning of children with bilateral CP
      compared with conventional occupational therapy (OT). Our hypothesis is that children
      receiving HABIT will present larger improvements in manual dexterity and daily functioning as
      compared to conventional OT.
    

Detailed description: 
      Study Design: Randomized Controlled Trial. Study Participants & Setting: Forty children with
      bilateral CP recruited from the Associação Mineira de Reabilitação, Belo Horizonte, Brazil.

      Procedures: After being included in the study, children will be randomly assigned to a
      intervention group (n=20) or a control group (n=20). Children in the intervention group will
      receive a 90-hour (6 hours/day; 5 days/week, 3 weeks) of Hand-Arm Bimanual Intensive Training
      (HABIT) while children in control group will maintain their usual frequency of Occupational
      Therapy (OT) sessions (45 minutes/session, twice a week, for 3 weeks), focusing on functional
      training, stretching and sensory stimulation. All participants will be assessed by an
      examiner blinded to group allocation before and after the intervention period, as well as 6
      months after the intervention (follow-up).

      Statistical Analysis: A 2 (groups) x 3 (assessments) analysis of variance will test the
      effects of group, assessment and group x assessment interaction with a level of significance
      set at 0.05.
    

Intervention name(s): HABIT; Conventional Occupational Therapy (OT)
Intervention type(s): Other; Other
Intervention description(s): Provision of individualized bimanual activities, individually chosen according to the child´s abilities, impairments and improvements in order to achieve success and to encourage bimanual use. Task difficulty is graded, focusing on enhancing the level of difficulty or speed, according to child's improvements. We use whole task practice (sequencing successive movements in the context of activities), part task practice (practice of specific components of the task in a repetitive sequence of time) and individualized functional goal training.; Children will maintain the occupational therapy sessions with their therapists, without any change in their routine at the rehabilitation center. Strategies such as functional training, stretching and sensory stimulation are used.
Other intervention name(s): occupational therapy
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: cerebral palsy; rehabilitation; hand function; daily functioning; hand-arm bimanual intensive training