Hand-Arm Bimanual Intensive Therapy Including Lower Extremities in Infants With Unilateral Cerebral Palsy: A...

Area of Science:

• Pediatric Rehabilitation
• Neuroscience
• Developmental Pediatrics

Background:

• Early detection of cerebral palsy (CP) is crucial due to high neuroplasticity in early childhood.
• There is a need for effective early interventions to enhance motor abilities in infants with CP.

Purpose of the Study:

• To evaluate the effectiveness of baby Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) in improving motor function for infants diagnosed with unilateral CP (UCP).

Main Methods:

• A parallel-group, 1:1 randomized clinical trial involved 46 infants (6-18 months) with UCP.
• The treatment group received 50 hours of baby HABIT-ILE over 2 weeks; the control group received usual care.
• Assessments included the Mini-Assisting Hand Assessment (Mini-AHA), Canadian Occupational Performance Measure (COPM), and Gross Motor Function Measure-66 (GMFM-66) at baseline and 1, 3-month follow-ups.

Main Results:

• The HABIT-ILE group showed significant improvements in Mini-AHA scores (P=.008, ηp2=.11) and COPM performance and satisfaction scores (P<.001, ηp2=.35/.33).
• Both groups improved in GMFM-66 scores, but the interaction was not significant (P=.43, ηp2=.02).
• Effect sizes for Mini-AHA and COPM favored the treatment group, indicating greater gains in affected hand use and functional goals.

Conclusions:

• Baby HABIT-ILE is a feasible and effective intervention for infants with UCP.
• The therapy significantly enhances the use of the more affected hand in bimanual tasks and improves functional goal outcomes.
• These findings support early intensive bimanual therapy for improving motor development in infants with unilateral CP.