Article

AIM: To examine the efficacy of caregiver-directed, home-based intensive bimanual
training in children with unilateral spastic cerebral palsy (USCP) using a
randomized control trial. METHOD: Twenty-four children (ages 2y 6mo-10y 1mo; 10
males, 14 females) performed home-based activities directed by a caregiver for 2
hours per day, 5 days per week, for 9 weeks (total=90h). Cohorts of children were
age-matched into groups and randomized to receive home-based hand-arm bimanual
intensive therapy (H-HABIT;
n=12) or lower-limb functional intensive training
(LIFT-control; n=12). Caregivers were trained before the intervention and
supervised remotely via telerehabilitation. Dexterity and bimanual hand function
were assessed using the Box and Blocks test (BBT) and the Assisting Hand
Assessment (AHA) respectively. Caregiver perception of functional goals was
measured using the Canadian Occupational Performance Measure (COPM). RESULTS:
H-HABIT showed greater improvement on the BBT compared to LIFT-control and no
improvement on the AHA. H-HABIT demonstrated significant improvement in
COPM-Performance compared to LIFT-control and both groups showed equal
improvement in COPM-Satisfaction. INTERPRETATION: H-HABIT improved dexterity and
performance of functional goals, but not bimanual performance, in children with
USCP compared to a control group receiving intervention of equal
intensity/duration that also controlled for increased caregiver attention.
Home-based models provide a valuable, family-centered approach to achieve
increased treatment intensity.
CI - (c) 2016 Mac Keith Press.

Langue : ANGLAIS