Grant: CIHR Fellowship

Stroke in the newborn affects 10,000 Canadian children and is the primary cause of lifelong weakness on one side, a form of cerebral palsy. Evidence-based physical interventions for children with newborn stroke are limited and are often initiated after two years of age. This time period falls beyond the most critical window of opportunity to capitalize on the remarkable ability of the developing brain to change. Early therapies targeting activity of the affected arm have the potential to drive brain development toward better lifelong function. Home therapy may be ideal, but methods to effectively engage and empower families and optimize outcomes are yet to be established. Non-invasive brain stimulation technologies have been shown to augment therapy in older children affected by newborn stroke. While existing technologies are not feasible for small children in the home, a new simple, portable and inexpensive static stimulation has effects that may enhance motor therapy. We propose a clinical trial to establish the safety, feasibility and possible efficacy of combining transcranial static magnetic stimulation with home-based movement therapy to improve motor function in infants and toddlers with newborn stroke. We will enrol 24 children aged 6 to 48 months. Families will complete a six-month home-based goal directed program, with random assignment to either active or placebo stimulation during therapy. Changes in activity levels, motor skill performance, individualized goal achievement, and family well-being will be assessed before, following, and 6-months after the intervention. For the first time, this study brings together non-invasive brain stimulation and early intervention in young children with newborn stroke. Caregivers are directly engaged and empowered to improve their child's motor function. This early, personalized, family-centred, patient-oriented approach has the potential to benefit many of the millions of children globally affected by cerebral palsy.