Tele-rehabilitation for upper limb functions of children with hemiplegic cerebral palsy during covid pandemic: randomized controlled trial

Background:The majority of children with hemiplegic cerebral palsy demonstrate poor upper limb function,rehabilitation aims to improve child's independence in daily living activities; constraint induced movement therapy has been used to improve upper limb function. Coronavirus pandemic and social distancing has put tele-rehabilitation on the front lines.Aim: To determine the effectiveness of telerehabilitation on the quality of upper limb functions of children with hemiplegic cerebral palsy during Covid pandemic. Methods:Thirtychildren with hemiplegic cerebral palsy aged from 5 to 7 years were randomly allocated into two equal groups (control and study). The control group received modified constraint therapy during daily home activities for ninety minutes every day. The study group received the same as the control group for four days/week and modified constraint therapy with selected play-based exercises through telerehabilitation sessions for ninety minutes, three days/week. The treatment was provided for 8 successive weeks. Baseline and post-treatment assessment of each child’s quality of upper limb functions was performed by using quality of upper extremity skills test scale. Parents' satisfaction about tele-rehabilitation sessions was determined for the study group by using tele health satisfaction survey. Results: Children in both groups showed significant improvements in the post-treatment mean values of all measured variables when compared with the pre-treatment values. Significant improvement was observed in favor to the study group when comparing the post-treatment mean values of both groups.Parents were highly satisfied by telerehabilitation sessions. Conclusion:Tele-rehabilitation usinghome-based modified constraintinduced movement therapy can be aneffective option of treatmentfor improving quality of upper limb function in children with hemiplegic cerebral palsy, especially during epidemic spread and its consequence restrictions.