Ataxic cerebral palsy is an abnormal movement or posture pattern accompanied by a loss of
coordinated muscle action, resulting in movements that lack proper force, rhythm, or
accuracy. Ataxic CP is classified into cerebellar ataxia and ataxic diplegia.

In Cerebellar Ataxia, the cerebellum is hypo-plastic or malformed which impairs the
integration of brain signals required for coordinating coordinated movement and balance.
This study aimed to determine the effect of HABIT-ILE on the balance and coordination of
children with cerebellar ataxic cerebral palsy.

Effects of Hand Arm Bimanual Intensive Therapy Including Lower Extremity on Balance and Coordination in Ataxic Cerebral Palsy

Ataxic Cerebral Palsy

Coordination and Balance Disturbances

OBJECTIVES:

The objectives of this study are:

  1. To determine the effect of HABIT-ILE on the coordination of children with cerebellar
     ataxic cerebral palsy.

  2. To determine the effect of HABIT-ILE on the balance of children with cerebellar
     ataxic cerebral palsy.

HYPOTHESIS:

Alternate Hypothesis:

There will be statistically significant differences in balance and coordination after
HABIT-ILE in ataxic cerebral palsy.(P&gt;0.05)

Null Hypothesis:

There will be no statistically significant differences in balance and cooordination after
HABIT-ILE in ataxic cerebral palsy.(P&gt;0.05)

Research Design: Experimental study. Quasi-experimental

Clinical setting: Al-Farabi Special Education Institute Islamabad Study duration: one
year from Feb 2024 to 2025.

Selection Criteria:

Inclusion Criteria

  1. Age group: 6 - 15 years.

  2. Gender: Both males and females.

  3. Cerebellar Ataxic cerebral palsy [1]

  4. Gross motor function classification system level I and II.

  5. Capable of following instructions and completing all necessary tests and tasks

Exclusion Criteria

  1. Uncontrolled epilepsy

  2. Orthopedic surgery within the past 6 months,

  3. Have visual, hearing impairments (diagnosed).

Sampling technique: convenicence sampling

Outcome Measures:

  1. Pediatric Balance Scale [2]

  2. Scale for the Assessment and Rating of Ataxia [3]

  3. Gross Motor Function Classification System - Expanded &amp; Revised (GMFCS -
     E&amp;R) [4]

Data analysis techniques:

Data will be analyzed using SPSS version 20.0.0.

Significance of the study:

Cerebellar ataxic cerebral palsy is characterized by hypoplasia or malformations of the
cerebellum, which hinders the integration of neural information necessary for
coordination and balance.

HABIT-ILE aims to collectively target the whole body both upper and lower extremity along
with trunk in intensive therapy comprising of fun and playful goal oriented tasks in
order to improve balance and coordination.

So this research will find out effects of HABIT-ILE on balance and coordination of
children with cerebellar ataxic cerebral palsy. Positive research outcome can contribute
to better independence.

This study will add data in the limited literature of ataxic cerebral palsy.

Hand Arm Bimanual Intensive therapy including lower extremity (HABIT-ILE)

A modified version of the Berg Balance Scale, the Pediatric Balance Scale is used to
evaluate school-age children&amp;#39;s functional balance abilities. The 14 items on the
scale have a maximum score of 56 points and are rated from 0 (lowest function) to 4
(highest function).

Method for evaluating ataxia is SARA, which consists of eight categories, each category
is scored from 0 (no ataxia) to 40 (severe ataxia) based on the performance.

HABIT-ILE is continuous intervention applied for 50-90 hours over two weeks. We will
design the activities based on the findings of the initial assessments (T0) T0he
customized functional goals that were previously discussed with the parents (e.g.,
drinking on one's own without spilling, using one hand to hold a book while turning pages
with the other, removing a t-shirt, etc.).

The whole environment is arranged in such a way that children perceive the therapy as
fun.

Progression of difficulty depend upon success in performance of current level. Specific
bi-manual activities are selected on basis of child's motor abilities, age and interest.

Effects of Hand Arm Bimanual Intensive Therapy Including Lower Extremity on Balance and Coordination in Ataxic Cerebral Palsy

About this trial

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