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☐ ☆ ✇ BMJ Open

Blood flow restriction during walking training in bilateral cerebral palsy (EMBRIN): a pilot feasibility study protocol

Por: Christiaens · A. · Dinomais · M. · Gilquin · V. · Coelho · A. · Carcreff · L. · Loiez · A. · Demas · J. — Febrero 12th 2026 at 14:16
Introduction

Children with bilateral cerebral palsy (BCP) frequently develop progressive gait impairments driven in part by muscle weakness. Although power training, which involves high-velocity loaded movements, can enhance functional capacity, its substantial physical demands often limit feasibility in this population. Blood flow restriction (BFR) training has emerged as a promising alternative, capable of eliciting comparable physiological benefits while using low-intensity exercise. This study evaluates the feasibility, safety and clinical effects of integrating BFR with treadmill training in children with BCP, an innovative approach that may deliver the advantages of intensive strengthening while reducing physical burden.

Methods and analysis

This single-centre pilot study uses a double-baseline design with 13 participants with BCP (Gross Motor Function Classification System II-III), aged 8–18. The protocol consists of a 10-week usual care period followed by a 10-week Blood Flow Restriction Treadmill Training (BFR-TT) intervention, with three sessions per week. Feasibility targets were defined as completion of at least 80% of at least 80% of sessions. Safety is monitored through pain scales and adverse events. Outcomes assess body function (strength, GAITRite), activity (walking speed, walking endurance and motor function) and participation (daily activities), comparing changes between the usual care and BFR-TT periods.

Ethics and dissemination

This study was approved by the French Protection of Persons Committee (2024-A00791-46). Results will be published in peer-reviewed journals and presented at international conferences.

Trial registration number

NCT06533956.

☐ ☆ ✇ BMJ Open

Is PARTNER, a hybrid HABIT-ILE programme with parent coaching, as effective as standard HABIT-ILE in children with cerebral palsy aged 3-5? A protocol for a multicentre, randomised controlled trial

Por: Demas · J. · Jacquemot · D. · Bouvier · S. · Goff · M. L. · Carcreff · L. · Dinomais · M. · Vuillerot · C. · Brochard · S. · Dubois · A. · Bailly · R. — Septiembre 17th 2025 at 06:57
Introduction

Hand-arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) is an intensive rehabilitation programme for children with cerebral palsy (CP) delivered in a day camp setting recognised to promote the acquisition of specific functional abilities and independence. Currently, during HABIT-ILE camps, families are minimally involved in their child’s motor learning processes. This explains the challenges reported by both families and therapists, including difficulties in reinforcing skills at home, limited transfer to other functional goals and a lack of confidence in parents’ adaptive competence (self-determination and empowerment). Increasing family involvement in intensive motor rehabilitation programmes and the child’s developmental process by reinforcing skills at home could help reduce the parental impact of the child’s disability, enhance family satisfaction and strengthen their resources to support their child’s daily learning during and after the camp.

To address this, we developed the PARTNER programme, which combines HABIT-ILE with a structured home component focused on parent coaching.

Methods and analysis

We designed a non-inferiority, mixed-methods, multicentre randomised controlled trial to compare the efficacy at 3 months of the PARTNER programme (35 hours HABIT-ILE+15 hours home programme) with the standard HABIT-ILE programme (50 hours) on the bimanual performance (Assisting Hand Assessment) of children with unilateral CP aged 3–5 years. The secondary aims are to compare the 3-month efficacy of the programmes on occupational performance, functional skills and upper limb activity levels, as well as families’ resources, the parent–child relationship, the quantity and quality of resources available in the home to stimulate the child’s motor development, and parental perceptions of their child’s disability and their child’s abilities (qualitative study). The tertiary aim is to conduct a cost-effectiveness analysis of care consumption in each group up to 6 months after the end of the programmes.

Target recruitment is 66 children (33 in each group) from 3 centres in France. Outcomes will be evaluated before the interventions, immediately after, at 3 months and up to 6 months for the cost-effectiveness analysis. Families in the PARTNER group will receive specific coaching and extensive support to perform the home programme. The coaching will focus on enhancing their resources.

Ethics and dissemination

The study protocol has been reviewed, and ethics approval obtained from the Protection of Persons Committee (PPC) (PPC number: 2024-A01051-46). The results from this study will be actively disseminated through manuscript publications and conference presentations.

Trial registration number

NCT06963151.

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