Background. Children with unilateral spastic cerebral palsy (USCP) have strength, coordination, and balance deficits affecting gross motor skills, such as walking, running, and jumping. However, there is a paucity of evidence for effective treatments for lower-extremity (LE) function in children with USCP. Objective. To determine the effectiveness of LE intensive functional training (LIFT) compared with an attention control group receiving upper-extremity bimanual training (Hand-Arm Bimanual Intensive Therapy [H-HABIT]). Methods. A total of 24 children with USCP were randomized to receive 90 hours of LIFT (5.8 [2.3] years) or an equivalent dosage of H-HABIT (5.1 [2.6] years) delivered 2 h/d, 5 d/wk for 9 weeks. Caregivers were trained to administer the intervention in the home setting. Progress and skill progression were monitored, and supervision was provided via weekly telerehabilitation. The primary outcome was the 1-minute walk test (1MWT). Secondary outcomes included self-selected and fast walking speeds, ABILOCO-kids, 30-s chair rise test, and single-leg stance. Results. LIFT showed greater improvement for the 1MWT (P = .017) and ABILOCO-kids (P = .008) compared with controls. The other secondary outcomes were not different between groups. Conclusions. The administration of LE intensive interventions in the home setting by caregivers was shown to be an effective and novel mode of delivery for improving gait capacity and performance. LIFT delivered in the home setting using telerehabilitation for monitoring resulted in improvements in ambulation distance and overall walking ability as compared to an intervention of equal intensity and duration that also controlled for the increased social interaction and attention between caregiver and child.

中文翻译：

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下肢功能训练 (LIFT) 对单侧痉挛性脑瘫幼儿的有效性：一项随机对照试验

背景。患有单侧痉挛性脑瘫 (USCP) 的儿童存在力量、协调和平衡缺陷，影响大运动技能，例如步行、跑步和跳跃。然而，缺乏有效治疗 USCP 儿童下肢 (LE) 功能的证据。客观的。确定 LE 强化功能训练 (LIFT) 与接受上肢双手训练（Hand-Arm Bimanual Intensive Therapy [H-HABIT]）的注意力对照组相比的有效性。方法。共有 24 名 USCP 儿童随机接受 90 小时的 LIFT（5.8 [2.3] 岁）或等效剂量的 H-HABIT（5.1 [2.6] 岁），2 小时/天，5 天/周，持续 9 周. 护理人员接受了培训，以在家庭环境中进行干预。监测进展和技能进展，并通过每周远程康复提供监督。主要结果是 1 分钟步行测试 (1MWT)。次要结果包括自选和快速步行速度、ABILOCO-kids、30 秒椅子上升测试和单腿站立。结果。与对照组相比，LIFT 对 1MWT (P = .017) 和 ABILOCO-kids (P = .008) 的改善更大。其他次要结果在组间没有差异。结论。护理人员在家庭环境中实施 LE 强化干预已被证明是改善步态能力和表现的有效且新颖的交付方式。