Therapy onset and characteristics associated with improvement following HABIT-ILE in infants with unilateral cerebral palsy: secondary analysis of a randomized controlled trial

Aim To explore the association between therapy onset and changes in motor and functional outcomes and identify characteristics associated with greater changes in infants with unilateral cerebral palsy (UCP) following Hand-Arm Bimanual Intensive Therapy-Including Lower Extremities (HABIT-ILE). Method This study included 38 infants aged 6 to 20 months (mean = 14.4 ± 4.3 months) with UCP. All received 50 h of HABIT-ILE and were assessed pre-intervention and 3 months later. Outcomes included Mini-Assisting Hand Assessment (Mini-AHA; primary), Gross Motor Function Measure-66 (GMFM-66) and Canadian Occupational Performance Measure (COPM). Regression analyses explored changes in outcomes in relation to age at therapy onset, prematurity, type and side of lesion, and baseline motor abilities. Results Age at therapy onset was not significantly associated with changes in Mini-AHA or COPM satisfaction scores. However, younger age was associated with larger changes in the GMFM-66 and the COPM performance scores. Regarding baseline characteristics associated with greater improvement, the baseline GMFM-66 score was associated with changes in GMFM-66. Interpretation These exploratory analyses found that younger age at therapy initiation was associated with larger changes in GMFM-66 and COPM performance scores, suggesting that early therapy onset may be associated with greater improvements in gross motor and functional performance. Baseline gross motor abilities were also associated with changes following HABIT-ILE, suggesting that these characteristics may contribute to variability in observed changes and warrant further investigation in larger studies. Clinical trial registration https://clinicaltrials.gov/ , identifier NCT04698395.