Parent-therapist partnership to provide early, intensive exercise to enhance walking outcomes in children with perinatal stroke
- Jaynie Yang, University of Alberta
- John Andersen, University of Alberta
- Adam Kirton, Alberta Children's Hospital Research Institute
- Man-Joe Watt, University of Alberta
- Heidi Sveistrup, University of Ottawa
- Jennifer Zwicker, University of Calgary
- Anna McCormick, Children's Hospital of Eastern Ontario (CHEO) Research Institute
- Elizabeth Condliffe, University of Calgary
- Women and Children's Health Research Institute
- University of Alberta
- University of Calgary
Perinatal (around birth) stroke is devastating, because the effects are life-long. Current treatments to improve walking are limited, and largely passive, such as stretching, bracing, botulinum toxin injections and surgery. Recent work in animals indicates that intensive active therapy is effective in the young, when nerve pathways for movement are maturing, but not when the animals are older. Dr. Yang’s group has applied these principles in a laboratory-based study in young children with perinatal stroke, using play-based, intensive activity, 4 days/week over 12 weeks. The results have been very promising, showing that intensive therapy in young children is feasible and results in better mobility than current care.
Here, the team designed a study with parents, clinicians, managers, and researchers, to extend this treatment to the real-world. The treatment will be delivered by partnering parent(s) with frontline physical therapists. This partnership was not only considered more feasible by their parent collaborators, but importantly, more empowering. Three centres – Edmonton, Calgary and Ottawa – will be involved. All children will be followed until they turn 4 years old to determine if long-term outcomes are better than published outcomes for similar children. The quality of life for the child and their family will be measured, as will the cost-effectiveness of the treatment. If successful, the treatment will be translated broadly to other therapists and parents. The hope is to reverse the current passive approaches to an intensive, active approach, which could lead to benefits for the child and their family well beyond the study period.