Intensive Home-based Bimanual and Lower-limb Training in Young Children With Hemiplegia

The investigators are currently recruiting children with hemiplegia between the ages of 2.5 to 12 years of age to participate in a study examining the effects of extensive practice on affected hand/arm use and lower- limb use. This is a research study that will teach caregivers how to administer either hand-arm bimanual intensive training (HABIT) or lower-limb intensive training in their own home. HABIT aims to improve the use and coordination of both arms in daily function, particularly during the performance of bimanual activities (i.e. buttoning a shirt, cutting with scissors). Lower-limb intensive training aims to improve the quality of lower-limb functioning with a particular focus on functional activities (i.e. getting up from a chair, walking, climbing stairs).

What does participation entail?

• Being randomized to learn to provide either intensive lower- or upper-limb activities in your own home (training will be provided over a a weekend session at our center)
• Getting trained to administer some basic upper- and lower-limb assessments in your own home
• Completing 90 hours of activities over a period of 9 weeks (2 hrs/day, 5 days/week; does not have to be 2 consecutive hours for daily activities)
• Videoconferencing online with a project supervisor at least 1 hour per week during activities
• Learning how to assess your child's motor function for posttesting.

Can I choose to receive upper or lower extremity training if my child qualifies?

• Unfortunately not, it must be randomly assigned as each group will be compared to the other. However, the investigators can provide training tips after completion of the study.

What if my child does not qualify?

• There may be opportunities at a later date or for another study.
• Please contact us at (212)-678-3332 or [email protected] if you have any questions.

Inclusion criteria

• Children between the ages of 2.5 - 12 years with hemiplegia; hemiplegia due to result of prenatal stroke, brain lesion, or malformation (or within the two years of life).
• Children that have the ability to grasp or release objects with the affected hand
• Children who are able to walk independently without the assistance of a device
• Children that have the cognitive capability to follow simple instructions and interact in play activities 2 hours per day with a parent/caregiver.
• Caregivers willing to commit to the entire intervention period of 90 hours over 9 weeks
• Caregivers able to provide one-on-one attention to child during the daily two hours of activities (note: because this is part of a research study, we can only train one caregiver per household)

Exclusion criteria

• Children that have received Botox or are planning any new treatment within 6 mos. of enrollment in the study.