Constraint-induced Movement Therapy (CIMT) and Bimanual Training (HABIT) in Children With Hemiplegic Cerebral Palsy

Study Overview
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Brief Summary
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A randomized control trial of bimanual training. The protocols have been developed at Columbia University to be child friendly and draws upon our experience since 1997 with constraint-induced movement therapy in children with cerebral palsy.

Detailed Description
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A new treatment involving bimanual (Hand-Arm Bimanual Intensive Therapy (HABIT). The protocols have been developed at Columbia University to be child friendly and draws upon our experience since 1998 with constraint-induced movement therapy in children with cerebral palsy. The interventions are performed in a 15 day day-camp setting with several children and at least one therapist per child. We have conducted 24 day camps to date since 2002, and are now collaborating with clinicians worldwide to expand our treatment availability. The aim is to promote the use of and improve the coordination of movement of both hands together. PARTICIPATION IS FREE. Please check out our website for more information: http://www.tc.edu/centers/cit/.

Official Title
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Bimanual Training (HABIT) in Children With Hemiplegic Cerebral Palsy

Conditions
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Cerebral Palsy, Hemiplegia, Children, Pediatric

Intervention / Treatment
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* Procedure: Constraint-Induced Movement Therapy (CIMT)
* Procedure: Hand-Arm Bimanual Intensive Therapy (HABIT)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: willingness to agree to intervention and testing procedures and travel to the University for participation and testing. Exclusion Criteria: health problems not associated with CP uncontrollable seizures visual problems that would interfere with carrying out the intervention or testing botulinum toxin therapy in the upper extremity musculature during the last six months or who wish to receive it within the period of study

Ages Eligible for Study
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Minimum Age: 30 Months
Maximum Age: 14 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CIMT Intervention<br>Participants randomized to this arm were provided with 90 minutes of Constraint-Induced Movement Therapy (CIMT), which requires hand restraint and progression of unimanual tasks. | Procedure: Constraint-Induced Movement Therapy (CIMT)<br>* 90 hours<br>|
| Experimental: HABIT Intervention<br>Participants randomized to this arm were provided with 90 minutes of Hand-Arm Bimanual Intensive Therapy (HABIT), which requires that tasks are progressed bimanually. | Procedure: Hand-Arm Bimanual Intensive Therapy (HABIT)<br>* 90 hours<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Score on Assisting Hand Assessment (AHA) | The Assisting Hand Assessment (AHA) quantifies the effectiveness with which a child with unilateral disability uses his/her affected (assisting) hand in bimanual activity. Scores range from 0-100 units, with higher scores signifying better bimanual performance. | Baseline, 6 months | 
| Change in Score on the Jebsen-Taylor Test of Hand Function (JTTHF) | The Jebsen-Taylor Test of Hand Function (JTTHF) is a standardized test of simulated functional tasks quantifying the time to complete a battery of unimanual tasks. The activities performed include flipping index cards, object placement, simulated eating, stacking checkers, and manipulating empty and full cans. Scores range from 0-1080 seconds, with a lower score signifying better hand function. | Baseline, 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cerebral palsy, constraint-induced therapy, constraint-induced movement therapy, CP, hemiplegia, hand, forced use, motor control, children, HABIT, Hand-arm bimanual intensive therapy, Bilateral training, Bimanual training, functional therapy, physical therapy, occupational therapy, intensive, pediatric, development, upper extremity, hemiplegic