Improving Parent and Therapist Experiences of Codelivering Intensive Upper Limb Interventions for Children With Hemiplegia: A Qualitative Study Using the Theoretical Domains Framework.

The sample was small (10 families) and lacked diversity in background, culture, and ethnicity, limiting transferability. The lead author had previously worked in the service, which could introduce bias, although reflexivity and external review were used to mitigate this. Hospital therapists may have been more willing to participate than community therapists, potentially skewing the data towards the hospital perspective. The study did not measure adherence to intervention fidelity or intensity, so it cannot confirm whether the reported challenges actually reduced the dose of therapy received.

The authors declare no conflicts of interest. The study was funded by the National Institute for Health and Care Research (NIHR) via a Clinical Doctoral Research Fellowship.

Do not interpret this study as evidence that codelivered intensive upper limb therapy improves functional outcomes more or less than other methods. This was a qualitative exploration of experiences and barriers, not a trial of efficacy. The findings describe what parents and therapists felt and struggled with, not what the therapy achieved for the children.