Feasibility of caregiver-directed home-based hand-arm bimanual intensive training: A brief report

Objective: To determine feasibility of a home-based, intensive bimanual intervention with children with unilateral spastic cerebral palsy. Methods: Eleven children (aged 29-54 months) received 90 hours of home hand-arm bimanual intensive therapy (H-HABIT) provided by their trained caregivers. Parenting stress levels and compliance were monitored using the Parenting Stress Index and daily logs. Quality of bimanual performance and changes in performance/ satisfaction of functional goals were assessed using the Assisting Hand Assessment (AHA) and Canadian Occupational Performance Measure (COPM), respectively, at two pretreatment baseline sessions and two posttreatment sessions (immediate and six months). Results: Ten children completed the study with caregivers completing on average 85.6 hours of H-HABIT. Daily logs indicated high caregiver compliance. Stress levels remained stable across the intervention. Children demonstrated significant improvements in the AHA and COPM. Conclusion: H-HABIT is a feasible intervention for improving hand function and merits further investigation in a randomized-control trial.