Hand-Arm Bimanual Intensive Training Including Lower Extremities (HABIT-ILE)

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Description[edit | edit source]


Hand-Arm Bimanual Intensive Therapy including Lower Extremities (HABIT-ILE) is a therapy approach for children with cerebral palsy, particularly those with spastic hemiplegia.[1] The principles of motor learning and neuroplasticity from Constraint-Induced Movement Therapy (CIMT) is applied into HABIT-ILE[2], which is achieved by encouraging problem-solving and repetitive practice[1]. Unlike CIMT, HABIT-ILE emphasises improving the use of upper limbs, as well as global postural control and cross-limb coordination[2], through intensive practice of activities that involve combined use of both upper and lower limbs bilaterally[1],

Indication[edit | edit source]

Previous research on HABIT-ILE focused on children diagnosed with cerebral palsy, with gross motor function of level II to IV, according to the Gross Motor Function Classification System[3]. The participants included in the studies adequete grasping and cognitive ability. Initially, HABIT-ILE was designed for children aged 6-12[1]. However, more recent studies have sought to investigate the potential application of HABIT-ILE in pre-school aged children[4], expanding the age range for potential therapeutic intervention.

Children with certain conditions were previously excluded from HABIT-ILE interventions, including those with uncontrolled seizures, recent orthopedic or neurological surgery, visual impairments impeding with treatment, and significant cognitive or behavioral impairments hindering their ability to comprehend or follow instructions[3]. It is important to consider these factors when selecting the HABIT-ILE approach to ensure that the intervention is effective for each individual.

Clinical Application ====== Outcome measures[edit | edit source]

Several studies have employed a range of outcome measures to evaluate the effectiveness of HABIT-ILE in assessing improvements in gross and fine motor function, as well as levels of participation and quality of life. Some examples are listed below.[2][5][6]

  • Assisting Hand Assessment (AHA)
  • 6-Minute Walk Test (6MWT)
  • Pediatric Evaluation of Disability Inventory (PEDI)
  • Box and Block test
  • Finger strength test
  • Step length & weight distribution
  • ABILHAND-Kids questionnaire
  • ABILOCO-Kids questionnaire
  • Assessment of Life Habits (Life-H) questionnaire
  • ACTIVLIM-CP questionnaire
  • Canadian Occupational Performance Measure

Procedure[edit | edit source]

Resources[edit | edit source]

[7]

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 Bleyenheuft Y, Gordon AM. Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) for Children with Cerebral Palsy. Physical & Occupational Therapy in Pediatrics [Internet]. 2014 Oct 1;34(4):390–403. Available from: https://doi.org/10.3109/01942638.2014.932884
  2. ↑ 2.0 2.1 2.2 Bleyenheuft Y, Arnould C, De Brito Brandão M, Bleyenheuft C, Gordon AM. Hand and arm bimanual intensive therapy including lower extremity (HABIT-ILE) in children with unilateral spastic cerebral palsy. Neurorehabilitation and Neural Repair [Internet]. 2014 Dec 19;29(7):645–57. Available from: https://doi.org/10.1177/1545968314562109
  3. ↑ 3.0 3.1 Sakzewski L, Bleyenheuft Y, Boyd RN, Novak I, Elliott C, Reedman S, et al. Protocol for a multisite randomised trial of Hand–Arm Bimanual Intensive Training Including Lower Extremity training for children with bilateral cerebral palsy: HABIT-ILE Australia. BMJ Open [Internet]. 2019 Sep 1;9(9):e032194. Available from: https://doi.org/10.1136/bmjopen-2019-032194
  4. ↑ Sakzewski L, Reedman S, McLeod K, Thorley M, Burgess A, Trost SG, et al. Preschool HABIT-ILE: study protocol for a randomised controlled trial to determine efficacy of intensive rehabilitation compared with usual care to improve motor skills of children, aged 2–5 years, with bilateral cerebral palsy. BMJ Open [Internet]. 2021 Mar 1;11(3):e041542. Available from: https://doi.org/10.1136/bmjopen-2020-041542
  5. ↑ Sakzewski L, Reedman S, McLeod K, Thorley M, Burgess A, Trost SG, et al. Preschool HABIT-ILE: study protocol for a randomised controlled trial to determine efficacy of intensive rehabilitation compared with usual care to improve motor skills of children, aged 2–5 years, with bilateral cerebral palsy. BMJ Open [Internet]. 2021 Mar 1;11(3):e041542. Available from: https://doi.org/10.1136/bmjopen-2020-041542
  6. ↑ Sogbossi ES, Adon SS, Adjagodo L, Dossou S, Dakè H, Ebner‐Karestinos D, et al. Efficacy of hand-arm bimanual intensive therapy including lower extremities (HABIT-ILE) in young children with bilateral cerebral palsy (GMFCS III-IV) in a low and middle-income country: protocol of a randomised controlled trial. BMJ Open [Internet]. 2021 Oct 1;11(10):e050958. Available from: https://doi.org/10.1136/bmjopen-2021-050958
  7. ↑ Cerebral Palsy Alliance. What is HABIT-ILE Intensive Therapy? [Internet]. YouTube. 2023 [cited 2024 Feb 1]. Available from: https://www.youtube.com/watch?v=1lCyLT_d-FU
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