Pediatric stroke poses significant challenges due to its impact on a child's developing brain. Both ischemic and hemorrhagic strokes in children can result in long-term motor, sensory, and cognitive impairments, particularly affecting upper limb function.

Comprehensive Hand Repetitive Intensive Strength Training is a structured intervention model that integrates high-repetition, strength-based, and goal-oriented exercises targeting upper limb coordination and use. This study aims to explore the efficacy of CHRIST in improving upper limb function using the ABILHAND-Kids questionnaire to assess changes in manual ability. The study aims to generate pediatric-specific evidence for intensive hand-focused rehabilitation strategies.

Inclusion Criteria:

• Children aged 7 to 12 years diagnosed with pediatric ischemic or hemorrhagic stroke(21).

  • Clinical evidence of upper limb motor impairment following stroke.
  • Parent/guardian consent and child assent obtained.

Exclusion Criteria:

• Severe cognitive or behavioral impairments interfering with therapy.

  • Uncontrolled seizures or medical conditions contraindicating exercise.
  • Previous participation in intensive upper limb therapy within the last 3 months.
  • Orthopedic conditions (e.g., fractures, contractures) that limit upper limb movement.