Hand and Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) in Children With Unilateral Spastic Cerebral Palsy: A Randomized Trial
Hand and Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) in Children With Unilateral Spastic Cerebral Palsy: A Randomized Trial
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DOI：
10.1177/1545968314562109
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发表时间：
2015-08-01
影响因子：
4.2
通讯作者：
Gordon, Andrew M.
中科院分区：
文献类型：
--
作者：
Bleyenheuft, Yannick;Arnould, Carlyne;Gordon, Andrew M.
背景与低强度的常规干预相比，强化双手训练对单侧痉挛性脑瘫（USCP）儿童的手功能有更大的改善。然而，目前尚不清楚在强化方案中的上肢和下肢联合训练是否比在通常的常规护理中提供的常规疗法对上肢和下肢功能能力更有效。objective.确定手和手臂双手强化治疗包括下肢功能（HABIT-ILE）对儿童USCP的疗效。方法. 24名USCP儿童被随机分为2组：立即HABIT-ILE组（IHG，最初接受HABIT-ILE，10天= 90小时）和延迟HABIT-ILE组（DHG），继续其常规/持续治疗，预计总持续时间为90小时。在第2阶段，DHG组的儿童交叉接受HABIT-ILE治疗，IHG组的儿童接受常规治疗。使用辅助手评估（AHA，主要结果），ABILHAND-Kids和儿科残疾评估量表对儿童进行评估。还测量了敏捷度（方块测试[BBT]）和捏力。采用6分钟步行试验（6MWT，主要结局）和ABBYY CO-kids评估运动能力。社会参与是用生活习惯评估来衡量的。结果2（组）× 3（测试会话）的方差分析表明，主要结局（AHA，P <0.001; 6MWT，P = 0.002）和所有次要评估（除BBT、步长和HABIT-ILE后的体重分布外）均显著改善，但常规治疗无效。结论研究结果表明，在强化训练方案中，上下肢联合训练可能对改善USCP儿童的上下肢功能有效。
Background. Intensive bimanual training results in more improvement in hand function in children with unilateral spastic cerebral palsy (USCP) than lower intensity conventional interventions. However, it is not known whether combined upper and lower extremity training in an intensive protocol is more efficacious for upper and lower functional abilities than conventional therapies provided in usual customary care. Objective. To determine the efficacy of Hand and Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) for children with USCP. Methods. Twenty-four children with USCP were randomized into 2 groups: an immediate HABIT-ILE group (IHG, initially receiving HABIT-ILE, 10 days = 90 hours), and a delayed HABIT-ILE group (DHG), which continued their conventional/ongoing treatment for an intended total duration of 90 hours. In phase 2, children in the DHG were crossed over to receive HABIT-ILE and children of the IHG were followed in their ongoing conventional therapy. Children were assessed using the Assisting Hand Assessment (AHA, primary outcome), the ABILHAND-Kids, and the Pediatric Evaluation of Disability Inventory. Dexterity (Box and Blocks Test [BBT]) and pinch strength were also measured. Locomotor abilities were assessed with Six-Minute Walk Test (6MWT, primary outcome) and ABILOCO-kids. Social participation was measured with the Assessment of Life-HABITs. Results. A 2 (groups) x 3 (test sessions) analysis of variance indicated significant improvements for primary outcomes (AHA, P < .001; 6MWT, P = .002) and all secondary assessments except BBT, step length and bodyweight distribution following HABIT-ILE, but not conventional therapy. Conclusion. The findings suggest that combined upper and lower extremity in an intensive training protocol may be efficacious for improving both upper and lower extremity function in children with USCP.