Gardas Shailesh S, Woosley Katie, Brown Caroline, Key Taylor, McBryde Natalie, Morton Brody, Lysaght Christine, Adams Caroline, Holland Holly, Surkar Swati M
Department of Physical Therapy, East Carolina University, Greenville, NC, USA.
Department of Occupational Therapy, East Carolina University, Greenville, NC, USA.
Phys Occup Ther Pediatr. 2025 Jun 2:1-21. doi: 10.1080/01942638.2025.2509542.
This study assesses real-world bimanual performance improvements following Hand-Arm Bimanual Intensive Therapy (HABIT) using an objective tool (accelerometers) and to identify demographic and clinical predictors of these gains in children with unilateral cerebral palsy (UCP).
Forty children with UCP (mean age: 10.7 ± 3.24 years) participated in 30 h of HABIT. Bilateral wrist-worn accelerometers measured bimanual performance using use ratio, bilateral magnitude, and median acceleration. Self-perceived performance was measured using the Canadian Occupational Performance Measure (COPM), and upper extremity (UE) capacity with Jebsen-Taylor Hand Function Test (JTHFT), Nine-Hole Peg Test (NHPT), and Box and Block Test (BBT). Predictors such as age, sex, affected side, severity levels, and baseline capacity were analyzed.
Use ratio ( = .02) and median acceleration ( = .04) showed improvements, indicating enhanced real-world performance. Gains were observed in COPM (performance and satisfaction, = .001) and UE capacity (JTHFT: = .001, NHPT: = .02, and BBT: = .01). Age, baseline NHPT and JTHFT scores explained 40.7% of the variance in use ratio, while NHPT accounted for 11.5% of the variance in median acceleration.
HABIT enhances real-world bimanual performance in children with UCP. Older age and more impaired baseline dexterity are significant predictors of greater therapeutic gains, offering potential strategy to maximize real-world functional gains.
本研究使用客观工具（加速度计）评估手-臂双手强化治疗（HABIT）后现实世界中双手操作能力的改善情况，并确定单侧脑瘫（UCP）儿童这些改善的人口统计学和临床预测因素。
40名UCP儿童（平均年龄：10.7±3.24岁）参与了30小时的HABIT治疗。双侧手腕佩戴加速度计，使用使用率、双侧幅度和中位加速度来测量双手操作能力。使用加拿大职业表现测量量表（COPM）测量自我感知的表现，使用杰布森-泰勒手功能测试（JTHFT）、九孔插板测试（NHPT）和箱块测试（BBT）测量上肢（UE）能力。分析年龄、性别、患侧、严重程度水平和基线能力等预测因素。
使用率（=0.02）和中位加速度（=0.04）显示出改善，表明现实世界中的表现得到增强。在COPM（表现和满意度，=0.001）和UE能力（JTHFT：=0.001，NHPT：=0.02，BBT：=0.01）方面观察到改善。年龄、基线NHPT和JTHFT分数解释了使用率方差的40.7%，而NHPT占中位加速度方差的11.5%。
HABIT可增强UCP儿童现实世界中的双手操作能力。年龄较大和基线灵活性受损程度较高是治疗效果更好的重要预测因素，为最大化现实世界功能改善提供了潜在策略。
