Comparison between changes in motor impairments of upper extremities in children with unilateral cerebral palsy during bimanual intensive training including or not a lower extremities stimulation

Details

Supervisors

Bleyenheuft, Yannick

Faculty

Faculté des sciences de la motricité

Degree label

Master [120] en sciences de la motricité, orientation générale

Abstract

enHand-arm bimanual intensive therapy (HABIT) promotes hand function using intensive practice of bimanual functional tasks. This intervention showed efficacy to improve upper extremities (UE) function in children with unilateral cerebral palsy (UCP). Recently, a new intervention has been proposed in which HABIT is associated to constant lower extremity (LE) stimulation (Hand-arm bimanual intensive therapy including LE; HABIT-ILE). However, it is unknown whether the addition of a LE component could attenuate UE improvements. This study aims to compare UE improvements in HABIT vs HABIT-ILE. 86 children with UCP received 90h of either HABIT (n= 42) or HABIT-ILE (n= 44). Primary outcomes were ABILHAND-Kids and Assisting Hand Assessment. Secondary measures were JTTHF, PEDI and COPM. Both groups showed similar significant improvements for all tests except the PEDI and COPM. Larger improvements on these tests were found for the HABIT-ILE group. These larger improvements may be explained as a consequence of the constant simultaneous UE-LE stimulation during HABIT-ILE intervention. LE and, more specifically, UE-LE coordination are often used during daily life activities, including some of the PEDI and COPM items. We conclude UE improvements in children with UCP are not attenuated by a LE component. In addition, a systematic LE stimulation during bimanual intensive intervention (HABIT-ILE) leads to larger functional improvements in activities of daily living involving LE.