Table 1

TIDieR checklist22: comparison between HABIT-ILE and traditional ‘usual care’ intervention

ItemExperimental HABIT-ILEControl traditional usual care
NameHABIT-ILETraditional eclectic usual care.
Why Rationale: Intense, repetitive, active motor learning induces activity-dependent neuroplasticity.
 Essential elements:
  1.  Goal directed (goals defined by child/caregiver).

  2.  Motor training with concurrent challenge for upper and lower limbs and posture.

  3.  Shaping.

  4.  Active practice of goals.

  5.  High repetition and intensity.

 Rationale: Usual care is highly variable, based on biomechanical and neurodevelopmental principles.
 Elements may include
  1.  Goals defined either by child/caregiver or therapist.

  2.  Stretching, splinting and casting.

  3.  Strengthening.

  4.  Functional training (eg, multimodal joint movements).

  5.  Therapist physically facilitates more typical (normal) movement patterns with children who are passive recipients.

  6.  May involve active goal practice.

MaterialsTherapy bench, fit ball, balance board to intensely and repeatedly challenge posture; activities/toys/games for children to actively develop bimanual hand skills with continuous practice of part and whole tasks. Whole-task practice of individually identified functional goals with specific materials related to each goal.Splints, casts, adaptive equipment to compensate for tasks child cannot perform.
WhoTherapy students (physiotherapy, occupational therapy and exercise science), volunteer physiotherapists and occupational therapists working directly with child with a ratio of 2:1 interventionists:child. Experienced physiotherapists and occupational therapists who have completed standardised training in HABIT-ILE will supervise and mentor interventionists.Occupational therapist and/or physiotherapist to the child.
HowClinic setting.Clinic, hospital, home or school setting.
How much6.5 hours/day for 10 weekdays over a 2-week period (total of 65 hours)Weekly, monthly therapist provided±home programme. Highly variable.
TailoringTailored to the child’s individually defined functional goals. Daily review of progress with a view to continually and incrementally increase the challenge.May be generic (eg, strength training, casting and splinting protocols), but highly variable.
How wellDaily video footage of participants at the day camp will be taken and reviewed by the supervising team and HABIT-ILE developer (YB) every second to third day to ensure delivery of intervention as per protocol.Detailed survey of parents about intervention approaches used. Contamination is not anticipated as intensive therapy interventions are not frequently available for children with CP.
  • CP, cerebral palsy ; HABIT-ILE, Hand–Arm Bimanual Intensive Training Including Lower Extremity; TIDieR, Template for Intervention Description and Replication.