A Multisite Randomized Controlled Trial of Hand Arm Bimanual Intensive Training Including Lower Extremity for Children with Bilateral Cerebral Palsy
Bibliographic record
Abstract
OBJECTIVE: To test the efficacy of Hand Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) to improve gross motor function, manual ability, goal performance, walking endurance, mobility, and self-care for children with bilateral cerebral palsy. STUDY DESIGN: This prospective, waitlist randomized controlled trial included children with bilateral cerebral palsy, aged 6-to-16-years and classified Gross Motor Function Classification System levels II to IV. HABIT-ILE delivered for 2 weeks (65 hours) was compared with usual care. Primary outcomes postintervention were gross motor function (Gross Motor Function Measure-66) and manual ability (ABILHAND-Kids). Secondary outcomes were goal performance (Canadian Occupational Performance Measure), self-care and mobility (Pediatric Evaluation of Disability Inventory-Computer Adapted Test), bimanual hand performance (Both Hands Assessment), and walking endurance (6 Minute Walk Test). Linear regression models were used to determine between group differences, adjusted for baseline scores. RESULTS: Ninety-two children were recruited; 2 were deemed ineligible after randomization and were excluded. Ninety children (HABIT-ILE n = 46, usual care n = 44), mean age 10.4 (SD 3.0) years, Gross Motor Function Classification System II = 32; III = 31; IV = 27 were included. HABIT-ILE led to superior gains in manual ability (mean difference 0.85, 95% CI 0.38-1.33; P < .001) but not gross motor function. HABIT-ILE led to superior changes on goal performance, self-care, and mobility. CONCLUSIONS: HABIT-ILE was effective in improving manual ability, mobility, self-care, and goal performance, but not gross motor function. Significant gains were immediately retained at 26 weeks postintervention. Large individual variability suggests further analyses need to be performed to understand characteristics of children who achieved clinically meaningful gains across outcomes. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry (ACTRN12618000164291).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".