Baby steps

Intensive therapy gets young stroke patients back on their feet 

Jaynie YangNine months seems a bit young to reach a turning point in one’s life. But, that’s when the future changed for Eloise, according to her mom Catherine Bangel. Newly diagnosed with cerebral palsy, the result of a perinatal stroke, Eloise was enrolled in a groundbreaking Women and Children’s Health Research Institute study led by Dr. Jaynie Yang, a professor of physical therapy in the Faculty of Rehabilitation Medicine at the University of Alberta.
 
At nine months, Eloise was not able to sit up. After three months of intensive physical therapy with Yang’s novel treatment four times a week, with lots of crawling and then walking, the sturdy toddler was catching up to other children her age.
 
Roughly one in every thousand babies suffers a stroke before or shortly after birth, says Yang, who is a world leader in the study of early walking development. Some of the children become hemiplegic—weakened on one side of the body. Normally, in Alberta, children with this condition are not treated until two years of age or older to improve their walking. They then might expect to see a therapist once or twice a month, for relatively low-intensity treatment for years. Yang and her team wanted to explore the potential of intensive physical therapy at an earlier age, which is a critical period for brain development. They wanted to see if the brain’s plasticity during this period could help to dramatically improve the babies’ gross motor skills, particularly their walking.
 
In 2012, Yang and her colleagues had narrowly failed in their bid for national-level funding for their study. A WCHRI bridge grant enabled the team to run a pilot study. Armed with preliminary results, Yang’s team resubmitted the proposal—successfully this time and received funding from both the Canadian Institutes of Health Research and Alberta Innovates - Health Solutions. “The WCHRI bridge grant was critical,” Yang declares.
 
Results of the study have been strongly encouraging, with better outcomes for babies who start the therapy earlier, as young as eight months. “Young brains can adapt, sometimes hugely,” Yang points out. The therapy, which costs roughly $2,400 per child, could prevent much more costly and long-term interventions later in a child’s development, she says.
 
Most importantly, early treatment should help children research study. affected by early strokes live healthier, happier lives. You’ll get no argument from Bangel, who is overwhelmed by the improvement she has seen in her daughter. “When Eloise joined the study, she was unable to sit,” Bangel recalls. “By the time she turned one, she was starting to take steps on her own. And now, at 14 months, she’s happily on the verge of running. The intense daily treatment that she received has allowed our little girl to reach the same milestones as other children her age. We cannot thank Dr. Yang and her team enough for giving her such a tremendous head start.”
 
Yang’s research has been funded by the generous support of the Stollery Children’s Hospital Foundation through WCHRI.