HABIT-ILE METHOD

General overview

HABIT-ILE (Hand and Arm Bimanual Intensive Therapy Including Lower Extremities) is an intensive and fun rehabilitation method based on the HABIT method.

 

The HABIT-ILE method was developed by the researcher in motor sciences at the Catholic University of Leuven (Belgium), Yannick Bleyenheuft in 2011, in Brussels on the basis of collaborative projects in which she had participated at Columbia University in New York. HABIT-ILE is used today in a research context:

  • In Belgium, in its research laboratory in Brussels (between 2011 and 2019, 140 children participated in 17 intensive courses)

  • In the United States, at Columbia's Center for Cerebral Palsy Research 

  • In Australia, in a large Australian multicentre study

  • In France, in Brest, in Professor Sylvain Brochard's team

  • As well as in Italy and the Netherlands

So far the method has been successfully applied and evaluated with children over 6 years of age, with unilateral or bilateral violations / It is currently being evaluated in the youngest (study on more than 100 children with unilateral or bilateral violations, from 1 to 4 years). 

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Main objectives of the method

The main objective of the HABIT-ILE method is to improve the autonomy in daily life and motor skills of the arms and legs in children with unilateral or bilateral cerebral palsy. 

Functional therapeutic objectives are set on the basis of the requests of children and their parents. Thus, during the internship in Brussels, for each child, four to five functional objectives specific to the child's daily life were determined by parents and therapists (managing to walk unassisted between furniture, peeling a clementine, etc.). 

Specificities of the method

HABIT-ILE, is above all a play-based method to motivate the child, which is characterized by:  

 

  • A high dosage (50 hours for 1 to 6 year olds in two weeks, 90 hours in two weeks for over 6 year olds, as part of mini-stages)

  • A time of motor engagement, i.e. the child active in useful tasks, at more than 80% of his time

  • Exclusively voluntary movements: no guidance or facilitation of movement

  • Progressive difficulty of tasks or movements to induce motor and neuroplastic changes

 

Compared to other intensive therapies, often targeted only on the upper limb, HABIT-ILE has two major original features: 

 

  • It constantly stimulates, at the same time, bimanual coordination, lower limbs and postural tone, thus inducing significant motor and functional changes in both the upper and lower limbs. 

  • Given its impact on the upper and lower limbs, it can be offered to children with bilateral cerebral palsy, which is a first. The changes observed in these children even exceed those initially observed in children with unilateral impairment. 

 

A specificity and strength of the method also lies in the power of the group 

  • Group work motivates children: even if each child works individually with a professional, they are in the same room, eating together and motivating each other

  • There is also emulation of the group at the professional level, who meet several times a day to exchange and benefit from the expertise of others and supervisors

Who is this method for ?

The method is primarily intended for children with cerebral palsy, hemiplegia or hemiparesis.

HABIT-ILE has also been tested on children who have undergone hemispherectomy or brain tumour removal, the results, submitted for publication, have been very positive.

What parents say about it

"While Philippine was not using her right hand at all, she managed to use both hands to close a pen in particular. Since this internship, she has been asking for autonomy and has made a lot of progress, beyond the objectives set during the study, even on the cognitive and language levels. »

Christèle, Filipino mother, victim of a stroke in utero

 

"The child sees his progress as he goes along, it motivates him." 

 

"Our children are more aware of their ability to progress through the internship, more involved afterwards in their rehabilitation."

 

"The internship made her aware of the existence of her arm and allowed her to use it much more. The internship was also an awareness of his difference, but with a positive vision of his ability to progress.

 

"If it were possible, I would do a Habit-ile internship at least once a year, to relieve the schedule the rest of the year."

 

"All children should do Habit-ile at a very young age, to adopt good habits, to anchor them in everyday life"

Scientific references

Hand Functioning in Children with Cerebral Palsy, https://www.semanticscholar.org/paper/Hand-Functioning-in-Children-with-Cerebral-Palsy-Arnould-Bleyenheuft/6bcb9e64992c8e470448189648fad042ef57e2a8

 

Including a Lower-Extremity Component during Hand-Arm Bimanual Intensive Training does not Attenuate Improvements of the Upper Extremities: A Retrospective Study of Randomized Trials, https://www.semanticscholar.org/paper/Including-a-Lower-Extremity-Component-during-does-A-Saussez-Brand%C3%A3o/68a22be9004cd838d0e807a179e2eed0b5923676

 

The Two-Arm Coordination Test: Maturation of Bimanual Coordination in Typically Developing Children and Deficits in Children with Unilateral Cerebral Palsy, https://www.ncbi.nlm.nih.gov/pubmed/30024779

Changes in Tactile Function During Intensive Bimanual Training in Children With Unilateral Spastic Cerebral Palsy, 

https://www.ncbi.nlm.nih.gov/pubmed/29433419

To know more about the topic

Les cahiers de la recherche sur la paralysie cerale, Fondation paralysie cerale, issue 23, November 2018 (https://www.fondationparalysiecerebrale.org/sites/default/files/inline-files/FONDATION%20PC_CAHIERS%20RECHERCHE%2023.pdf)

 

Intensive rehabilitation for toddlers: promising first observations, Charlène Catalifaud, Le quotidien du médecin, 25/03/2019 (https://www.lequotidiendumedecin.fr/archives/la-reeducation-intensive-chez-les-tout-petits-des-premieres-observations-prometteuses)

 

The game to treat children with cerebral palsy, The Conversation, May 24, 2019 (https://theconversation.com/le-jeu-pour-soigner-les-enfants-atteints-de-paralysie-cerebrale-117580?utm_source=facebook&utm_medium=facebookbutton&fbclid=IwAR1uxVqFkR0bjZ-DPnprtyIWLcMcQEhnYyhCPsjU84FKw5vlx1E9l-Axcuc) Paper published at the 31st European Academy of Childhood Disability Conference 

Any remarks or comments ?

This work is based on a collaborative approach to sharing research and family experience.

If you have any comments, suggestions for modifications or corrections or clarifications to make, please let us know by email at contact@leneurogroupe.org