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Comparison of Synchronous Telerehabilitation and Face-to-Face Methods on Upper Extremity Function in Children with
Gamze Polen Altun1, Ayşe Zengin Alpözgen2
1Department of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpaşa, Istanbul, Türkiye.
Aims:
This study investigates whether synchronous telerehabilitation improves upper extremity function in children with hemiparetic cerebral palsy (CP).
Methods:
Children aged 6-12 with Manual Ability Classification System (MACS) levels I-III were randomized into two groups. One group received Bilateral Activity-Based Exercise Training (BiActBET) in a clinic, while the other group received it via synchronous telerehabilitation (2 sessions/week for 12 weeks). The evaluations (the Quality of Upper Extremity Skills Test (QUEST), Shriners Hospital Upper Extremity Evaluation (SHUEE), ABILHAND-Kids Scale, Modified Tardieu Scale (MTS), Selective Control of the Upper Extremity Scale (SCUES), range of motion (ROM), Pediatric Evaluation of Disability Inventory (PEDI), and Cerebral Palsy Quality of Life Questionnaire for Children (CPQOL-Child)) were conducted face-to-face. Treatment efficacy, improvement, and satisfaction were also questioned.
Results:
Both groups showed statistically significant improvements in all outcome measures (p < 0.001), with large effect sizes, with no comparison showing superiority (p > 0.05). Caregiver-rated effectiveness and improvement were similar between groups (both p = 0.183), but satisfaction was higher in the face-to-face group (p < 0.001).
Conclusion:
BiActBET enhances upper extremity function through both delivery methods. Synchronous telerehabilitation is a feasible, accessible option, associated with improvements in measured spasticity-related parameters (MTS outcomes), selective motor control, ROM, independence, and quality of life, though face-to-face therapy yields greater satisfaction.
