HABIT-ILE in young children with bilateral cerebral palsy in Benin: A randomized controlled trial.

AIM: To investigate the efficacy of the Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) compared with usual physiotherapy delivered at the same dosage in children with bilateral cerebral palsy (CP) in Benin. METHOD: This randomized controlled trial involved 32 children (19 males, 13 females) with bilateral CP, aged 2 to 4 years, classified in Gross Motor Function Classification System levels III and IV, randomly allocated to HABIT-ILE or a high-dosage physiotherapy group. Interventions were delivered at a 2-week camp. Children were assessed before and after interventions and at the 2-month follow-up using the Gross Motor Function Measure (GMFM), the Both Hands Assessment (BoHA), the Canadian Occupational Performance Measure (COPM), and the Activity Limitations Questionnaire, West African version (ACTIVLIM-CP-WA). RESULTS: A significant group × testing time interaction indicated a significant improvement in GMFM scores after HABIT-ILE, which was sustained at the follow-up. Children in the usual physiotherapy group improved slightly at the follow-up. No significant changes in BoHA were observed in either group. Both groups improved in COPM scores, with a larger improvement after HABIT-ILE. The ACTIVLIM-CP-WA measures improved over time with no group differences. INTERPRETATION: HABIT-ILE is more efficacious in improving motor and functional outcomes in children with bilateral CP than usual physiotherapy administered at the same dosage, demonstrating the importance of therapy content.