Breakthrough Therapy Shows Lasting Gains for Infants and Toddlers After Stroke

In a groundbreaking development for pediatric stroke treatment, researchers have unveiled promising results from a Phase 3 clinical trial evaluating a specialized therapy for infants and toddlers who suffered a stroke before or shortly after birth. The study, presented at the American Stroke Association’s International Stroke Conference 2026, focused on a modified form of Constraint-Induced Movement Therapy (CIMT) called I-ACQUIRE. This innovative approach combines restricting the use of the child's stronger arm with intensive, task-oriented physical therapy delivered in the child's home or natural settings, aiming to rewire the brain and improve motor function on the stroke-affected side. The trial involved 167 children, aged 8 to 36 months, across 15 U.S. sites, who were randomly assigned to receive either a high-dose (six hours daily), a moderate-dose (three hours daily) of I-ACQUIRE therapy, or continue with their usual care, which typically involved about two hours of weekly occupational and physical therapy.

Led by study author Sharon Ramey, Ph.D., of the Fralin Biomedical Research Institute at Virginia Tech, the research team discovered that children receiving the high-dose I-ACQUIRE therapy showed the most significant and lasting improvements. At the six-month post-treatment mark, these children demonstrated larger gains in specific neuromotor skills and daily functional use of their weaker arm and hand compared to those in the moderate-dose or usual care groups. Skills gained included improved manipulation of toys, communication gestures, and essential self-help activities. Notably, while the usual care group also showed some clinical improvement in arm skills, parent ratings indicated that only the I-ACQUIRE groups saw meaningful, real-world functional benefits that parents could observe in everyday home activities. This study is the first to specifically evaluate this intensive, home-based CIMT approach for this young clinical population, filling a critical knowledge gap and offering new hope where prognosis was once considered grim.

The findings, funded by the National Institute of Neurological Disorders and Stroke, highlight the therapy's safety and measurable benefits, though researchers noted the gains were smaller than anticipated, suggesting varied individual responses. The study's design, which included a parent program and was conducted in natural settings, proved feasible and effective. While the research is preliminary and awaits peer-reviewed publication, it represents a significant step forward in pediatric neurorehabilitation, demonstrating that intensive, early intervention can substantially improve outcomes for the youngest stroke survivors. The American Heart Association’s 2026 Heart Disease and Stroke Statistics underscore the importance of such advances, as stroke remains a leading cause of disability. For more details, the full study abstract is available in the American Stroke Association International Stroke Conference 2026 Online Program Planner, and additional resources can be found on the American Stroke Association's official website at www.stroke.org.