Daily upper limb use of children with hemiparesis; perspectives of families through a qualitative study

Abstract

[Abstract] Performance of activities of daily living is fundamental in supporting participation across school, home and community environments and it is a high priority for parents because the lack of them is considered very disabling. Children with hemiparesis often experience restrictions in their participation. The aim of this study is to understand how limitations in the use of the more affected arm influence daily activities of children with hemiparesis, analyzing the needs and barriers perceived by families. 15 caregivers of children with hemiparesis aged 3-7 years participated in this qualitative study using online semi-structured individual interviews. Interviews were recorded, transcribed verbatim, codified and analyzed thematically with Atlas.ti. The following main thematic categories were drawn from the data analysis: limitations of spontaneous use and impact on daily life activities, child and family strategies to use the arm during routines and most purposeful activities and use of domestic technology. Bimanual tasks are reduced by a learning-non-used phenomenon as a common child strategy. Families encourage children to use the more affected arm by mainly verbal instructions. They are satisfied with their performance because of their medical condition but they would like to have more strategies to achieve better outcomes. Key barrier identified was child´s frustration when comparing with peers. Children enjoy domestic technology as a unimanual activity, but its use is often restricted by parents. Next phases will focus on studying new strategies to address child and families´ needs and to diminish the impact of the non-use of the more affected arm in bimanual activities during daily life.