Neuromotor Rehabilitation Interventions After Pediatric Stroke: A Focused Review

Hart, Emerson; Humanitzki, Elizabeth; Schroeder, Julia; Woodbury, Michelle; Coker-Bolt, Patty; Dodds, Cindy

doi:10.1016/j.spen.2022.100994

Cited by 7 publications

(10 citation statements)

References 45 publications

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“…The profound impact of strokes on cognitive and motor functions in pediatric patients is well-documented. The patient's gradual recovery and subsequent need for comprehensive rehabilitation mirror the outcomes reported in a study by Hart et al [7], highlighting the importance of early intervention to optimize functional recovery.…”

Section: Discussionsupporting

confidence: 59%

Pediatric Antiphospholipid Syndrome Presenting as a Massive Stroke: A Case Report

Marzooq

2023

Cureus

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Pediatric strokes are infrequent yet impactful occurrences with distinct challenges due to their unique pathophysiology and diagnostic complexities. Antiphospholipid syndrome, an autoimmune disorder characterized by antiphospholipid antibodies, can lead to prothrombotic states causing vascular occlusions. Here, we present the case of a previously healthy two-year-old girl who presented with sudden right-sided hemiparesis and altered consciousness. Comprehensive assessments and evaluations revealed a diagnosis of a massive left middle cerebral artery ischemic stroke secondary to antiphospholipid syndrome. The patient received intensive care, antiplatelet therapy, and supportive measures. Gradual improvement in neurological status and motor skills was observed during hospitalization, and the patient underwent comprehensive rehabilitation. This case emphasizes the importance of vigilance, thorough diagnostic evaluation, and tailored treatment strategies. Anticoagulation therapy plays a pivotal role, necessitating a delicate balance between thrombosis prevention and bleeding risk. The significance of multidisciplinary approaches and specialized care for pediatric stroke cases is underscored.

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Section: Discussionsupporting

confidence: 59%

Pediatric Antiphospholipid Syndrome Presenting as a Massive Stroke: A Case Report

Marzooq

2023

Cureus

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“…The constraint of upper-extremity function between 3 and 9 months post stroke and traumatic brain injury (TBI) was shown to improve recovery, with CIMT patients showing improved function compared to patients who did not receive CIMT [ 3 , 4 ]. This improved outcome was not restricted to adults and has also been found to benefit brain-injured children, who also saw improved outcomes with CIMT [ 5 , 6 ]. As such, this approach has been modeled in rodent stroke models to show that the immobilization of the unaffected limb has similar salutary properties to that in humans [ 7 ].…”

Section: Introductionmentioning

confidence: 95%

Use of Botulinum Toxin for Limb Immobilization for Rehabilitation in Rats with Experimental Stroke

et al. 2023

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Motor rehabilitation strategies after unilateral stroke suggest that the immobilization of the healthy, unimpaired limb can promote the functional recovery of a paretic limb. In rodents, this has been modeled using casts, harnesses, and other means of restricting the use of the non-paretic forelimb in models of experimental stroke. Here, we evaluated an alternative approach, using botulinum toxin injections to limit the function of the non-paretic forelimb. Adult male rats were subjected to permanent ligation of the left distal middle cerebral artery, resulting in right forelimb paresis. The rats were then subjected to: (1) no treatment; (2) botulinum toxin injections 1 day post stroke; or (3) cast placement 5 days post stroke. Casts were removed after 5 weeks, while the botulinum toxin injection effectively immobilized subjects for approximately the same duration. Rats with bilateral forelimb impairment due to the stroke plus casting or botulinum injections were still able to feed and groom normally. Both immobilization groups showed modest recovery following the stroke compared to those that did not receive immobilization, but the casting approach led to unacceptable levels of animal stress. The botulinum toxin approach to limb immobilization had both advantages and disadvantages over traditional physical limb immobilization. The major advantage was that it was far less stress-inducing to the subject animals and appeared to be well tolerated. A disadvantage was that the paresis took roughly 10 weeks to fully resolve, and any degree of residual paresis could confound the interpretation of the behavioral assessments.

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“…It is generally thought that rehabilitation plays an important role in achieving optimal post-stroke recovery. However, current guidelines only recommend that patients undergo rehabilitation, without specification on techniques or duration (Hart et al, 2022). This is due to a general dearth of evidence on optimal rehabilitation strategies in pediatrics (Malone and Felling, 2020;Hart et al, 2022).…”

Section: Part : Rehabilitationmentioning

confidence: 99%

Grand challenges in pediatric stroke

Ullman

Licht

2023

Front. Stroke

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Neuromotor Rehabilitation Interventions After Pediatric Stroke: A Focused Review

Cited by 7 publications

References 45 publications

Pediatric Antiphospholipid Syndrome Presenting as a Massive Stroke: A Case Report

Pediatric Antiphospholipid Syndrome Presenting as a Massive Stroke: A Case Report

Use of Botulinum Toxin for Limb Immobilization for Rehabilitation in Rats with Experimental Stroke

Grand challenges in pediatric stroke

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