Research for pediatric stroke is historically under-supported and under-funded. However, there has been some progress made and we thought it was time to highlight some of the promising work that has been accomplished as well as some of the challenges for the future. Dr. Adam Kirton is the Professor of Pediatrics and Clinical Neurosciences at the University of Calgary and an attending Pediatric Neurologist at the Alberta Children’s Hospital. He is also on the International Alliance for Pediatric Stroke Board of Directors. We thank Dr. Kirton for writing an article specifically to provide an update for World Stroke Day 2017.
Progress in Pediatric Stroke
Adam Kirton, MD, MSc, FRCPC
Identification of risk factors associated with stroke in adults has led to prevention strategies with enormous impact on stroke occurrence and recurrence. Unfortunately, no such modifiable risk factors have yet been identified for stroke in the fetus, newborn or child, resulting in no ability for parents or physicians to prevent children from suffering a stroke.
Global research efforts are working hard toward solving this problem. The International Pediatric Stroke Study (IPSS) performs collaborative research aimed at understanding, preventing and improving outcomes in pediatric stroke, and to promote professional education, support families with pediatric stroke members, and support public education.
The IPSS currently includes over 150 participating research staff, investigators and collaborators from 55 active centers that have enrolled over 5600 children with stroke. Establishing this network has led to successful competitions for millions of dollars in research grants to fund the execution of the multicentre research studies and clinical trials required to advance knowledge and improve outcomes.
Improved education and awareness is facilitating earlier times to diagnosis, advancing opportunities for new acute treatments which have been rapidly advancing in adult stroke and are applicable to children.
More specific forms of rehabilitation are being explored though most still lack definitive evidence of efficacy. Examples include constraint-induced and bimanual therapies as well as non-invasive brain stimulation for pediatric hemiparesis. Additional ideas are being explored such as mirror therapy while other concepts are not yet ready for translation to human subjects such as stem cells. Attention to the support of healthy development including an active lifestyle, child participation and engagement, educational support, and the mental health and quality of life for the entire family remain the mainstays of optimizing outcomes in pediatric stroke.
Continued investment on the part of researchers, clinicians, allied health, community partners, patients and their families promises to see many additional advances in the coming years.
Note: The International Pediatric Stroke Study’s website will be coming soon. In the meantime, if your hospital or medical center is interested in becoming one of the registered sites, please send an email to email@example.com
The “Mirrorable” Project
Francesca Fedeli, founder of Fight the Stroke and an International Alliance for Pediatric Stroke board member along with her husband Roberto D’Angelo have been working with scientists, researchers and physicians on development of the “Mirrorable” Project. Mirrorable (patent pending) is an interactive platform that allows a new model of rehabilitation therapy at home, specially designed to meet the needs of children who have suffered brain damage at a very early stage of their lives, with motor level impacts. The scientific principle on which it is based is the ability to stimulate the plasticity of the motor system by activating the mechanism of mirror neurons, just watching the video-stories and exercising with other children with similar needs. You can get more information about this promising rehabilitation therapy on the Frequently Asked Questions page.
Groundbreaking Book on Pediatric Stroke Rehabilition
Just published! “Pediatric Stroke Rehabilitation: An Interprofessional and Collaborative Approach” by Heather L Atkinson, PT DPT NCS ; Kim Nixon-Cave, PT PhD PCS ; Sabrina E Smith, MD PhD. This is a long awaited and invaluable resource designed to enhance the practice of all health care providers, enrich discussion, and emphasize the interdisciplinary nature of managing best outcomes for a child who has had a stroke. The book’s dedication sums up who should be buying it: “This book is dedicated to the survivors of childhood stroke, their amazing families, and to the interprofessional teams who work in partnership to help the children and families achieve their goals.”
There were quite a few contributing authors for this exceptional text, including two of International Alliance for Pediatric Stroke board members, Dr. Adam Kirton and Mary Kay Ballasiotes.
Pediatric Stroke Warriors Family Toolkit
The Pediatric Stroke Warriors Family Toolkit is intended to give families guidance on how to navigate this journey after their child has suffered a stroke. This toolkit has been made accessible online to download, however, hard copies are available at no charge for individuals, physicians and hospitals. The information is applicable to both impacted families and medical professionals. It is intended to give guidance on how to navigate the journey after a child has suffered a stroke and addresses important topics such as:
-Recognition and types of stroke in the pediatric population
-What to expect during acute hospital recovery and long term therapy
-Organizations, resources and websites specific to Pediatric Stroke
-Directory of common medical professionals and terminology
-Personal stories and words of advice from parents and survivors
Please contact Pediatric Stroke Warriors at firstname.lastname@example.org for more information.