Development of a manual for an upper extremity intensive rehabilitation program for pediatric hemiplegia in Japan and assessment of its effectiveness and usability.

Objective: The aim of this study was to develop a manual for an upper extremity intensive rehabilitation program for pediatric hemiplegia in Japan, and to clarify its effectiveness and usability.

Methods: The manual was created through discussions among nine experts with sufficient pediatric clinical experience in Japan. A total of 39 children with hemiplegia aged 2 to 16 years underwent 44 intensive therapy sessions using the manual. Each child's upper limb function was assessed pre-, post- and 6-month after the intervention using the Canadian Occupational Performance Measure (COPM), ABILHAND-Kids, the Quality of Upper Extremity Skills Test (QUEST), and Box and Block Test (BBT). Questionnaire assessments were also conducted to evaluate usability of the manual.

Results: All four indices showed statistically significant improvements from pre- to post-intervention; COPM improved by 4 points in both performance and satisfaction; the ABILHAND-Kids logit score improved by 0.78; the total QUEST score improved by 2.8 in total score; and BBT improved by 5 on the affected side and 6 on the non-affected side. These effects were maintained 6 months later. Most therapists responded that the manual is useful, and most children and their parents were satisfied with the rehabilitation.

Conclusions: An upper extremity intensive rehabilitation program for pediatric hemiplegia using our manual was clinically effective. The manual was useful for therapists, and the level of satisfaction among parents and children who received the therapy was high.