Assessment of Spontaneous Use and Experience of Use of The Affected Upper Limb in 6-Year-Old Infantile Hemiplegia After Applying Combined Intensive Therapy. Case Series

Introduction: Children with hemiplegia do not use the affected upper limb. This disuse of the upper limb is known as “Disregard development.” Therefore, therapy should create the opportunity, experience and environment in which a child can learn to use the affected member. Being the modified Constraint Induced Movement Therapy (mCIMT) and the Bimanual Intensive Therapy carried out at home.

Objective: To assess the increase in spontaneous use of the affected upper limb in congenital hemiplegia childhood 6-10 years with low hand performance after applying a combined intensive therapy protocol.

Method: 3 children (6 years old) diagnosed with congenital infantile hemiplegia are recruited to execute a 100-hour combined intensive therapy protocol. 3 measurements are carried out for the variables of spontaneous use and the experience of use of the upper limb. Results: Increased spontaneous use of 24 AHA units, measured with the Assisting Hand Assessment (AHA) scale after the end of the protocol and for the experience of use of the upper limb, measured by Children’s Hand- Use Experience Questionnaire (CHEQ) increases of 11.67 activities executed with both hands.

Conclusion: Children with congenital infantile hemiplegia with low hand performance could obtain a greater increase in spontaneous use executing a protocol of combined intensive therapy.

Key words: Disabled children; Family; Physical therapy specialty; Hemiplegia; House calls; Upper extremity